Pancreas and Biliary Surgery Program

Pancreas & Biliary Surgery Program

Mass General's Pancreas and Biliary Surgery Program provides surgical treatments for diseases of the pancreas, gall bladder, liver and bile ducts.
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Call to request an appointment or refer a patient: 617-726-4400

Overview

Located within a world-class academic medical center, Mass General's Pancreas and Biliary Surgery Program includes board-certified, Harvard Medical School-affiliated general surgeons who specialize in performing surgery of the pancreas and biliary system (i.e. gall bladder and bile ducts). This specialization requires rigorous advanced training and a highly focused clinical practice.

Multidisciplinary Pancreatic & Biliary Care

Depending on your condition and diagnosis, your treatment team includes your surgeon as well as gastrointestinal specialists in the Tucker Gosnell Center for Gastrointestinal Cancers or the Pancreas and Biliary Center. Your surgeon works side-by-side with your entire Mass General treatment team, including the Cyst Imaging Surveillance and Treatment (CIST) Center, to provide comprehensive, personalized treatment for cancer patients and other patients with complex conditions.

Carlos Fernandez-del Castillo, MD, meets with a patient to determine the next phase of treatment.
Carlos Fernandez-del Castillo, MD, meets with a patient to determine the next phase of treatment.


We regularly hold multidisciplinary conferences that are attended by specialists from across Mass General. During these conferences, we collaborate on unique and particularly challenging patient cases. Receiving input from this range of expert perspectives helps us deliver comprehensive care for everything from the most common to the rarest pancreatic and biliary diseases.

Conditions We Treat

We treat a variety of conditions that affect the pancreas, gall bladder or bile ducts, including:

  • Acute and chronic pancreatitis (inflammation of the pancreas)
  • Benign tumors and cysts
  • Cancer of the pancreas, gallbladder or bile ducts
  • Congenital abnormalities of the pancreas
  • Intraductal papillary mucinous neoplasms (IPMNs)
  • Gallstones

Our Procedures

Mass General has one of the largest pancreatic cancer practices in New England. Our program has a history of pioneering innovative, minimally invasive approaches such as:

Keith Lillemoe, MD (left), and surgical team perform a Whipple procedure.
Keith Lillemoe, MD (left), and surgical team perform a Whipple procedure.
  • Laparoscopic distal pancreatectomy, is the removal of the left end of the pancreas, and may include the body and tail. This procedure is often done through small incisions and may also include removal of the spleen.

  • Middle pancreatectomy, a limited removal of the mid-portion of the pancreas, preserving the tail and body. The goal of this procedure is to preserve as much of the pancreas as possible to lessen the likelihood of diabetes.

  • Spleen-preserving distal pancreatectomy, which removes the tail and/or body of the pancreas, but not the head of the pancreas or spleen.

A Mass General care team will work with you to determine which procedure is most appropriate for you based on the size, location and spread of your tumor.

We are also highly experienced in specialized procedures such as the Whipple procedure, enucleation and pancreatic debridement.

  • Whipple procedure (pancreatoduodenectomy), is the removal of the head of the pancreas, a part of the small intestine (duodenum), a portion of the stomach, bile duct (tube-like structure that carries bile) and gallbladder.  This procedure is done mostly for cancerous (malignant) or potentially cancerous tumors that are located in (one or more of the following areas):
    • Head of the pancreas
    • Bile duct
    • Ampulla, where the bile duct and pancreatic duct come together and empty into the small intestine
    • Duodenum, the upper part of the small intestine

    The Whipple procedure is typically used to remove cancerous tumors, but can also be used to remove non-cancerous, or benign, tumors that cause symptoms such as jaundice, pain or recurrent pancreatitis.

  • Enucleation, or wedging out, of pancreatic tumors, is the surgical removal of small tumors without removing the pancreas. The goal of this procedure is also to preserve as much of the pancreas as possible to lessen the likelihood of diabetes.

  • Pancreatic debridement, is the removal of the necrotic (dead) pancreatic and peripancreatic tissue.  This is now often done by minimally invasive approaches, including Video- Assisted Retroperitoneal Debridement (VARD) and endoscopic debridement.  This minimally invasive approach allows for a faster recovery. At Mass General, we have a unique multidisciplinary team to deal with this complex problem that involves surgeons, endoscopists, and interventional radiologists.

Our surgeons will tell you if you are a candidate for any of these specialized procedures based on the size, location and malignant (cancerous) potential of the tumor.  

Surgical Results

Our high volume of pancreatectomies — and skilled team of highly rated pancreatic surgeons, anesthesiologists, nurses, and physical therapists— help us to attain expected results in treating patients with extremely complex conditions of the pancreas. In our care, we emphasize minimally invasive surgical and anesthetic techniques that enable shorter stays and fewer complications. Patients at Mass General are able to leave the hospital sooner compared to the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) norms. Learn more about Mass General’s surgical outcomes for pancreatectomy compared to national data.

High Marks in Surgical Quality 

The Mass General Department of Surgery and Codman Center for Clinical Effectiveness have been recognized for meritorious outcomes in surgical patient care from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Hospitals achieve this distinction based on composite quality score in the outcomes in mortality and complications such as cardiac, respiratory, unplanned intubation, ventilator greater than 48 hours, renal failure, surgical site infections and urinary tract infections for all surgery cases during the period of January 1, 2016 to December 31, 2016.

This recognition reflects the outstanding performance of the hospital’s surgical teams in providing patient care at many levels. This distinction goes to only approximately 10 percent of the 680 participating hospitals entering data into NSQIP in 2016 and represents the first time that Mass General has reached this status.

Research & Clinical Trials

Our surgeons are accomplished researchers who are at the forefront of the latest surgical and medical innovations. Browse online for open clinical trials.

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.

Our Surgeons

  • Fagenholz, Peter J., MD

    617-726-2760

    Accepting New Patients

    Clinical Interests
    • Pancreatitis (acute and chronic)
    • Surgical emergencies
    • Critical care
    • Hypoxia and High Altitude Illness
    • Gallbladder disease
    • Hernia surgery
    • Traumatic injuries
    • Surgery in the developing world
    Board Certifications
    • Surgery, American Board of Surgery
    • Surgical Critical Care, American Board of Surgery
    Locations
    • Boston: Churchill Surgical Clinic
  • Fernandez-del Castillo, Carlos, MD

    617-726-5644

    Accepting New Patients

    Clinical Interests
    • Pancreatic disease
    • Pancreatobiliary surgery
    • Gastrointestinal surgery
    • Pancreatic cancer
    • Pancreatic cystic tumors
    • Pancreatitis (acute and chronic)
    • Pancreatic and hepatobiliary surgery
    Locations
    • Boston: Massachusetts General Hospital
    • Waltham: MGH Waltham Cancer Center
  • Ferrone, Cristina R., MD

    617-643-6189

    Accepting New Patients

    Clinical Interests
    • Gastrointestinal malignancies and metastatic liver disease
    • Immunologic treatment of solid tumors and GI malignancies
    • Primary Hepatic and Pancreatic Cancers
    • Pancreatic cancer
    Board Certifications
    • Surgery, American Board of Surgery
    Locations
    • Boston: Massachusetts General Hospital
    • Waltham: MGH Waltham Cancer Center
  • Lillemoe, Keith D., MD

    617-643-1010

    Accepting New Patients

    Clinical Interests
    • Pancreatic cancer
    • Pancreatic cystic tumors
    • Pancreatitis (acute and chronic)
    • Gallbladder and biliary tract disease
    • Gastrointestinal disease
    • Hernia
    Board Certifications
    • Surgery, American Board of Surgery
    Locations
    • Boston: Surgery Department
  • Qadan, Motaz, MD, PhD

    617-643-5153

    Accepting New Patients

    Clinical Interests
    • Pancreatic and hepatobiliary surgery
    • Pancreatobiliary surgery
    • Liver surgery
    • Pancreatic cancer
    • Liver metastases
    • Liver cancer
    • Pancreatic cystic tumors
    • Hepatocellular carcinoma, Cholangiocarcinoma, Liver tumors
    • Surgical oncology
    • Minimally invasive surgery
    Board Certifications
    • Surgery, American Board of Surgery
    • Complex General Surgical Oncology, American Board of Surgery
    Locations
    • Boston: Surgical Oncology Associates

Patient Outcomes

At Mass General, we believe it's important to provide safe and effective care. The Department of Surgery tracks many performance measures and compares them to national data. On the following pages, you can view some of these metrics.

 Distal Pancreatectomy Outcomes

Distal Pancreatectomy Outcomes
See how Mass General’s distal pancreatectomy outcomes compared to the American College of Surgeons norms.

 Pancreatectomy Case Volumes

Pancreatectomy Case Volumes
See how Mass General’s pancreatectomy case volumes compared to the national average.

 Patient Ratings of Pancreatic Surgeons

Patient Ratings of Pancreatic Surgeons
See how Mass General’s pancreatic surgery patients rate their doctors.

 Pancreatectomy Length of Stay

Pancreatectomy Length of Stay
See how Mass General’s pancreatecomy length of stay compared to the American College of Surgeons norms.

 Whipple Procedure Outcomes

Whipple Procedure Outcomes
See how Mass General’s Whipple procedure outcomes compared to the American College of Surgeons norms.

Conditions & Diseases

  • 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).

News

  • Understanding life after pancreatic surgery - 12/4/2015, Mass General

    Thirty-six former MGH patients, ranging in age from 35 to 81, recently returned to the hospital for the inaugural pancreatic surgery patient symposium, “Through Patients’ Eyes: Understanding Life After Pancreatic Surgery.”

  • A new chapter begins - 5/13/2011, Mass General

    MGH Hotline 6.13.11 On April 26, Andrew L. Warshaw, MD, stepped into the operating room to perform his last procedure after four decades of practice and nearly 14 years as surgeon-in-chief and chair of the MGH Department of Surgery.

  • Introducing Keith D. Lillemoe, MD - 5/13/2011, Mass General

    MGH Hotline 5.13.11 Keith D. Lillemoe, MD, the MGH's new surgeon-in-chief and chair of the Department of Surgery, spent 27 years at Johns Hopkins and most recently led the Department of Surgery at Indiana University Hospital.

Video

Request an appointment

Call to request an appointment or refer a patient: 617-726-4400

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