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Pancreatic head cancer (resectable) — MCCQE Part 1 MCQ

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HardJaundicePancreatic head cancer (resectable)MCCQE Part 1

A 55-year-old man has a painless jaundice, dark urine, pale stools, 6kg weight loss x 6 weeks. Palpable non-tender gallbladder. CT: 3cm pancreatic head mass with dilated CBD, no vascular invasion or mets. Most appropriate next step?

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Correct answer: D — Surgical referral for pancreaticoduodenectomy (Whipple procedure)

Courvoisier's sign + pancreatic head mass without vascular invasion/mets = potentially resectable pancreatic cancer. Whipple is only curative option. Biopsy may seed; surgery preferred when resectable. ERCP only if cholangitis.

Reference: Canadian HPB Surgery / CCO