A 60-year-old woman presents with painless progressive jaundice, weight loss, and a palpable, non-tender gallbladder (Courvoisier's sign). CA 19-9 is 450 U/mL. CT shows a mass at the head of the pancreas with no vascular involvement and no distant metastases. What is the standard surgical procedure?
- A Pylorus-preserving pancreaticoduodenectomy (PPPD / Traverso-Longmire) ✓
- B Distal pancreatectomy and splenectomy
- C Total pancreatectomy with hepaticojejunostomy
- D Palliative hepaticojejunostomy and gastrojejunostomy
Correct answer: A. Pylorus-preserving pancreaticoduodenectomy (PPPD / Traverso-Longmire)
Explanation
Resectable carcinoma of the head of the pancreas is treated with pancreaticoduodenectomy; the pylorus-preserving variant (PPPD/Traverso-Longmire) preserves the pylorus and proximal 2 cm of duodenum, reducing dumping syndrome and nutritional morbidity while achieving equivalent oncological outcomes compared to the classic Whipple procedure.
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.