Hepatobiliary and pancreatic surgery: unresectable pancreatic head cancer: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: unresectable pancreatic head cancer

Sample item

A 62-year-old man with a pancreatic head adenocarcinoma undergoes multiphase CT for staging. Which finding indicates locally advanced, unresectable disease?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Encasement of the superior mesenteric artery beyond 180 degrees

Circumferential involvement of the superior mesenteric artery (more than 180 degrees of encasement) indicates locally advanced disease that cannot be cleared by pancreaticoduodenectomy. Biliary and duct dilatation and nodes within the resection field do not preclude surgery.

Option by option

  • A. Encasement of the superior mesenteric artery beyond 180 degrees (correct)

    Correct. Arterial encasement beyond half the circumference precludes curative resection.

  • B. Dilatation of the common bile duct and pancreatic duct

    Double duct dilatation is the usual presentation of a resectable head tumour.

  • C. Enlarged nodes inside the planned resection field

    Nodes within the resection field are removed during the operation.

  • D. A 3 cm tumour confined to the pancreatic head

    A small localised head tumour is potentially resectable.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Encasement of the superior mesenteric artery beyond 180 degrees. Circumferential involvement of the superior mesenteric artery (more than 180 degrees of encasement) indicates locally advanced disease that cannot be cleared by pancreaticoduodenectomy.

Why is "Dilatation of the common bile duct and pancreatic duct" not the answer?

Double duct dilatation is the usual presentation of a resectable head tumour.

Why is "Enlarged nodes inside the planned resection field" not the answer?

Nodes within the resection field are removed during the operation.

Why is "A 3 cm tumour confined to the pancreatic head" not the answer?

A small localised head tumour is potentially resectable.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: unresectable pancreatic head cancer in General Surgery. Biliary and duct dilatation and nodes within the resection field do not preclude surgery.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: unresectable pancreatic head cancer?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.