GI Section VII: Surgical

Question 1

The standard Whipple procedure

Answer 1

Resection of the:
pancreatic head
duodenum
gastric antrum
and almost always the gallbladder.

Plus

Jejunal loop to the RUQ for GJ, Choledochojejunal or hepaticojejunal, and pancreaticojejunal anastomosis.

Question 2

Complications of Whipples

Answer 2

Delayed gastric emptying {needfor NG tube longer than 1- day)

and

Pancreatic fistula amylase through the surgical drain >50 mlfor longer than 7-10 days)

Then wound infection

Question 3

established therapy for severe type 1 diabetes

Answer 3

Pancreas transplant (usually with a renal tranpslant)

Question 4

the pancreas transplant receives arterial inflow from two sources:

Answer 4

Donor SMA (head) and splenic artery (body and tail)

Question 5

buzzword for chronic rejection, where the graft progressively gets smaller in size.

Answer 5

“Shrinking transplant”