Advanced Pancreatic Disease Diagnosis, Treatment and Surgery

Our multidisciplinary team uses the latest evidence-based approaches to diagnose pancreatic conditions, assess cancer risk, guide treatment decisions, and provide long-term follow-up. As a leading academic medical center, we are also committed to advancing pancreatic care through clinical research, clinical trials, and innovative diagnostic and treatment approaches.

Diagnostic Imaging and Procedures

Our specialists use advanced imaging and endoscopic techniques to evaluate pancreatic diseases, identify concerning changes, and guide treatment. These include:

• Computed tomography (CT) scans: Our specialized pancreas CT scans use carefully optimized imaging techniques, including precise timing of intravenous contrast administration, to provide highly detailed images of the pancreas, surrounding blood vessels, and other organs. These specialized imaging techniques have been developed and refined to improve the detection of subtle pancreatic abnormalities that may be missed on routine CT scans. They are particularly important for the early detection and staging of pancreatic cancer, assessing tumor involvement of nearby blood vessels, determining surgical treatment options, and monitoring response to therapy.
• High-resolution MRI and magnetic resonance cholangiopancreatography (MRCP): Our specialized pancreatic MRI techniques have been developed and refined to provide highly detailed images of the pancreas, pancreatic ducts, and surrounding structures. These protocols use advanced imaging techniques, including optimized sequences and contrast timing, to improve the detection of subtle pancreatic abnormalities that may be missed on routine MRI scans. MRI/MRCP is particularly valuable for evaluating pancreatic cysts, identifying small pancreatic lesions, and monitoring individuals at increased risk of developing pancreatic cancer.
• Endoscopic ultrasound (EUS): This procedure uses a flexible scope with an ultrasound probe passed through the mouth into the esophagus and stomach to obtain detailed images of the pancreas and surrounding structures (bile ducts, lymph nodes, liver, and intestines).
• EUS-guided fine needle aspiration and biopsy: This procedure uses endoscopic ultrasound to collect fluid or tissue samples from pancreatic cysts, masses, lymph nodes, or liver for further evaluation and diagnosis.
• Endoscopic retrograde cholangiopancreatography: This procedure uses a flexible scope passed through the mouth into the stomach and small intestine to access the bile ducts and the pancreatic duct to assess and treat blockages and other problems in the ducts.

Advanced Therapeutic Endoscopy

Our advanced endoscopists (gastroenterologists with additional, specialized training) offer a comprehensive range of innovative, minimally invasive treatments for pancreatic diseases, including pancreatic cancer, pancreatic cysts, acute and chronic pancreatitis, and complications involving the bile ducts and gastrointestinal tract. Using specialized endoscopic ultrasound (EUS) and other advanced techniques, our team can perform complex procedures without traditional surgery in appropriately selected patients. These approaches may reduce discomfort, shorten recovery times, and provide important treatment options for patients with challenging conditions.

Our specialized endoscopic treatments include:

• Treatment of acute and chronic pancreatitis: Advanced endoscopic procedures to treat pancreatic duct stones, strictures (narrowing), fluid collections, and other complications of pancreatitis. These include pancreatic duct stenting, stone removal, and endoscopic drainage of pancreatic pseudocysts and infected or symptomatic pancreatic necrosis.
• Endoscopic bypass and drainage procedures: Highly specialized procedures to relieve blockages caused by pancreatic tumors or other conditions. Using EUS guidance, our specialists can create internal drainage pathways to bypass obstructions involving the bile ducts, stomach, or small intestine, potentially avoiding more invasive surgery or external drainage tubes.
• Endoscopic treatment and ablation of pancreatic tumors: Specialized techniques, including EUS-guided radiofrequency ablation, to treat selected pancreatic tumors and lesions when appropriate.
• Endoscopic management of pancreatic cysts: Advanced evaluation and selected minimally invasive treatments for pancreatic cysts, with recommendations tailored to the type of cyst, its risk of becoming cancerous, and individual patient factors.
• Endoscopic pain management: Specialized procedures, including EUS-guided celiac plexus interventions, to help manage pain associated with pancreatic cancer and chronic pancreatitis.

Our advanced endoscopists work closely with pancreatic surgeons, oncologists, radiologists, and other specialists to determine the most appropriate treatment for each patient, providing access to the full spectrum of endoscopic and surgical options.

Specialized Pancreatic Surgery

Our pancreatic surgeons offer the full spectrum of surgical treatments for pancreatic cancer, pancreatic neuroendocrine tumors, pancreatic cysts, and other complex pancreatic conditions. From minimally invasive robotic and laparoscopic procedures to highly complex operations involving major blood vessels, our team has extensive experience performing specialized pancreatic surgery. We tailor each surgical approach to the patient's diagnosis, anatomy, and individual treatment needs, with the goal of achieving the best possible outcomes.

Minimally Invasive and Robotic Pancreatic Surgery

We offer state-of-the-art robotic and laparoscopic pancreatic surgery for appropriately selected patients, including Whipple procedures (pancreaticoduodenectomy), distal pancreatectomy, and other pancreatic operations. These approaches use smaller incisions and specialized instruments to perform complex procedures with precision. When appropriate, minimally invasive surgery may reduce postoperative pain, shorten hospital stays, and allow patients to recover more quickly. Our surgeons carefully evaluate each patient to determine whether a robotic, laparoscopic, or traditional open approach will provide the safest and most effective treatment.

Complex Pancreatic Surgery and Vascular Reconstruction

Some pancreatic tumors involve major blood vessels, making surgical removal particularly challenging. Our pancreatic surgeons specialize in complex pancreatic operations, including the removal and reconstruction of major blood vessels involved by pancreatic tumors. Working closely with our vascular and liver transplant surgeons, we perform highly specialized procedures involving venous and, in carefully selected cases, arterial resections and reconstructions. This collaborative expertise allows us to evaluate complex tumors involving major blood vessels and consider surgical options for selected patients who may have been told that their tumors cannot be removed.

Surgery for Borderline Resectable and Locally Advanced Pancreatic Cancer

Patients with borderline resectable or locally advanced pancreatic cancer often require a combination of treatments before surgery can be considered. Our multidisciplinary team brings together pancreatic surgeons, medical and radiation oncologists, radiologists, and other specialists to develop personalized treatment strategies. These may include chemotherapy, sometimes combined with radiation, followed by careful reassessment to determine whether surgery is possible.

Our surgeons have particular expertise in evaluating complex tumors involving major blood vessels and determining whether specialized surgical techniques may offer an opportunity for complete tumor removal. We also welcome patients seeking second opinions, particularly those who have been told that their pancreatic cancer cannot be surgically removed. Our goal is to ensure that every patient receives a comprehensive evaluation and access to all appropriate treatment options.

Innovative Treatments and Clinical Trials

Our patients have access to innovative clinical trials evaluating new approaches to pancreatic cancer prevention, early detection, and treatment, as well as other pancreatic diseases. Our clinical trial program spans all stages of pancreatic cancer, including early-stage, borderline resectable, locally advanced, and metastatic disease. Our multidisciplinary team helps patients understand available clinical trial options and determine which opportunities may be appropriate for their individual diagnosis and treatment needs.

Make an Appointment

To schedule an appointment with the Comprehensive Pancreas Program at Weill Cornell Medicine, please give us a call at (646) 962-4000 or book online with one of our physicians.