A 60-Year-Old Man Is Hospitalized Due to Elective Pancreaticoduodenectomy

A 60-year-old man is hospitalized due to elective pancreaticoduodenectomy.  The patient recently had worsening jaundice and was found to have a tumor in the head of the pancreas causing biliary obstruction.  Further evaluation revealed early-stage pancreatic adenocarcinoma.  A modified Whipple procedure with resection of the head of the pancreas, distal duodenum, common bile duct, and gallbladder, followed by pancreatic-enteric, biliary-enteric, and enteroenteric anastomoses, is performed.  After the surgery, the patient begins enteral feeding.  His pain is controlled, but a large amount of output is noted from the surgical drain placed at the pancreatic bed.  The drainage fluid appears cloudy and has a high amylase level.  A postoperative pancreatic leak is suspected, and nonoperative management is planned.  This patient is at greatest risk for which of the following metabolic derangements due to this operative complication?

A) A
B) B
C) C
D) D
E) E

Correct Answer:

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