Pancreas & Biliary Surgery Program
Pancreas & Biliary Surgery Program
Wang Ambulatory Care Center, Suite 460
55 Fruit Street
Boston, MA 02114
Explore This Program
About the Program
Located within a world-class academic medical center, the Pancreas & Biliary Surgery program in the Division of Gastrointestinal & Oncologic Surgery at Massachusetts General Hospital 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 at the Mass General Cancer Center or the Pancreas & 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 patients with cancer and other complex conditions.
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 and bile duct
- Gallstones and gallbladder polyps
- Intraductal papillary mucinous neoplasms
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:
Intraoperative Radiation Therapy
A treatment technique in which a large, precise dose of radiation is delivered directly into the tumor cavity during surgery. This technique can be an option for patients with localized, but inoperable, disease, for tumors that are difficult to remove and if there is concern that the resection margins may be positive.
Laparoscopic Distal Pancreatectomy
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.
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
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 of Pancreatic Tumors
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 Outcomes for the Pancreas
The Center for Outcomes & Patient Safety in Surgery (COMPASS) ensures that surgical data is transparent and accessible for patients. Watch the video to learn about Mass General's outcomes and performance for surgical treatment of pancreatic conditions including cancer and necrotizing pancreatitis.
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.
View our surgical outcomes 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.
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% of the 680 participating hospitals entering data into NSQIP. The ACS NSQIP has recognized Mass General as a national leader for surgical outcomes for four consecutive years—2016, 2017, 2018 and 2019.
Research & Clinical Trials
Our surgeons are accomplished researchers who are at the forefront of the latest surgical and medical innovations.
We are actively enrolling eligible patients in various clinical trials:
- An ongoing National Institutes of Health-sponsored clinical trial where patients with intraductal papillary mucinous neoplasms (IPMNs) that have worrisome features are randomized to sulindac versus placebo and undergo close surveillance. Learn more
- A multicenter trial comparing two antibiotics (Cefoxitin and Piperacillin-Tazobactam) as antibiotic prophylaxis in patients undergoing pancreatoduodenectomy. Learn more
- A trial for patients with resectable pancreatic cancer to compare chemotherapy given before and after surgery (perioperative chemotherapy) versus chemotherapy given after surgery (adjuvant chemotherapy). Learn more
- A variety of clinic trials that study new therapies to treat pancreatic cancer. Learn more
Research Video: Advances in Prehabilitation
In this video, Motaz Qadan, MD, PhD, a hepatobiliary and pancreatic surgical oncologist in the Division Gastrointestinal and Oncologic Surgery and Mass General Cancer Center, discusses his research on prehabilitation and its promising potential for patients with pancreatic cancer.
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 health care facilities that focus on the multidisciplinary treatment of pancreatic cancer and acute pancreatitis, best possible outcomes and improved quality of life for patients.
Meet our expert team of physicians in the Pancreas & Biliary Surgery program at Mass General.
Carlos Fernandez-del Castillo, MD
- Clinical Co-director; GI Cancer Center
- Director, Pancreas and Biliary Surgery Program
- Chief of General Surgery, Salem Hospital
- Surgical Director, Mass General/North Shore Cancer Center
- Chief of Surgery
- Gapontsev Family Endowed Chair in Surgical Oncology
- Associate Professor of Surgery
Carol Goodermote's Patient StoryCarol Goodermote came to Mass General to have a malignant neuroendocrine tumor on her pancreas removed through a Whipple procedure performed by Carlos Fernandez-del Castillo, MD. Prior to her Whipple, she had an aortic stenosis repaired through a transcatheter aortic valve replacement performed by Ignacio Inglessis-Azuaje, MD.
Beatriz Riordan’s Patient StoryBeatriz Riordan was treated at Mass General for pancreatic cancer, which included undergoing a Whipple procedure with Andrew Warshaw, MD, surgeon-in-chief emeritus, following radiation and chemotherapy at the Mass General Cancer Center. Today, she remains healthy and is living her life to the fullest. Hear from Beatriz about her experience being diagnosed with pancreatic cancer and receiving surgical care at Mass General.
The Dream Team: Shifting the Pancreatic Cancer Curve
At the Mass General Cancer Center, medical oncologists, radiation oncologists, surgeons and other specialists approach a patient’s case as one united team with a common goal—to provide the best possible care with the best chance for a cure. In this video, you’ll meet a group of those master clinicians and researchers that one patient describes as his “Dream Team.”
Surgical Outcomes for Pancreatic Conditions
Mass General provides its outcomes and performance data for surgical treatment of pancreatic conditions including cancer and necrotizing pancreatitis.
Mass General is home to the fastest growing robotic surgery program in New England and is a minimally invasive treatment option for many conditions.
Mass General Digestive Healthcare Center
The Digestive Healthcare Center offers comprehensive, coordinated care for patients with various digestive diseases, from heartburn to organ failure.
If you would like to request an appointment with or refer a patient to the Pancreas & Biliary Surgery Program, please use the following contact information.