Treatment and Support
If you've been diagnosed with a disease of the pancreas or biliary tract, you'll receive exceptional care and a personalized treatment plan from the Pancreatic and Biliary Diseases Program. The care team at Cedars-Sinai performs innovative, minimally invasive and conventional surgery, and delivers nonsurgical treatment options, as needed. Every approach is patient-centered, with the goal to help you get better and stay healthy.
Minimally Invasive Procedures
If you have been diagnosed with a pancreatic or biliary condition, rest assured there are many treatment options available to you. Many of these procedures are minimally invasive and require only a small incision. This usually results in much faster recoveries and shorter hospital stays than with conventional operations. Some interventional gastroenterology procedures offered at Cedars-Sinai include:
- Endoscopic Retrograde Cholangiopancreatography (ERCP): ERCP is used to remove or open obstructions in the gallbladder or bile ducts, repair complications from previous surgeries and to reach pancreatic or bile duct tumors for biopsy.
- Endoscopic Ultrasound (EUS): EUS uses an endoscope with an ultrasound component on the tip of it to view underneath the surface of the gastrointestinal tract, as well as into surrounding organs. EUS also is used to perform biopsies on tissue growths to identify what they are.
- Extracorporeal shock wave lithotripsy (ESWL): ESWL can be used to crush stones in the pancreas and bile ducts using sound waves generated by a machine (lithotriptor) placed outside the body. Cedars-Sinai is one of the only medical facilities with a lithotriptor and skilled technicians on-site.
- Interventional Radiology: Many diagnostic or therapeutic procedures involve injection of an X-ray contrast dye directly into the bile duct or placement of external drainage tubes to relieve blockages of the biliary tract.
The Pancreatic and Biliary Diseases and Interventional Gastroenterology programs at Cedars-Sinai also offer a full range of procedures in what is called interventional or therapeutic endoscopy. In addition to the procedures listed above, other interventional endoscopic options offered include double balloon enteroscopy, endoscopic pancreatic therapy, mucosectomy and pancreatic and biliary stenting.
Conventional Surgery Options
If your pancreatic or biliary condition can't be treated endoscopically or through other minimally invasive techniques, your doctor may consider a more conventional surgical option as part of your treatment, such as:
- Gallbladder removal: One of the most common surgeries performed, laparoscopic cholecystectomy (gallbladder removal) is done when gallstones, which typically go away on their own, begin to cause pain or bring about other symptoms of discomfort. Recovery times are much shorter than with traditional surgical gallbladder removal.
- Pancreatic cancer surgery: Surgery (resection) is the only way to cure pancreatic cancer, though not all pancreatic cancers can be operated on. Cedars-Sinai is one of only a few medical centers using advanced laparoscopic procedures for pancreas and liver resection.
- Pancreas surgery: Surgically draining the pancreatic ducts can relieve pain in about one-third of patients with chronic pancreatitis. Other surgical procedures combine duct drainage with resection (cutting away of the pancreas head). Some patients may need to have the pancreas removed completely. In some cases, pancreatic transplantation may be an option.
Preparing for Your Procedure
Knowing what will happen before, during and after your procedure will help you feel more prepared. Every procedure is different, so ask your gastroenterologist or surgeon about the details. Some of the things you'll want to discuss are:
- Whether you should stop taking certain medications or nutritional supplements days or weeks ahead of your procedure.
- How far ahead of time you need to stop eating and drinking, and whether any additional prep is needed.
- What kind of procedure you'll have. Many pancreatic/biliary conditions can be treated with noninvasive or minimally invasive procedures, so you may not need to prepare for conventional surgery, although some minimally invasive procedures can end up converting to conventional surgery once they are underway.
- How long your procedure is expected to take.
- What the possible complications are, even if they're uncommon.
- If you'll need to stay in the hospital afterward.
- If you aren't staying overnight in the hospital, you will need to arrange for someone to take you home after the procedure. (You will receive sedative medications and will not be allowed to drive yourself.) If you are planning to take a taxi or ride-share service, a family member or friend must accompany you.
- How much recovery time and ongoing care you'll likely need when you return home.
In addition to diagnosis and treatment for pancreatic and biliary tract diseases, Cedars-Sinai offers a variety of programs to support patients and their families.
- Genetic counseling. Certain types of cancers and chronic diseases run in families. Knowing your genetic profile can help you take action to minimize risk and understand how to manage an inherited disease should it occur, as well as helping your close family understand their risks.
- Pain management. Chronic pancreatitis and pancreatic cancer can cause a great deal of pain, though the severity varies. Pancreatic cancer pain can be especially resistant to treatment. The Interventional Pain Management Program at the Cedars-Sinai Pain Center can provide some alternatives through its advanced pain therapies.
- Supportive care. For help dealing with a terminal diagnosis, many patients and family members turn to counseling to learn skills for coping with pain and illness.