Hepatobiliary and pancreatic surgery: delayed gastric emptying: 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: delayed gastric emptying

Sample item

After pancreaticoduodenectomy, a patient cannot tolerate diet from day 8 and has high nasogastric aspirates. A contrast study shows no leak and CT is normal. What is the first-line management?

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

The answer and the reasoning

D. Nasogastric decompression, jejunal feeding and a prokinetic

Delayed gastric emptying is common after pancreaticoduodenectomy and is managed conservatively with decompression, prokinetics and enteral or parenteral nutrition once leak and collection are excluded.

Option by option

  • A. Immediate re-laparotomy

    Re-laparotomy is not required without a leak or collection.

  • B. Octreotide infusion alone

    Octreotide does not restore gastric emptying.

  • C. Total gastrectomy

    Gastrectomy has no role.

  • D. Nasogastric decompression, jejunal feeding and a prokinetic (correct)

    Correct. Conservative support with feeding is first line.

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 D, Nasogastric decompression, jejunal feeding and a prokinetic. Delayed gastric emptying is common after pancreaticoduodenectomy and is managed conservatively with decompression, prokinetics and enteral or parenteral nutrition once leak and collection are excluded.

Why is "Immediate re-laparotomy" not the answer?

Re-laparotomy is not required without a leak or collection.

Why is "Octreotide infusion alone" not the answer?

Octreotide does not restore gastric emptying.

Why is "Total gastrectomy" not the answer?

Gastrectomy has no role.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: delayed gastric emptying in General Surgery. The correct option holds because: Correct. Conservative support with feeding is first line.

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: delayed gastric emptying?

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.