Q ) Post Whipple's pancreatectomy drain amylase is done on ? (AIIMS ONCO)
a) 1st day
b) 3rd day
c) 5th day
d) Not required
Onco Surgery AIIMS 2019 Q 21-40
Pancreas
Cystic disease of Pancreas
Q) 30 yr old female with dull aching pain since 1 year with a cystic mass in tail of pancreas, pancreatic duct appear normal what is the diagnosis
a) Ipmn
b) Mcn
c) Cystic teratoma
d) Pseudocyst
Creeping Resection – Surgery
Q) Creeping resection is done for?
a) IPMN
b) PSEUDOCYST Pancreas
c) SCN ( Serous Cystic neoplasm)
d) MCN ( Mucinous Cystic Neoplasm)
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) Mucinous cystic neoplasm, all are true except
1. Most common
2. Low amylase
3. Enucleation is the management
4. Observation after resection for 2 year
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