Pancreatitis Treatment Center
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About This Program
The Pancreatitis Treatment Center within the Digestive Healthcare Center at Massachusetts General Hospital is distinguished by our commitment to treating all cases in multidisciplinary fashion. We have a team of surgeons, gastroenterologists, radiologists and intensive care doctors, and our collective expertise of techniques and procedures is used to treat acute pancreatitis.
We have the resources, technology and background to ensure the best possible outcome in every case, and we are fully committed to the care of each individual patient and to advancing the entire field of care for pancreatitis patients.
With procedures like Video-assisted Retroperitoneal Debridement (VARD) and Sinus Tract Endoscopy (STE), our physicians are at the forefront of bringing minimally invasive surgical techniques to the treatment of pancreatitis.
Our team has also contributed to the latest international guidelines for the management of acute pancreatitis, and we publish extensively on patient care and hold lectures across the country.
Below is a list of our most common procedures. Our physicians work with each patient to determine which procedure is appropriate for them.
Video-assisted Retroperitoneal Debridement (VARD)
VARD is a minimally invasive technique for the removal of necrotic (dead) pancreatic tissue through a small incision in the side. This procedure involves placement of a small drain under CAT-scan guidance, which then allows the surgeon to access the area of necrosis using a laparoscopic camera.
Mass General performed the first VARD procedure in New England and have the most experience in the region with this technique. By minimizing the size of the incision, the patient experiences less post-op pain, a lower systemic response to surgery and minimal damage to healthy pancreatic tissue. This results in less time in intensive care while lowering the risk of post-operative diabetes and reducing the chances of hernia formation.
Sinus Tract Endoscopy (STE)
STE is a minimally invasive technique for the removal of necrotic (dead) pancreatic tissue through a small incision. This procedure involves placement of a small drain under CAT-scan guidance, which then allows the surgeon to access the area of necrosis using a camera.
We have the most experience in the nation with this technique, which is similar to VARD, but allows access to areas which cannot be reached by VARD. By minimizing the size of the incision, the procedure reduces post-operative pain, lowers the systemic response to surgery and minimizes damage to healthy pancreatic tissue. This results in the patient spending less time in intensive care while lowering the risk of post-operative diabetes and reducing the chances of hernia formation.
Transgastric Endoscopic Necrosectomy
Transgastric endoscopic necrosectomy is another minimally invasive technique for the removal of necrotic (dead) pancreatic tissue. A flexible endoscope is passed into the stomach and a tube called a stent is placed from the stomach into the necrosis. The endoscope is then used to remove the dead tissue.
Its main advantage is that in certain patients it can treat necrotic (dead) pancreatic tissue with no external incisions or drains. By eliminating incisions, the patient experiences minimal post-op pain, a lower systemic response to surgery and minimal damage to healthy pancreatic tissue. This results in less time in intensive care while lowering the risk of post-operative diabetes and eliminating the chances of hernia formation.
Percutaneous drainage is a procedure in which a CT scan or an ultrasound is used to guide a drain into an area of infection or necrosis (dead tissue). It can be used as a guide for VARD or other procedures, or can be used for treatment of an infection.
A laparoscopic (keyhole incision) approach can be used for treatment of necrosis, pancreatic pseudocyst (a benign collection of pancreatic fluid) and to remove the gallbladder to prevent recurrent episodes of gallstone pancreatitis.
In certain circumstances, open surgery via an abdominal incision may be the best option for patients. We have the largest published experience in the United States with open necrosectomy and some of the very best results.
Open surgery may also be used for treating complications of pancreatitis such as disconnected pancreatic duct syndrome.
We constantly strive to provide the best possible care for each individual patient and to advance the entire field of patient caring for pancreatitis. All our pancreatic necrosectomy patients are prospectively enrolled in a secure pancreatic surgery database. Our research efforts include studies focusing on:
- Comparisons between different approaches to necrosectomy in patients with acute pancreatitis
- Epidemiology and economic costs of acute pancreatitis
- Novel methods of combining minimally invasive techniques to reduce the complications of pancreatic necrosectomy
- Management of gallstones during and after an episode of pancreatitis
About the Digestive Healthcare Center
The Massachusetts General Hospital Digestive Healthcare Center is a collaborative practice of gastroenterologists, endoscopists, surgeons, radiologists, pathologists, hepatologists, oncologists and radiation oncologists dedicated to the prevention, diagnosis, treatment and management of digestive diseases.