Hepatobiliary and pancreatic surgery: pancreaticoduodenectomy complications: 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: pancreaticoduodenectomy complications

Sample item

Five days after a pancreaticoduodenectomy, a patient has fever and a drain output of amylase-rich fluid, with no peritonitis. Which complication is this?

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

The answer and the reasoning

C. Postoperative pancreatic fistula

A leak from the pancreatic-enteric anastomosis produces amylase-rich fluid in the drain and is a common major complication of pancreaticoduodenectomy. Management is drainage with nutritional support, and re-operation is only for sepsis.

Option by option

  • A. Delayed gastric emptying

    Delayed gastric emptying presents with vomiting and high gastric aspirates.

  • B. Marginal ulcer

    Marginal ulcer is a late complication presenting with pain or bleeding.

  • C. Postoperative pancreatic fistula (correct)

    Correct. Amylase-rich drain fluid indicates a pancreatic fistula.

  • D. Chyle leak

    Chyle is milky and rich in triglyceride, not amylase.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Postoperative pancreatic fistula. A leak from the pancreatic-enteric anastomosis produces amylase-rich fluid in the drain and is a common major complication of pancreaticoduodenectomy.

Why is "Delayed gastric emptying" not the answer?

Delayed gastric emptying presents with vomiting and high gastric aspirates.

Why is "Marginal ulcer" not the answer?

Marginal ulcer is a late complication presenting with pain or bleeding.

Why is "Chyle leak" not the answer?

Chyle is milky and rich in triglyceride, not amylase.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: pancreaticoduodenectomy complications in General Surgery. Management is drainage with nutritional support, and re-operation is only for sepsis.

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: pancreaticoduodenectomy complications?

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.