Chronic Pancreatitis

Question 2

Define chronic pancreatitis?

Answer 2

Question 3

What are the main causes and RFs for chronic pancreatitis?

Answer 3

Question 4

What are the chronic inflammatory changes seen in chronic pancreatitis?

Answer 4

Question 5

Describe the pathophysiology of chronic pancreatitis and its sequelae.

Answer 5

Question 6

List the symptoms of chronic pancreatitis.

Answer 6

Question 7

List the signs/ biochemical findings of chronic pancreatitis.

Answer 7

Question 8

List some ddx for chronic pancreatitis.

Answer 8

Question 9

Explain what type of CT is used in dx of chronic pancreatitis.

Answer 9

Question 10

What would expect to find on US abdo in chronic pancreatitis?

Answer 10

Question 11

What would expect to find on MRCP in chronic pancreatitis?

Answer 11

Question 12

What would expect to find on ERCP in chronic pancreatitis?

Answer 12

Question 13

What is the purpose of endoscopic US and aspiration cytology in the context of chronic pancreatitis?

Answer 13

Question 14

Why is faecal elastase measured in chronic pancreatitis and what is the expected result?

Answer 14

Question 15

How would you investigate for chronic pancreatitis?

Answer 15

Question 16

Outline the conservative management of chronic pancreatitis.

Answer 16

Question 17

Outline the medical management of chronic pancreatitis.

Answer 17

Question 18

What is a pancreaticojujunostomy and what is it used for?

Answer 18

Anastamosis of pancreatic duct to the jejunum. It is used to decompress or drain an obstructed pancreatic duct whether it be due to strictures or stones

Question 19

What surgery can be done for pancreatic cancer pain?

Answer 19

Endoscopic-guided celiac plexus blockade or thoracoscopic splanchnicectomy .

Question 20

What is whipple’s procedure? Is it a pylorus-preserving proceedure?

Answer 20

Resection (Removal of Structures):

Head of the Pancreas: The primary site of pancreatic cancers.
Duodenum: The first part of the small intestine.
Gallbladder: Often removed as it shares a bile duct with the pancreas.
Common Bile Duct: Partially or entirely removed.
Stomach (partially): In the classic Whipple’s procedure, part of the stomach (pylorus) is removed. In the pylorus-preserving Whipple’s, the pylorus is spared.

Reconstruction (Anastomoses):

Pancreaticojejunostomy: Reconnecting the remaining pancreas to the jejunum (middle part of the small intestine) to allow pancreatic enzymes to flow into the gut for digestion.
Hepaticojejunostomy: Connecting the remaining bile duct to the jejunum to restore bile flow for fat digestion.
Gastrojejunostomy: Connecting the stomach (or pylorus, if preserved) to the jejunum to enable food to pass from the stomach to the intestines.

Question 21

What is the use of a partial or distal pancreatectomy?

Answer 21

to remove tail ± body of pancreas.

Question 22

Outline the surgical management of chronic pancreatitis.

Answer 22

Surgical management only if:
1. failed medical therapy or
2. in the case of intractable pain (most common)

Question 23

Outline the FULL management of chronic pancreatitis.

Answer 23

Question 24

Is pancreatic cancer a cause or a complication of chronic pancreatitis?

Answer 24

Both, you dumbass.