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Surgery > Pancreas > Flashcards

Pancreas Flashcards

1
Q

What time of gland is the pancreas?

A
  1. Endocrine

2. Exocine

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2
Q

What do you call the duct from ventral anlage of the pancreas?

A

main pancreatic duct or duct of wirsung

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3
Q

Duct of Wirsung refers to

A

Main pancreatic duct

via ampulla of vater

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4
Q

The duct of santorini refers to

A

Accessory duct of the pancreas

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5
Q

What do you call the duct from the dorsal anlage?

A

Duct of Santorini

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6
Q

What is the most common congenital anomaly of the pancreas?

A

Pancreas divisum

functional obstruction of the main pancreatic duct

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7
Q

The most commonly affected part of the duodenum by the annular pancreas

A

2nd part of the duodenum

Associated with trisomy 21

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8
Q

[Acute pancreatitis]

____ sign refers to blood extending to the flank tissue resulting to flank ecchymosis

A

Grey Turner Sign

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9
Q

[Acute pancreatitis]

____ sign refers to blood dissecting up to the falciform ligament and create periumbilical ecchymosis

A

Cullen Sign

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10
Q

[Acute pancreatitis]

____ sign refers to ecchymosis of the inguinal ligament

A

Fox Sign

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11
Q

[Acute pancreatitis]

____ sign refers to the bluish discoloration of the scrotum

A

Bryan sign

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12
Q

What is the diagnostic gold standard to diagnose acute pancreatitis?

A

Abdominal CT scan

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13
Q

What is the pathognomonic abdominal CT scan finding of pancreatic infection?

A

Abnormal Extraluminal Gas Bubbles

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14
Q

When will you initiate enteral feeding in patients with severe pancreatitis?

A

<48 hours

Nasojejunal tube is preferred

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15
Q

What are the Ranson Prognostic Signs at admission?

A

GALAW

  1. Glucose >200 mg/dL
  2. Age >55 years old
  3. LDH >350 u/mL
  4. AST >250 u/nL
  5. WBC >16,000
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16
Q

What are the Ranson prognostic signs in the initial 48 hours?

A

CHOB BF

  1. Ca <8mg/dL
  2. Hct fall >10 points
  3. O2 <60mmHg
  4. BUN elevation >5mg/dL
  5. Base deficit >4mEq/L
  6. Fluid deficit >6L
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17
Q

A Ranson score of 3-5 is associated with how many percent mortality?

A

10-20%

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18
Q

What are the indications for surgical intervention in Acute pancreatitis?

A
  1. Diagnostic uncertainty
  2. Intraabdominal catastrophe unrelated to necrotizing pancreatitis
  3. Infected necrosis documented by FNA or extraluminal gas on CT
  4. Severe sterile necrosis
  5. Symptomatic organized pancreatic necrosis
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19
Q

What is the most effective surgical intervention if the target lesion in acute pancreatitis have a significant fluid component?

A

Catheter drainage

20
Q

This surgical intervention for acute pancreatitis allows for the removal of necrosis via video-assisted retroperitoneal debridement

A

Minimally invasive necrosectomy

21
Q

What is the reference standard of treatment in patients with infected necrotizing pancreatitis?

A

Open necrosectomy

22
Q

What is the most common etiology of chronic pancreatitis?

A

Alcohol

23
Q

What is the most common symptom of chronic pancreatitis?

A

abdominal pain

24
Q

[Chronic Pancreatitis Surgical Intervention: Drainage Eponym]

caudal pancreaticojejunostomy

A

Duval-Zollinger

25
Q

[Chronic Pancreatitis Surgical Intervention: Drainage Eponym]

longitudinal Roux en Y pancreaticojejunostomy

A

Puestow-Gillesby

26
Q

[Chronic Pancreatitis Surgical Intervention: Drainage Eponym]

modified puesto-gillesby that does not include caudal pancreatectomy

A

Partington-Rochelle

27
Q

[Chronic Pancreatitis Surgical Intervention: Resectional Eponym]

distal pancreatectomy; preserves the rim of the pancreas

A

Fry and Child

28
Q

[Chronic Pancreatitis Surgical Intervention: Resectional Eponym]

Pancreaticoduodenectomy

A

Kaush-Whipple

29
Q

[Chronic Pancreatitis Surgical Intervention: Resectional Eponym]

Total Pancreatectomy

A

Priestly

30
Q

[Chronic Pancreatitis Surgical Intervention: Hybrid Eponym]

Duodenum-preserving pancreatic head resection

A

Beger

31
Q

[Chronic Pancreatitis Surgical Intervention: Hybrid Eponym]

Local resection of the pancreatic head with longitudinal pancreaticojejunostomy

A

Frey and Smith

32
Q

[Chronic Pancreatitis Surgical Intervention: Hybrid Eponym]

excavation of the central portion of the head without formal division if the pancreatic neck

A

Berne

33
Q

Pseudocyst persisting about ___ weeks are unlikely to resole spontaneously

A

4-6 weeks

34
Q

What the most common location of pancreatic CA?

A

pancreatic head

35
Q

What do you call an enlarged palpable GB that is non-tender without fever that is a reliable diagnostic criteria for malignant choledochal obstruction

A

Courvoiser GB

36
Q

What is the only definitive and potentially curative treatment of periampullary CA

A

Whipple surgery

37
Q

[Palliative Options for Periampullary CA]

Gastric outlet obstruction with good performance status?

A
  1. Gastrojejunostomy +/- jejunostomy tube

2. consider enteral stent

38
Q

[Palliative Options for Periampullary CA]

gastric outlet obstruction with poor performance status

A
  1. Enteral stent

2. PEG tube

39
Q

What is the Whipple’s Triad that is associated with insulinoma?

A
  1. Symptomatic fasting hypoglycemia
  2. Serum glucose <50mg/dL
  3. Relief of symptoms with glucose administration
40
Q

What do you call the area where gastrinoma typically occurs

A

Passaro’s Triangle

41
Q

What are the borders of Passaro’s Triangle?

A
  1. Head of the pancreas
  2. Duodenum
  3. Lymphatic bed posterior and superior to the duodenum
42
Q

Which part of the pancreas will you typically see the VIPoma?

A

Tail

43
Q

What is the most sensitive imaging modality for VIPoma?

A

EUS

44
Q

Presence of necrolytic migratory erythema is associated with what pancreatic disease

A

Glucagonoma

45
Q

What is the second most common pancreatic islet cell tumor?

A

Non functioning islet-cell tumor

Surgery (19 decks)

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