Transplant and Hepato-Pancreato-Biliary (HPB) Institute

Skip to main content

HPB Site Menu

 Verity Health
   Transplant and Hepato-Pancreato-Biliary (HPB) Institute

Pancreatic Cancers

Program Directors

The Multidisciplinary Team

In order to successfully guide you through the process, we have a full team of specialists to meet all of your medical and social needs. These include:

  • Surgeon
  • Oncologists
  • Nurse Coordinators
  • Social Workers
  • Registered Dieticians
  • Pharmacists
  • Financial Counselors

Our mission is to provide you state-of-the art treatment that is customized to your specific needs. We provide:

  1. Trans-disciplinary Care: Our Institute consists of oncologists, surgeons, gastroenterologists, hepatologists, radiologists, and anesthesiologists working closely together to give you speedy and cutting-edge care. Oftentimes you will see multiple doctors in a single clinic visit!

  2. Breakthrough Technology: Our state-of-the art technologies allow our doctors to give you the latest breakthroughs, whether that be surgical equipment, clinical trials, or cancer vaccines.

  3. Attention to the Whole Patient: Because your journey may require the expertise of multiple specialties, we provide psychologists, patient educators, social workers, dieticians, and financial counsellors to meet with who can actively participate in your care.

Brochure

Our campuses are located near downtown Los Angeles, Orange County, and Bakersfield.

SVMC Building

St. Vincent Medical Center

2131 West Third Street
Los Angeles, CA 90057
(213) 484-7111
SVMCInfo@verity.org

Campus Map | Parking


Monday - Friday | Open 24 hours
Saturday - Sunday | Open 24 hours

St. Vincent Medical Center is located at the corner of Third and Alvarado streets in downtown Los Angeles.

  • From the South: Take the Harbor 110 Freeway north, exit at Third Street and proceed west approximately two miles to Alvarado Street. The medical center is on the corner of Third and Alvarado streets.
  • From the North: Take the Hollywood 101 Freeway south, exit at Alvarado Street, proceed south on Alvarado 3/4 of a mile. The medical center is on the corner of Third and Alvarado streets.
  • From the West: Take the Santa Monica 10 Freeway to the Harbor 110 Freeway north, exit at Third Street and proceed west approximately two miles to Alvarado Street.
  • From the East: Take the San Bernardino 10 Freeway to the Harbor 110 Freeway north exit at Third Street and proceed west approximately two miles to Alvarado Street.
SFMC Building

St. Francis Medical Center

3630 East Imperial Highway
Lynwood, CA 90262
(310) 900-8900

Campus Map | Parking Info


Hours

Visiting Hours

Mariposa Clinic
Chan Soon-Shiong Institute for Medicine

2040 E Mariposa Ave
El Segundo, CA 90245
(855) 797-9277
info@CSSIFM.org


Hours

8 AM - 6 PM

We are not currently accepting walk-ins. Please call to schedule an appointment.

Laguna Hills Clinic
Chan Soon-Shiong Institute for Medicine

23961 Calle De La Magdalena, Suite 130
Laguna Hills, CA 92653
(855) 797-9277


Hours

8 AM - 6 PM

We are not currently accepting walk-ins. Please call to schedule an appointment.

Bakersfield building

Bakersfield Satellite

8501 Camino Media, Suite 100
Bakersfield, CA 93311
(661) 665-1500


Monday - Friday | 8 AM - 3 PM
Saturday - Sunday | Closed

A diagnosis of pancreatic tumor can be difficult and complex to understand and navigate. Our mission is to stand by you and walk with you every step of the way. While every patient’s journey is different, and may start at different paths, a typical journey consists of:


Referral

Occurs when your regular doctors identify the need to consult with our Institute and refer you to us.

Workup

Includes all the labs, imaging studies, and procedures required to make a diagnosis.

Tumor Board

A discussion about your care held by your treatment team at our Institute. After discussion, a recommendation is made about treatment options.

Treatment

Can include a variety of treatments customized to you! Typical treatments include surgery, chemotherapy, radiation, or clinical trial.

Surveillance

Occurs after treatment is complete, and usually consists of imaging studies, labs, and examinations to make sure you are treated.

Journey

Your pancreas is located in your upper abdomen, behind your stomach and on top of your spine. It is divided into 3 parts: the head, which is located next to the small intestine, the body, and the tail, which is close to your spleen.

The pancreas has 2 main functions:

  1. Production of juices to help digest food.
  2. Production of hormones, like insulin.

Pancreas system
Pancreas

Problems with your Pancreas

Diseases of the pancreas can present with a variety of symptoms including abdominal pain, diarrhea, diabetes, or jaundice (yellowing of the eyes and skin).


Animated pancreas
Pancreatitis

Pancreatitis

Pancreatitis occurs when the pancreas becomes inflamed, which can be due to a variety of sources including alcohol use, gallstones, or medications.

  • About Pancreatitis

    What is pancreatitis?

    Pancreatitis is inflammation of your pancreas which can cause leakage of pancreatic fluid into other parts of the pancreas or surrounding areas.

    What are the signs and symptoms of pancreatitis?

    Pancreatitis often presents with sudden severe pain in your upper belly. You may also experience nausea, vomiting, fevers, chills and upper back pain.

    Why do I get pancreatitis?

    The most common causes of pancreatitis are gallstones and alcohol. Other, less common reasons are certain medications and diseases that run in your family. If you have one sudden attack, you have acute pancreatitis. Multiple attacks are called chronic pancreatitis, and lead to permanent damage of your pancreas and its function.

  • Diagnosis of Pancreatitis

    How is pancreatitis diagnosed?

    If you have symptoms of pancreatitis, your doctor may order blood tests or scans of your abdomen. Sometimes you may also need a procedure.

    Blood tests

    • Your doctor may check blood tests to look for an infection and check he function of your liver and pancreas.
    Blood Tests

    Imaging

    • Abdominal Ultrasound to look for gallstones in your gallbladder.
    • CT or MRI scan of your belly (or of the abdomen and pelvis) to look for gallstones and inflammation of the pancreas.
    Imaging

    Procedures

    • An Endoscopic Retrograde Cholangiopancreatography (ERCP) can remove gallstones that cause pancreatitis. Your doctor can perform and ultrasound at the same time called EUS, which can look at your pancreas.
    ERCP
  • Treatment of Pancreatitis

    How is pancreatitis treated?

    • Hospital admission and supportive care
    • Surgery for Pancreatitis

    Hospital Admission

    Some patients with pancreatitis have to be admitted to the hospital. You will receive intravenous fluids and pain medications until your pain has gone away.

    Some patients have more severe episodes of pancreatitis and might spend some time in the intensive care unit. Sometimes the treatment involves not eating which may require a feeding tube through your nose into your intestines until you get better.

     

    Surgery for Pancreatitis

    If you have gallstones, your gallbladder will be removed with an operation called a laparoscopic cholecystectomy after you have recovered from pancreatitis.

    Remove Gallbladder
    Gallbladder

    If your pancreas has been severely damaged, you can develop a pocket of fluid or infection which may require an endoscopy procedure or a surgery to drain it.



Darkspots in pancreas

Pancreatic Cysts

Pancreatic cysts are usually benign, but can sometimes lead to problems which require treatment. Some cysts can have the potential to turn into cancer.

  • Pancreatic Cysts

    What are pancreatic cysts?

    Pancreatic cysts are fluid filled masses within the pancreas. They can appear after an attack of pancreatitis, or found on A CT scan. Since some cysts are pre- cancers, accurate diagnosis is very important.

    What are the signs and symptoms of pancreatic cysts?

    Most pancreatic cysts are silent, but patients may experience:

    • Upper belly or back pain
    • Nausea/Vomiting
    • Acute onset of Diabetes

    What is my risk for getting pancreatic cysts?

    Pancreatic Pseudocysts can develop after an attack of pancreatitis. Mucinous Neoplasms of the pancreas have been linked to diabetes and chronic pancreatitis. They are sometimes more common in patients with a family history of pancreatic cancer.

    Pancreas Cyst

    Cysts We Treat

    • Pseudocysts
    • Serous cystadenomas
    • Mucinous Cystic neoplasms (MCN)
    • Intraductal Mucinous Neoplasms (IPMN)
    • Cystic Islet cell tumors
  • Diagnosis of Pancreatic Cysts

    How are pancreatic cysts diagnosed?

    If you have any symptoms of a pancreatic cyst, your doctor will order blood tests and pictures (imaging) of your belly. You will also need a biopsy to confirm the diagnosis.

    Blood tests

    • Blood counts and liver function tests
    • Ca19-9 and CEA levels. These blood tests are called “tumor markers,” and are often ordered, when patients have a “mass” in the pancreas.
    Blood Tests

    Imaging

    • CT or MRI scan of your belly (or of the abdomen and pelvis) to look at the cyst in the pancreas. Often cysts are discovered on a CT scan, which was done for a different reason. This test will allow your doctor to evaluate, if your cyst needs to be removed with surgery
    Imaging

    Procedures

    • Endoscopic Ultrasound (EUS): Your doctor inserts a camera into your intestines through your mouth, so your pancreas can be seen. Usually a needle biopsy and some fluid is taken for analysis.
    ERCP
  • Treatment of Pancreatic Cysts

    How are pancreatic cysts treated?

    TIf you have a cysts which is concerning for cancer, you will be presented in our multidisciplinary tumor board, where your doctors will discuss your case. You might need to have your cyst removed with surgery. If surgery is not recommended, your doctor may repeat evaluation every 3-6 months to follow the cyst.

    How are pancreatic cysts from pancreatitis treated?

    If you have a pancreatic cyst due to pancreatitis, you might not need any treatment, unless you have symtoms. If you cannot eat and your cyst does not get smaller, your doctor might recommend a procedure or surgery called cystgastrostomy.



Pancreas Tumor
Pancreatic Cancer

Pancreas Tumors

Tumors in the pancreas can be either benign or cancerous.

  • Pancreas Tumors and Pancreatic Cancer

    What is pancreatic cancer?

    Pancreatic Cancer occurs when the cells of the pancreas grow out of control. The pancreas has cells that form ducts and cells that produce hormones like insulin. Both types of cells can turn into cancer cells.

    Ampullary

    What are the signs and symptoms of pancreatic cancer?

    Pancreatic Cancer is often silent in early stages. Patients may present with:

    • Abdominal and back pain
    • Poor appetite, nausea, vomiting, weight loss
    • Jaundice (yellow skin and eyes)
    • Bowel blockage
    • High blood sugars and Diabetes

    What is my risk for getting pancreatic cancer?

    Smoking, diabetes, obesity and pancreatitis increase your risk of getting pancreatic cancer. There are diseases that run in families, which increase the risk of pancreatic cancer.

    Pancreatic Cancer

    Tumors We Treat

    Cancers

    Pre-Cancers

  • Diagnosis of Pancreatic Cancer

    How is pancreatic cancer diagnosed?

    If you have any symptoms of pancreatic cancer, your doctor may order blood tests and pictures (imaging) of your belly. You will also need a biopsy to confirm the diagnosis.

    Blood tests

    • Complete blood count (CBC) to check your blood count.
    • Comprehensive Metabolic Panel (CMP) to check your electrolytes and liver function.
    • Ca19-9 and CEA levels. These blood tests are called “tumor markers,” and will give your doctor a chance to follow your response to treatment.
    Blood Tests

    Imaging

    • CT or MRI scan of your belly (or of the abdomen and pelvis) to look for a mass in the pancreas. This test will allow your doctor to evaluate, if your tumor can be removed with surgery.
    Imaging

    Procedures

    • Endoscopic Ultrasound (EUS): Your doctor inserts a camera into your intestines through your mouth, so your pancreas can be seen. Usually a small needle biopsy is taken at that time for diagnosis.
    • An Endoscopic Retrograde Cholangiopancreatography (ERCP) is another form of endoscopy that allows your doctor to place a stent into the bile duct for patients with jaundice. This can be done at the same time as the EUS.
    ERCP
  • Treatment of Pancreatic Tumors and Cancer

    How is pancreatic cancer treated?

    The treatment of pancreatic cancer depends on the stage of the tumor, and involves a multidisciplinary team of doctors, nurses and medical support staff:

    • Medical Oncology
    • Gastroenterology
    • Surgery
    • Radiation
    • Dietary and Social work, Palliative care.

    Every patient seen here will be presented in our multidisciplinary tumor board, where we will devise your individual treatment plan. This plan may include:

    We strongly encourage and support all of our patients to participate in clinical trials. We are happy to talk to you about clinical trials during your clinic visit.

Cystgastrostomy

A cystgastrostomy is a procedure or surgery, which allows the fluid from your pancreatic cyst to drain into the stomach.

This can be done by your gastroenterologist during endoscopy or surgeon with laparoscopic surgery. A small hole will be made in your stomach right over the cyst, and the edge of the stomach and cyst will be sewn together. You will be able to eat and drink normally after your surgery.

Radiation Therapy

Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is therapy using ionizing radiation, generally as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator.

Chemotherapy

Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardized chemotherapy regimen. Chemotherapy may be given with a curative intent, or it may aim to prolong life or to reduce symptoms.

Multidisciplinary Tumor Board

A Multidisciplinary Tumor Board is a team of doctors and nurses who discuss your individual case to recommend the best treatment options for you based on your specific information. The members of Tumor Board include:

  • Surgeons
  • Oncologists
  • Radiologists
  • Pathologists
  • Gastroenterologists
Tumor Board
Tumor Board Meeting

When does Tumor Board meet?

Usually once a week

When will I be presented at Tumor Board?

The Tumor Board needs to have the latest imaging available to make accurate recommendations. Patients are typically presented after all of the appropriate tests are completed.

Am I allowed to participate in Tumor Board?

Because multiple patients are presented at a single Tumor Board, having patients attend is discouraged for privacy concerns. However, you will learn the recommendations of the Tumor Board at your next clinical appointment.

Cholecystectomy

cholecystectomy

Patients, who have recovered from pancreatitis due to gallstones, may need to have their gallbladder removed surgically. The procedure is called a cholecystectomy, and can be done with a camera and small incisions (laparoscopic) or through a larger cut (open). During the operation the cystic duct and artery have to be clipped and cut. The gallbladder will be separated from the liver, and removed.

Patients can usually leave the hospital the day after the operation after laparoscopic surgery. They able to eat a regular diet, and will be given medication for pain at their incision (cut).

Pancreatic Surgery

If surgery is part of your treatment plan, your doctor will likely suggest one of two surgical procedures:


Whipple Procedure
(also called Pancreaticoduodenectomy)

Before whipple
Before
after whipple
After

During surgery, the head of the pancreas, the gallbladder, the first part of the bowel called the duodenum, part of the stomach and bile duct are removed. New connections called “anastomoses” are made between the bile duct and the bowel, the pancreas and the bowel and the stomach and the bowel. These new connections are necessary for you to eat and digest your food.


Distal Pancreatectomy

The body or tail of the pancreas and the spleen are removed. No new connections or “anastomoses” are made. You will need vaccinations before surgery, because your spleen usually eliminates certain types of bacteria.

distal pancreatectomy

Vein resection and reconstruction

If your tumor grows into the portal vein, which is the main blood vessel to liver passing behind the pancreas, your surgeon might have to remove a small piece, when removing a tumor. The portal vein can be repaired.

venin resection and reconstruction
Vein Resection & Reconstruction

Insulinoma

This is a tumor of pancreatic island cells, which make insulin. Insulin controls the blood sugar. If there is too much insulin in the blood, the blood sugar will drop to a dangerously low level. Most insulinomas are benign (not cancer). Some are associated with a genetic disease called MEN 1. Those tumors have a higher chance of being a cancer (malignant).

Signs and symptoms

Patients with an insulinoma may feel light-headed, confused, weak, sweaty, always hungry and have blurry vision.

Diagnosis

In addition to the workup for any pancreatic tumor, there is a specific blood test for an insulinoma. The patient’s blood will be checked for blood sugar and insulin levels after fasting for at least 24 hours.

Treatment

Insulinomas will always be removed by surgery, even if they have spread beyond the pancreas. If the tumor is small, it can be enucleated.

Enucleation means that only the part of the pancreas containing the tumor will be removed. This is almost always done by laparoscopy, which involves a camera and surgical instruments being inserted into the abdomen through small cuts. The tumor can be taken out of the abdomen through one of these small incisions.

For larger tumors in the head or tail of the pancreas, that patient will need a Whipple procedure or distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

Glucagonoma

This is a tumor of the islet cells that make Glucagon. Glucagon helps regulate the blood sugar by releasing sugar into the blood. Patients with excess glucagon will have a high blood sugar (hyperglycemia), which cannot be controlled with medication. Glucagonomas are often malignant (cancer).

Signs and symptoms

Patients with a glucagonoma can have a rash on their arms and legs, blood clots in their legs or lungs and experience all the effects of having a high blood sugar such as extreme thirst, dry mouth and skin, frequent urination, weakness and fatigue.

Diagnosis

In addition to the standard workup for a pancreatic tumor, glucagon levels can be measured in the blood after at least 8 hours of fasting.

Treatment

Glucagonomas will be removed with surgery. Patients with a tumor in the head of the pancreas need a Whipple procedure and in the body or tail of the pancreas a distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

Somatostatinoma

This is a tumor of the islet cells that make somatostatin, which plays an important role in regulating blood sugar and other aspects of digestion. Somatostatinomas are often malignant.

Signs and symptoms

Patients with a somatostatinoma can experience all the effects of having a high blood sugar such as extreme thirst, dry mouth and skin, frequent urination, weakness and fatigue. They may have diarrhea, foul-smelling, fatty stools (steathorrhea) and gallstones.

Diagnosis

In addition to the standard workup for a pancreatic tumor, somatostatin levels can be measured in the blood after at least 8 hours of fasting. A special imaging test called an octreotide scan can be helpful, when a small tumor cannot be found on CT scan, MRI or Endoscopic Ultrasound.

Treatment

Somatostatinomas will be removed with surgery. Patients with a tumor in the head of the pancreas need a Whipple procedure and in the body or tail of the pancreas a distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

Gastrinoma

This is a tumor of the islet cells that make gastrin. Gastrin stimulates the stomach to release acid, which helps with the digestion of food. Patients with too much gastrin and acid will have diarrhea and stomach ulcers. Gastrinomas are often malignant (cancer) and the most common pancreas tumors in patients with a genetic disease called MEN1.

Gastrinoma

Signs and symptoms

Patients with gastrinoma can have ulcers that cannot be treated with medication, acid reflux diarrhea and abdominal and back pain.

Diagnosis

In addition to the standard workup for pancreatic tumors, gastrin levels in the blood can be measured after fasting for at least 8 hours. A hormone named secretin can be given, and the amount of acid in the stomach can be measured, if the gastrin blood test is not conclusive. A special imaging test called an octreotide scan can be helpful, when a small tumor cannot be found on CT scan, MRI or Endoscopic Ultrasound.

Treatment

Gastrinomas will be removed with surgery. Patients with a tumor in the head of the pancreas need a Whipple procedure and in the body or tail of the pancreas a distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

VIPomas

This is a tumor of the islet cells that make vasoactive intestinal peptide (VIP), which plays an important role in regulating other hormones and the body’s salt and water balance in digestions. VIPomas are often malignant.

Signs and symptoms

Patients with a Vipoma will have watery diarrhea and dehydration. The potassium levels in the blood will be low, and they may experience muscle weakness, cramps, tingling or numbness.

Diagnosis

In addition to the standard workup for a pancreatic tumor, VIP levels can be measured in the blood. While potassium will be low in the blood, potassium and sodium will be high in the stool.

Treatment

Somatostatinomnas will be removed with surgery. Patients with a tumor in the head of the pancreas need a Whipple procedure and in the body or tail of the pancreas a distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

Nonfunctioning Pancreatic Neuroendocrine Tumors

Pancreatic neuroendocrine tumors, which arise from islet cells, but do not make hormones are called nonfunctional. They represent the majority of pancreatic neuroendocrine tumors, and can be benign (not cancer) or malignant (cancer).

Signs and symptoms

Patients with nonfunctioning pancreatic neuroendocrine tumors can have vague symptoms such as diarrhea, indigestion abdominal and back pain, which worsen as the tumor grows in size. If the tumor is in the head of the pancreas, patients may become jaundiced.

Diagnosis

In addition to the standard workup for a pancreatic tumor, the patient’s blood will be checked for chromogranin A levels.

Treatment

Nonfunctioning pancreatic neuroendocrine tumors will be removed with surgery. Patients with a tumor in the head of the pancreas need a Whipple procedure and in the body or tail of the pancreas a distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

Surgical removal of the tumor in the pancreas might also be recommended, if patients have metastases in other organs i.e. the liver.

Cystic Neoplasms of the Pancreas

Cystic neoplasms of the pancreas are different types of fluid-filled masses, which are benign (not cancer), but can become cancer over time. The type of cystic neoplasm is important for treatment.

These are the different types:

  • Intraductal mucinous neoplasm (IPMN): This tumor s associated with the tubes (ducts) in the pancreas, which transport digestive juices to the intestine. The fluid is thick and called mucin. IPMN can become cancer.
  • Mucinous cystic neoplasm (MCN): This tumor is in the pancreas, but not associated with ducts. It is filled with mucin. MCN can become cancer.
  • Serous cystic neoplasm (SCN): This tumor is in the pancreas, but not associated with ducts. It is filled with thin (serous) fluid. SCN can become cancer.
  • Solid pseudopapillary tumor: This tumor can occur anywhere in the pancreas, and is dense and not always fluid-filled. It occurs more common in young women. It is not cancer, but can become cancer.

Signs and Symptoms

Most cystic neoplasms do not cause any symptoms, and are discovered by chance, when patients get a CT scan, MRI or ultrasound for another reason. As they grow, these tumors can cause pain, yellowing of the skin and diabetes.

Treatment

The patient’s care team will recommend if the pancreatic cyst needs to be removed. Patients with a tumor in the head of the pancreas need a Whipple procedure and in the body or tail of the pancreas a distal pancreatectomy.

What is a Whipple Procedure?

The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation.

Distal Pancreatectomy

A distal pancreatectomy (pan-krea-tek-tuh-me) is a surgery that removes a tumor from the body or tail of your pancreas.

Pseudocysts

Pancreatic pseudocysts are fluid filled masses in the pancreas. They form as a result of injury to the pancreas after acute pancreatitis.

Signs and Symptoms

Large pseudocysts can cause pain and difficulty eating. When pseudocysts get infected, patients present with fevers, chills and low blood pressure, and require immediate treatment.

Treatment

Most pancreatic pseudocyst cause no symptoms, and require no treatment. If a cyst does not resolve without treatment, patients may require a cystgastrostomy. Infected pseudocysts are treated with antibiotics and need to be drained like an abscess.

A cystgastrostomy is a procedure or surgery, which allows the fluid from your pancreatic cyst to drain into the stomach.

This can be done by your gastroenterologist during endoscopy or surgeon with laparoscopic surgery. A small hole will be made in your stomach right over the cyst, and the edge of the stomach and cyst will be sewn together. You will be able to eat and drink normally after your surgery.

Tara Seery, MD

Seery's photo

Tara Seery, MD
Hematology/Oncology, Director of Pancreatic Cancer Oncology

Request an appointment

 

Locations

Chan Soon-Shiong Institute for Medicine

23961 Calle De La Magdalena, Suite 130
Laguna Hills, CA 92653
(949) 770-0797
(949) 770-0730

 

Education

  • University College, Dublin School of Medicine (Dublin)
  • Caritas St. Elizabeth Medical Center (Boston, MA)
  • Caritas St. Elizabeth Medical Center (Boston, MA)
  • Caritas St. Elizabeth Medical Center (Boston, MA)
  • University of Illinois at Chicago

 

Board Certifications

  • American Board of Internal Medicine, Medical Oncology
  • American Board of Internal Medicine, Hematology
  • American Board of Internal Medicine

 

Professional Society Memberships

  • American Society of Clinical Oncology
  • American Society of Hematology
  • SWOG
  • Alliance for Clinical Trials

 

Selected Publications

  1. Villano, J.E., Seery, T.E., Bressler, L.R. Temozolomide in malignant gliomas: current use and future targets. Cancer Chemotherapy and Pharmacology, 2009 Mar; 64 (4), 647-655
  2. Seery, T.E., Ziogas, A., Lin, B., Pan, CG, Stamos, M., Zell, J. Mortality Risk After Preoperative versus Postoperative Chemotherapy and Radiotherapy in Lymph Node Positive Rectal Cancer. Journal of Gastrointestinal Surgery, 2013 Feb; 17, 374-381
  3. Tsang, W. Ziogas, A., Lin, B., Seery, T.E., Karnes, W., Stamos, M., Zell, J.  Role of Surgical Resection Among Chemotherapy-Treated Colorectal Cancer Patients with Stage IV Disease: A survival Analysis. Journal of Gastrointestinal Surgery; Mar 2014, Vol. 18 Issue 3, p592.
  4. Joon-II Choi, David Imagawa, Priya Bhosale, Puneet Bhargava, Temel Tirkes, Tara E Seery, Chandana Lall.  MRI following treatment of advanced HCC with sorafenib. Clinical and Molecular Hepatology, 2014. June; 20(2):218-222.
  5. M. Nayyar, D. Imagawa, T. Tirkes, A. Demirjian, R. Houshyar, K. Sandrasegaran, C. Nangia, T. Seery, P. Bhargava, J. Choi, C. Lall. Composite liver tumors: A Radiologic-Pathologic Correlation. Clinical and Molecular Hepatology 2014; 20:406-410.
  6. R.K. Ramanathan, S.L McDonough, H.F.Kennecke, S. Iqbal, J.C. Baranda, T. E. Seery, H.J. Lim, A. F. Hezel. G. M. Vaccaro, C. C. Blanke. A Phase II Study of MK-2206, an Allosteric Inhibitor of AKT as Second Line Therapy for Advanced Gastric and Gastroesophageal Junction Cancer, a SWOG Cooperative Group Trial (S1005). Cancer. 2015 Mar 30. Doi:10.1002/cncr.29363
  7. A. Le Rolle, S. Klempner, C. Garrett, T. Seery, E. Sanford, S. Balasubramanian, J. Ross, P. Stephenas, V. Miller, S Ali, V. Chiu.  Identification and Characterization of RET fusions in Advanced Colorectal Cancer.  Oncotarget. 2015 May 30
  8. R. Tang, T. Kain, J Herman, T. Seery. Durable Response using Regorafenib in An Elderly Patient with metastatic Colorectal Cancer: Case Report. Cancer Management and Research 2015:7 1-3.
  9. A. Grothey, J. Marshall, T. Seery. Current Options for Third Line Treatment of Metastatic Colorectal Cancer. Clinical Advances in Hematology & Oncology. Volume 14, Issue 3, Supplement 3 March 2016
  10.  V. Chung, S. McDonough, PA Philip, A. Wang-Gillam, L Hui, MA Tejani, T Seery, IA Dy, T. Al Baghdadi, AE Hendifar, LA Doyle, AM Lowy, KA Guthrie, CD Blanke, HS Hochster. Effect of Selumetinib and MK-2206 vs Oxaliplatin and Fluorouracil in Patients With Metastatic Pancreatic Cancer After Prior Therapy: SWOG S115 Study Randomized Clinical Trial. JAMA Oncol. 2016 Dec 15. Doi: 10.1001/jamaoncol.2016.5383. [Epub ahead of print]
  11. T. Seery, A. Choudhry, A Eapen, Y Cheng. Pancreatic Neuroendocrine Tumors Therapy. JOP. J Pancreas (Online) 2017 Dec 18;S(3):216-220.
  12. S. Hingorani, L. Zheng, A. Bullock, T. Seery, W. Harris, D. Sigal, F. Braiteh, P Ritch, M. zalupski, N Bahary, P Oberstein, A. Wang-Gillam, W. Wu, D. Chondros, P, Jiang, S. Khelifa, J. Pu, C. Aldrich, A. Hendifar. Halo 202: Randomized Phase II Study of PEGPH20 Plus Nab-Paclitaxel/Gemcitabine Versus Nab-Paclitaxel/Gemcitabine in Patients with  Untreated, Metastatic Pancreatic Ductal Adenocarcinoma. Journal of Clinical Oncology 36, no. 4 (February 1 2018) 359-366.

 

 

Arvind M. Shinde, MD, MBA, MPH

Shinde's photo

Arvind M. Shinde, MD, MBA, MPH
Director, Hepatopancreatobiliary (HPB) Hematology & Oncology

English, Spanish

Request an appointment

 

Locations

St. Vincent Medical Center

2200 West 3rd Street
Suite 200
Los Angeles, CA 900057

St. Francis Medical Center

3630 E Imperial Hwy
Lynwood, CA 90262

 

Education

  • University of Southern California, Los Angeles, CA
  • Cedars Sinai Medical Center/West Los Angeles Veterans Administration, Los Angeles, CA
  • Cedars Sinai Medical Center/West Los Angeles Veterans Administration, Los Angeles, CA
  • City of Hope/Harbor UCLA, Los Angeles, CA
  • UCSD/Scripps/San Diego Hospice and Institute for Palliative Medicine, San Diego, CA
  • Harvard University, Boston, MA
  • University of Southern California, Los Angeles, CA

 

Board Certifications

  • American Board of Internal Medicine - Internal Medicine
  • American Board of Internal Medicine - Medical Oncology
  • American Board of Internal Medicine - Hospice and Palliative Medicine

 

Professional Society Memberships

  • American College of Clinical Oncology
  • American Academy of Hospice and Palliative Medicine

 

Selected Publications

  1. Shinde A, Pal S, Hurria A. “Geriatric Oncology.” The American Cancer Society’s Principles of Oncology: Prevention to Survivorship. First Edition. Ed. American Cancer Society. Atlanta: John Wiley & Sons, Inc., 2018. 323-31.
  2. Gresham G, Schrack J, Gresham L, Shinde, A et al. “Wearable activity monitors in oncology trials. Current use of an emerging technology.” Contemporary Clinical Trials. 2018; 64: 13-21.
  3. Shinde A, Dashti A. “Palliative Care in Lung Cancer.” Lung Cancer. Cancer Treatment and Research. Vol 170. Ed. Reckamp K. Springer, Cham., 2016. 225-250.
  4. Gong J, Tuli R, Shinde A, Hendifar A. Meta-analyses of treatment standards for pancreatic cancer. Molecular and Clinical Oncology. 2016;4(3):315-325.
  5. Shinde AM, Zhai J, Yu KW, et al. “Pathologic complete response rates in triple-negative, HER2-positive, and hormone receptor-positive breast cancers after anthracycline-free neoadjuvant chemotherapy with carboplatin and paclitaxel with or without trastuzumab.” Breast. 2015;24(1):18-23. 
  6. O’Connor T, Shinde A, Doan C, Katheria V, Hurria A. “Managing Breast Cancer in the Older Patient.” Clinical advances in hematology & oncology. 2013;11(6):341-347.

 

 

Elise Diner PA-C

Diner's photo

Elise Diner, PA-C
Transplant & Hepatopancreatobiliary (HPB) Surgery

English

Request an appointment

 

Locations

St. Vincent Medical Center

2200 West 3rd Street
Suite 200
Los Angeles, CA 900057

St. Francis Medical Center

3630 E Imperial Hwy
Lynwood, CA 90262

Chang Soon-Shiong Institute for Medicine

2040 E Mariposa Ave
El Segundo, CA 90245

 

Education

  • University of Colorado, Boulder, CO
  • Midwestern University, Glendale, AZ

 

Board Certifications

  • National Commission on Certification of Physician Assistants

 

Professional Society Memberships

  • Americas Hepatopancreatobiliary Association
  • International Hepatopancreatobiliary Association

 

 

Jamie Taylor, MD

Taylor's photo

Jamie Taylor, MD
Director, Anesthesia/Critical Care

Request an appointment

 

Locations

St. Vincent Medical Center

2200 West 3rd Street
Suite 200
Los Angeles, CA 900057

St. Francis Medical Center

3630 E Imperial Hwy
Lynwood, CA 90262

 

Education

  • Louisiana State University School of Medicine
  • Harbor-UCLA - Anesthesiology
  • University of Pennsylvania - Critical Care Medicine

 

Board Certifications

  • Anesthesiology, Critcal Care Medicine

 

Professional Society Memberships

  • American Society of Anesthesiology
  • Society of Critical Care Medicine
  • Society of Critical Care Anesthesiologists
  • International Liver Transplant Society

 

 

Julio Gutierrez, MD

Gutierrez's photo

Julio Gutierrez, MD
Transplant Hepatology, Medical Director of Liver Transplant

English, Spanish

Request an appointment

 

Locations

St. Vincent Medical Center

2200 West 3rd Street
Suite 200
Los Angeles, CA 900057

St. Francis Medical Center

3630 E Imperial Hwy
Lynwood, CA 90262

 

Education

  • Mount Sinai School of Medicine (2007)
  • Internal Medicine, UCSD (2009)
  • Gastroenterology, UCSD (2013)
  • Transplant Hepatology, University of Miami/Jackson (2014)
  • BA, UC Berkeley (2000)
  • MS, Columbia University (2003)

Areas of Expertise

  • Cirrhosis
  • Liver Cancers
  • Ascites
  • Hepatitis C
  • Fatty Liver
  • Primary Biliary Cholangitis

 

Board Certifications

  • ABIM - Internal Medicine
  • ABIM - Gastroenterology
  • ABIM - Transplant Hepatology
  • ABOM - Obesity Medicine

 

Professional Society Memberships

  • American Society of Anesthesiology
  • Society of Critical Care Medicine
  • Society of Critical Care Anesthesiologists
  • International Liver Transplant Society

 

 

Brian Van Ness PA-C

no photo

Brian Van Ness PA-C
Anesthesia/Critical Care

Request an appointment

 

Locations

St. Vincent Medical Center

2200 West 3rd Street
Suite 200
Los Angeles, CA 900057

 

Education

  • Seton Hall University, Physician Assistant Program
  • Seton Hall University

 

Board Certifications

  • National Commission for the Certification of Physician Assistants

 

Professional Society Memberships

  • Society of Critical Care Medicine
  • Eastsern Association for the Surgery of Trauma
  • American Academy of Physician Assistants
  • California Academy of Physician Assistants
  • New Jersey State Society for Physician Assistants