Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

In a Whipple procedure, which anastomoses are involved in the reconstruction of the GI tract?

1. Hepaticojejunostomy, duodenojejunostomy, gastrojejunostomy

2. Pancreatojejunostomy, choledocojejunostomy, gastrojejunostomy

3. Roux-en-Y anastomosis, ileocecal anastomosis

4. Esophagogastrostomy, cholangiojejunostomy

The correct answer is: Pancreatojejunostomy, choledocojejunostomy, gastrojejunostomy

The Whipple procedure, also known as pancreaticoduodenectomy, is a complex surgical operation commonly performed for pancreatic cancer or other disorders of the pancreas. The main goal of this operation is to remove the head of the pancreas, along with the duodenum, gallbladder, and a portion of the bile duct. During the reconstruction of the gastrointestinal tract after the resection, specific anastomoses are made to ensure continuity of the digestive system. The correct response includes pancreatojejunostomy, choledocojejunostomy, and gastrojejunostomy. The pancreatojejunostomy is crucial as it connects the remaining portion of the pancreas to the jejunum, allowing digestive enzymes to enter the intestinal tract. The choledocojejunostomy is performed to reestablish bile flow by connecting the common bile duct to the jejunum, thus allowing bilirubin to be cleared into the intestine. Lastly, the gastrojejunostomy connects the stomach to the jejunum, facilitating gastric contents to pass into the intestine post-surgery. These three anastomoses are essential for the proper functioning of the digestive system after a Whipple procedure, as they restore the continuity of the alimentary canal