Pancreas and Biliary Program

About This Program

We are one of the largest referral centers nationally for patients with pancreatic and biliary disorders. We have expertise in the treatment of acute pancreatitis using a variety of approaches. We also have extensive experience treating pancreatic cysts and pancreatic cancer through the Cancer Center, including neuroendocrine tumors of the pancreas. Our pancreatic cancer patients have some of the best survival rates in the U.S.

We offer treatments for patients with the full range of pancreatic and biliary diseases, including a specialized Cyst Imaging Surveillance and Treatment (CIST) Center for pancreatic cysts.

Benign conditions of the pancreatic-biliary system

• Chronic pseudocysts
• Pancreatic divisum
• Bile duct stones
• Primary sclerosing cholangitis (PSC)
• Autoimmune cholangitis
• Autoimmune pancreatitis
• Acute and chronic pancreatitis
• Acute and chronic cholangitis
• Biliary strictures
• Pancreatic stones
• Sphincter of Oddi dysfunction
• Congenital diseases of the bile duct
• Serous cystadenoma
• Lymphoepithelial cysts

Premalignant conditions of the pancreatic-biliary system

• Intraductal papillary mucinous neoplasms
• Mucinous cystic neoplasia
• Solid pseudopapillary tumors
• Ampullary adenomas

Malignant conditions of the pancreatic-biliary system

• Pancreatic cancer (adenocarcinoma)
• Neuroendocrine tumors
• Zollinger Ellison syndrome
• Cholangiocarcinoma
• Metastatic tumors to the pancreas

After referral and initiation of therapy, we work closely with both the patient and the referring physician on long-term care plans, striving to offer the best possible outcomes.

Our Approach

Our leading-edge medical, endoscopic, and surgical interventions provide patients with timely diagnosis and individualized, ongoing care for the entire spectrum of pancreatic and biliary diseases.

Each patient's treatment is overseen by a personal care team of pancreatic and biliary specialists that are all part of the Mass General Digestive Healthcare Center:

• Interventional GI endoscopists
• Gastroenterologists
• Surgeons
• Radiologists
• Oncologists
• Radiation oncologists
• Nurse practitioners and oncology nurses

The team works with both the patient and the referring physician to coordinate a care plan designed to offer the best outcomes.

Advanced Endoscopic Imaging Approaches

Mass General is a leader in detecting early malignancies. We offer advanced endoscopic imaging techniques of the pancreas and biliary tract, including:

• Endoscopic cholangioscopy, used to detect and treat of stones, tumors and diseases of the bile duct; this technology is currently being used in clinical trials
• Endoscopic pancreatoscopy, used to detect early malignancies in the pancreatic duct
• Endoscopic confocal microscopy
• High-frequency probe endosonography (EUS), used to examine of superficial malignancies
• Endoscopic-ultrasound-guided fine-needle aspiration of solid, cystic, and complex tumors of the pancreas and bile ducts
• Optical coherence tomography, used to detect benign and malignant diseases of the bile duct
• Linear endoscopic ultrasound, used to detect early malignancies of the pancreas

Mass General was one of the first U.S. hospitals to offer endoscopic retrograde cholangiopancreatography (ERCP), a minimally invasive procedure that combines X-ray and video endoscope technologies to diagnose and treat conditions of the bile ducts. We helped pioneered cholangioscopy, a new technique in ERCP, and have introduced other novel diagnostic and therapeutic approaches, some of which are available only at Mass General.

Other treatments include:

• ERCP guided stent placement, stone removal and incision of the pancreatic-biliary sphincters
• Endoscopic-guided drainage of pancreatic pseudocysts
• Endoscopic diagnosis and ablation of cystic neoplasms of the pancreas
• Endoscopic removal of polyps, ampullary tumors and early cancers
• Endoscopic ultrasound guided celiac neurolysis to help control pancreatic pain
• Radiofrequency ablation for liver tumors, a technique that heats and kills cancer cells, performed first at Mass General
• Intraoperative radiation therapy (IORT), which treats advanced pancreatic tumors by intensifying radiation and minimizing damage to healthy tissue

Our diagnostic radiology team is composed of dedicated imaging specialists whose practice focuses specifically on GI scans (CT, MRI, PET). They are also nationally recognized for expertise in using the most sophisticated imaging tests to detect, diagnose and biopsy lesions in the pancreatic-biliary system.

Surgical Options

We take a collaborative, multidisciplinary approach that provides access to surgical expertise. Mass General has pioneered landmark pancreatic-biliary surgical procedures including: Sphincter of Oddi resection, Pancreatic cyst resection, Pancreaticoduodenectomy (Whipple Procedure), Distal pancreatectomy, Middle pancreatectomy, Cyst-gastrostomy, Pancreatic debridement or necrosectomy, Choledochojejunostomy, Pancreaticojejunostomy, Laparoscopic cholecystectomy.

Learn more about pancreatic-biliary surgical procedures in the Department of Surgery

Designated National Pancreas Foundation Center

The National Pancreas Foundation (NPF) has recognized Mass General as both an NPF Pancreatic Cancer Center and an NPF Pancreatitis (non-cancerous) Center. These important recognitions are given to premier healthcare facilities that focus on the multidisciplinary treatment of pancreatic cancer and acute pancreatitis, best possible outcomes and improved quality of life for patients. Learn more about the NPF recognitions.

Clinical Research to Improve Patient Care

We are recognized as one of the nation's foremost research centers in the study of pancreatic and biliary malignancies. Our research focuses on prolonging and improving patients' lives and includes:

• Cutting-edge endoscopic approaches to pancreatic and biliary diseases
• A nationally recognized research program in pancreatic cystic lesions
• Hepatic and bile duct cancer research
• Research related to the mechanisms that cause pancreatitis and pancreatic cancer

Our physicians are active in clinical trials and research studies related to pancreatic-biliary conditions, allowing us to bring our patients promising new treatments as quickly as possible.

Browse open trials