A 60-year-old woman presents with painless progressive jaundice, weight loss, and a palpable non-tender gallbladder. CT confirms a mass in the head of the pancreas. The most appropriate surgical procedure with curative intent is:

• A Distal pancreatectomy with splenectomy
• B Biliary bypass (choledochojejunostomy)
• C Total pancreatectomy
• D Whipple's pancreaticoduodenectomy ✓

Explanation

Carcinoma of the head of the pancreas presents with painless obstructive jaundice and Courvoisier's sign (palpable non-tender gallbladder). Whipple's pancreaticoduodenectomy — resecting the pancreatic head, duodenum, distal bile duct, and gallbladder — is the only potentially curative procedure. Distal pancreatectomy is for body or tail lesions. Choledochojejunostomy provides palliative relief of jaundice but is not curative. Total pancreatectomy carries higher morbidity without survival benefit for isolated head lesions.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.