This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T, Subject name: Surgery
What is the most common surgical complication following whipple procedure? 
Select and explain. 
A. Disruption of pancreatic anastomosis, B. Biliary peritonitis, C. Disruption of gastric anastomosis, D. GI bleeding
C: Disruption of gastric anastomosis
Answer: C: Disruption of gastric anastomosis 
Explanation: If disease mainly involves head of the pancreas, then pancreatico-duodenectomy can be done--Whipple's procedure.Whipple's operation is done by removing tumour with head and neck of pancreas, C loop of duodenum, 40% distal stomach, 10 cm proximal jejunum, lower end of the common bile duct, gallbladder, peripancreatic, pericholedochal, paraduodenal and perihepatic nodes. Continuity is maintained by choledochojejunostomy, pancreaticojejunostomy and gastrojejunostomy. Few advocate pancreaticogastrostomy into posterior wall of the stomach. Moality in Whipple's operation is 2-8%. Original Whipple's operation (1935) was two staged procedure- initial by pass and a second stage resection with closure of pancreatic stump. In 1941, Trimble performed one stage pancreaticojejunostomy. Complications are delayed gastric emptying (19%); pancreatic fistula (14%); infection (intraabdominal abscess, wound infection, cholangitis, pancreatitis, pneumonia); bile leak. Moality is 3%. ref:SRB&;S manual of surgery,ed 3,pg no 635