Pancreas and Liver Disease Program

Diseases and tumors of the pancreas and liver require special evaluation and management. Mary Washington Healthcare has a special team of physicians and providers who have additional training, interest and experience in managing liver and pancreatic disease. This team includes specialists from Gastroenterology, Surgical Oncology, Diagnostic Radiology, Interventional Radiology, Medical Oncology, Radiation Oncology and Nutritional Medicine. The team also includes specialized nursing and other supportive services.

These team members comprise the core of the Mary Washington Healthcare Pancreas and Liver Disease Program. The team has experience with the following:

Benign tumors of the liver, such as adenoma and focal nodular hyperplasia.
Malignant tumors of the liver, including primary hepatocellular carcinoma, metastatic colon cancer and metastatic liver tumors from other organ sites.
Malignant tumors of the bile ducts.
Surgical management of complex gallstone disease.
Adenocarcinoma of the pancreas.
Neuroendocrine tumors of the pancreas, both benign and malignant.
Pre-malignant tumors and cysts of the pancreas.
Pancreatic pseudocysts and chronic pancreatitis.

Special expertise in surgical procedures to treat the above conditions include:

Pancreatico-duodenctomy (Whipple operation).
Distal pancreatectomy.
Laparoscopic pancreatectomy.
Liver resection, both open and laparoscopic.
Resection and reconstruction of the bile duct system.

The Gastroenterology and Interventional Radiology teams also specialize in diagnostic and therapeutic procedures of the liver and pancreas:

Complex endoscopic management, including endoscopic ultrasound (EUS), endoscopic retrograde pancreatography (ERCP), bile duct stenting, endoscopic biopsy and endoscopic cyst-gastrostomy.
Microwave and radiofrequency ablation of liver tumors.
Radioembolization (Yttrium-90) ablation of liver tumors.
Chemoembolization of liver tumors.
Percutaneous transhepatic cholangiography and stent placement.

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Specialists from Radiation Oncology also use radiation treatment selectively in the management of these diseases, particularly pancreatic cancer.

Nutritional Medicine specialists assist with the important nutritional support of these patients, both before and after surgery. Nutritional support is important in getting these patients through the complex procedures, and diseases of these organs frequently poses problems with malnutrition as part of the disease process itself.

Other important support is provided by specialized nursing for all these procedures, and by the oncology nurse navigators, who assist patients with the many appointments and procedures that these patients require during their evaluation and treatment.