FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2017
POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
SURGICAL GASTROENTEROLOGY
PAPER II
GIS/J/17/46/II
Time 3 hours
Max. Marks 100
Important instructions:
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
1. While doing a laparoscopic cholecystectomy, a general surgeon thinks
he has transected the common bile duct. He contacts you during the
operative procedure seeking your advice. List the information that you
will seek from him, the advice that you will give him and the further
management.

2. Surgical interventions in a patient with chronic pancreatitis and list
the pros and cons of each.
3+7
3. A patient underwent a laparoscopic cholecystetomy four weeks ago.
The histopathology of the gall bladder suggests carcinoma. Outline
the evaluation and management of such a patient.
5+5
4. Role of PET imaging in patients with hepatobiliary and pancreatic
lesions.
5+5
5. How will you assess the future liver remnant in a patient requiring
an extended right hepatectomy for colorectal liver metastasis?
What are the options to increase the future liver remnant?
5+5
6. Role of preoperative biliary drainage in a patient with surgical
obstructive jaundice planned for a pylorus preserving pancreatoduodenectomy.
What are the options for achieving preoperative biliary drainage?
List their pros and cons.

7. Enumerate the devascularisation procedures that can be done for
a patient with variceal bleeding.
What are the results of these patients in cirrhotic and non-cirrhotic
patients when done for acute variceal bleeding?
4+6
8. What is hemosucuss pancreaticus?
Its causes and outline the management.

9. How will you evaluate and manage a 30 year old lady with an
incidentally detected cystic lesion in the liver on ultrasound?
10
10. Evaluation and management of a patient with hepatic venous outflow
tract obstruction.
4+6