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Pancreas and Biliary Program

The Pancreas and Biliary Program at the Gastroenterology Division of Massachusetts General Hospital provides patients with specialized options for the diagnosis, treatment and management of pancreatic and biliary diseases.

Our Approach

Individualized, Multidisciplinary Care for Each Patient

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 MGH 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, Pancreatico-jejunostomy, Laparoscopic cholecystectomy.

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

One Call Coordinates Care

We provide patients and referring physicians with an experienced access coordinator, a clinician who is available to assess patients’ needs, coordinate appointments and begin the appropriate testing regimen.

Contact the Pancreas and Biliary Center’s access coordinator

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.

A Dedicated Referral Line for Physicians and Patients

We provide patients and referring physicians with an experienced access coordinator, a clinician who helps assess patient needs, coordinate appointments and begin the appropriate testing regimen.

Contact the Pancreas and Biliary Center's access coordinator

Calls will be returned within 24 hours.

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. Patients interested in participating in clinical trials can browse online for open trials, including an ongoing study on endoscopic therapy of malignant bile duct strictures.

Biliary Cirrhosis / Bile Duct Cancer

Biliary cirrhosis is a rare form of liver cirrhosis, caused by disease or defects of the bile ducts.

Cholangitis

Cholangitis is an inflammation of the bile duct system that is usually related to a bacterial infection. The bile duct system is the drainage system that carries bile from the liver and gallbladder into the area of the small intestine called the duodenum. The infection may occur suddenly or may be chronic.

Cholecystitis

Cholecystitis is an inflammation of the gallbladder wall and nearby abdominal lining. Cholecystitis is usually caused by a gallstone in the cystic duct, the duct that connects the gallbladder to the hepatic duct.

Gallstones

Gallstones form when bile stored in the gallbladder hardens into stone-like material.

Pancreatic Cancer

Pancreatic cancer is the fourth most common cause of cancer death in men and women in the US. Pancreatic cancer occurs when malignant cells grow out of control.

Pancreatitis

Pancreatitis is the inflammation of the pancreas. The inflammation may be sudden (acute) or ongoing (chronic).

Pseudocysts of the Pancreas

Pseudocysts of the pancreas are abnormal collections of fluid, dead tissue, pancreatic enzymes, and blood that can lead to a painful mass in the pancreas.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

New Radiology and Endoscopy Techniques Are Improving Treatment of Pancreatic and Biliary Disorders

Patients seeking care for pancreatic and biliary system disorders at Massachusetts General Hospital’s Digestive Healthcare Center receive the latest in diagnostic and therapeutic treatments from a collaborative team of experts, including gastroenterologists, interventional endoscopists, pathologists, medical oncologists, surgeons, radiation oncologists, and radiation therapists.

Diagnosis of pancreatic cystic neoplasms (for medical professionals)

Cystic pancreatic lesions are being detected with increasing frequency, and pancreatic cystic neoplasms account for the majority of these lesions. Designed for medical professionals, this video illustrates the use of endoscopic ultrasound and cyst fluid analysis in differential diagnosis of cystic pancreatic lesions.

Radiofrequency of the Bile Duct

Endoscopic bipolar Radiofrequency ablation is a new technique for ablation of neoplastic tissue in the bile duct.

Pancreas and Biliary Center

Blake 4
55 Fruit Street
Boston, MA 02114

Phone: 877-644-3636
Hours: 8:00 am to 5:00 pm, Monday through Friday


To begin the appointment process, contact the Pancreas and Biliary Center access coordinator at 617-617-643-567 or request an appointment online.