NBME 12 laparoscopic cholecystectomy question

[britesky89]

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"Surgeon performs laparoscopic cholecystectomy on 32 to F, he will be unable to directly inspect which of the following organs during the procedure?"

A. Ileum
B. Jejunum
C. Pancreas (Correct)
D. Stomach
E. Transverse colon (WRONG)

The reasoning is that the pancreas is the only retroperitoneal organ. I don't understand why that makes pancreas the right answer. Isn't the pancreas very close to the gallbladder? I mean carcinoma of the head of the pancreas can lead to common bile duct obstruction.

I thought it was transverse colon because it's farther away from the gallbladder.

Why is it that the pancreas can't be accessed?

 

[dfib slim]

Don't over think it. To see the pancreas you would need to pierce the pertioneal fascia. You would see the transverse colon when you stick the camera in and advance to the gallbladder.

 

[animando]

the keyword is "directly". You cannot reach the pancreas directly. You have to go (for example) through the lesser omentum or the foramen omentale.