外科：一般外（pancreas）

19 flashcards · Other · by Wanying Koh

1. complications of acute pancreatitis

   phlegmon abscess necrosis pseudocyst pseudoaneurysm

2. Tx for pancreatic pseudocyst

   can heal spontaneously - supportive care persisting 6 weeks later / >6cm: internal drainage of pancreatic duct endoscopic (prefer) surgery

3. treatment when main pancreatic duct dilatation >7mm

   Puestow procedure - 會切 tail modified Puestow procedure (Partington-Rochelle) - 保留 tail

4. hemosuccus pancreaticus is?

   bleeding from the ampulla of Vater via the pancreatic duct pancreatic pseudoaneurysm rupture

5. courvoisier sign is?

   jaundice + enlarged gallbladder that is not painful

6. diffuse peritonitis abd pain 什麼樣的型態 bowel sounds increase / decrease?

   rebounding pain bowel sounds decrease

7. Grey turner sign 1) describe 2) indicates

   1) flank ecchymosis 2) acute hemorrhage from pancreatitis

8. acute pancreatitis conservative tx includes?

   NPO IV fluids pain medication - meperidine (不能用 morphine) *ABx - only when necessary (necrotic pancreatitis, multi-organ failure)

9. most common complication of acute pancreatitis

   fluid retention - 40% pancreatic pseudocyst - 20%

10. serious gallstone pancreatitis 如何治療

    NPO IV fluids ABx *surgery not necessary unless necrosis

11. pancreatic Ca 好發 which part of pancreas

    pancreatic head

12. pylorus preserving pancreaticoduodenectomy (PPPD) most common complication

    delayed gastric emptying 第二多為 marginal ulcers

13. resectable periampullary tumor first-line therapy

    surgery: Whipple procedure

14. most serious complication of Whipple procedure

    anastomosis leak (of pancreatic juice) 胰液滲漏

15. insulinoma hypoglycemia periods during

    early morning evening

16. pancreatic ca modes of treatment do not include which: surgery, chemo, immunotherapy, RT

    immunotherapy

17. duct of Santorini & duct of Wirsung 分別為什麼

    duct of Santorini: accessory pancreatic duct duct of Wirsung: main pancreatic duct

18. post-pancreaticoduodenectomy complications bile leak chyle leak pancreatic juice leak intra-abd abscess 如何分辨

    bile leak - yellow-green fluid chyle leak - milky fluid, high TG > 100 pancreatic juice leak - clear fluid, high amylase intra-abd abscess - fever, bacterial cx

19. follow-up pancreatic NETS using tumor marker chromogranin A for functional or non-functional tumors?

    both functional or non-functional 都可以 f/u using chromogranin A