A 65-year-old man who is 5 days status post–pancreaticoduodenectomy has ongoing clear output from his surgical drain—a volume of 500 mL over 24 hours and is otherwise recovering uneventfully. Drain amylase is 8000 U/L and serum amylase is 75 U/L. The most appropriate next step in management of this pancreatic fistula is which of the following?
A. Computed tomography scan of the abdomen and pelvis
B. Observation, maintenance of the surgical drain, nothing by mouth (NPO; nil per os), and total parenteral nutrition
C. Broad-spectrum antibiotics
D. Return to the operating room for revision of the pancreaticojejunostomy
E. Observation and maintenance of the drain
Select your answer:
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