Q) Creeping resection is done for?
a) IPMN
b) PSEUDOCYST Pancreas
c) SCN ( Serous Cystic neoplasm)
d) MCN ( Mucinous Cystic Neoplasm)
Pancreas
Cystic Neoplams of Pancreas Important points
Important points on cystic neoplasms of pancreas
From NEET Questions and discussions
- Old age and no history of pancreatitis, it is cystic neoplasm of pancreas
- Most common is SCN followed by MCN and IPMN
- OLd patient with dilated duct, cystic neoplasm is IPMN
- The most important point of differentiation in cystic neoplasms is whether the epithelium is serous or mucinous.
- All mucinous cystic lesions should be resected; lesions < 2 cm remain controversial.
- Mucinous neoplasm in middle aged female, body and tail of pancreas
- Creeping Resection is for IPMN Intraoperative frozen sectionsin the management of IPMNs. If margins are positive for adenoma or borderline atypia with minimal cytoarchitectural atypia and gastric/foveolar-type epithelium, no further resection is required. If instead they are positive for invasive carcinoma, carcinoma in situ, or borderline atypia exhibiting florid papilla formation, further resection is warranted, if feasible.In such instances, further “creeping” resection toward the head for a tail lesion, or toward the tail for a head or uncinate process lesion, can often be sufficient.
Pseudocyst Pancreas
Q) True about pseuodocyst of the pancreas is ? ( Questions in pancreas)
a) It is lined by epithelium and collagen
b) Spontaneous regression occurs in less than 50% of cysts
c) Symptoms occur in more than 50% of case
d) Transduodenal endoscopic drainage IS safe and effective approaches for patients with pancreatic pseudocysts in close contact (defined as less than 2 cm)
Pancreatic necrosis
Q) Pancreatic necrosis all are true except
a) Sterile pancreatic necrosis may be managed conservatively in most of the cases
b) Infected Pancreatic Necrosis is managed by surgery at 2 weeks
c) Minimal access techniques have given better results than open necrosectomy
d)WOPN may be drained by either a transgastric or, less commonly, a transdoudenal route.
Mucinous cystic neoplasm
Q) Which of the following statements about Mucinous Cystic Neoplasms (MCNs) of the pancreas is incorrect?
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Pancreatic Neuro Endocrine tumor (Pnet)
Q) Genetic disease not associated with Pancreatic neuro endocrine tumor is
a) MEN1
b) VON Recklinghausen disease
c) Von Hipple Lindau disease
d) Lynch Syndrome
Post Whipple’s Bleeding
Q) A 50-year-old male undergoes Whipple pancreaticoduodenectomy. On post-op day 4, he develops fever, tachycardia, and pain. Ultrasound shows a collection in the lesser sac, which is drained percutaneously. On post-op day 10, 100 ml of frank blood is noted in the drain. What is the next best step?
✅ Correct Answer: a. CT angiography
🔍 Explanation:
This is an extraluminal bleed on the 10th POD, likely due to a pancreatic fistula. The earlier POD 4 symptoms indicate a leak, which can lead to pseudoaneurysm formation. CT angiography is crucial to identify the bleeding source and evaluate for vascular injury or pseudoaneurysm, which may be amenable to embolization.
- Emergency laparotomy is reserved for unstable patients or failed embolization.
- Flushing the drain or observation are inappropriate and potentially harmful in the setting of active bleeding.
🔗 For more MCQs on the pancreas, visit: www.mcqsurgery.com/pancreas
🔍 Explanation:
This is an extraluminal bleed on the 10th POD, likely due to a pancreatic fistula. The earlier POD 4 symptoms indicate a leak, which can lead to pseudoaneurysm formation. CT angiography is crucial to identify the bleeding source and evaluate for vascular injury or pseudoaneurysm, which may be amenable to embolization.
- Emergency laparotomy is reserved for unstable patients or failed embolization.
- Flushing the drain or observation are inappropriate and potentially harmful in the setting of active bleeding.
🔗 For more MCQs on the pancreas, visit: www.mcqsurgery.com/pancreas
Post op pancreatic fistula
Q) Regarding postoperative pancreatic fistula (POPF), which of the following is TRUE?
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Association of carcinoma pancreas
Q) Least common association of Carcinoma Pancreas is with
a) Smoking
b) Male gender
c) Obesity
d) Lynch Syndrome