• Departments & Services
• For Patients
• Research & Trials
• Education
• Find a Doctor

The Penn Pancreatic & Biliary Center

One of the highest volume pancreatic & biliary care centers in the country

May/June 2007

An estimated 32,180 people in the United States were diagnosed with pancreatic cancer in 2005, according to the American Cancer Society. Unfortunately, the disease is often associated with a high mortality rate. The ACS estimates the 5-year survival rate is about 4 percent. For many patients, surgical resection is a treatment option and successful pancreatic cancer surgery requires accurate diagnosis and preoperative staging. At the Penn Pancreatic and Biliary Center, physician clinicians and researchers are advancing the field to offer the best possible patient outcomes.

“We have recently published our experience which is remarkable for a 5-year survival rate of 19 percent for those who are eligible for surgical resection,” says Michael Kochman, MD, Penn's co-director of gastrointestinal oncology. More recent data would suggest that even better long-term survivals are being seen in pancreatic cancer patients who have surgery, radiation therapy and chemotherapy at Penn.

Advanced Therapeutic Endoscopy Team
For pancreatic cancer and other benign and malignant pancreatic and biliary diseases, endoscopic ultrasound (EUS) has become an important tool. At Penn, specialized endoscopic techniques such as EUS and endoscopic retrograde cholangiopancreatography (ERCP) are the norm.

“Our EUS program is one of the most widely recognized and largest volume programs in the country,” says Jeffrey Drebin, MD, professor and chief of gastrointestinal surgery and a member of the Penn Pancreatic and Biliary Center. “This collective experience enables us to perform EUS-guided biopsy permitting major pancreatic resection with low morbidity as well as resection for neoplastic cysts.”

Established in 1993, the Penn EUS program has grown to be “the largest and most experienced in the region,” continues Dr. Kochman, one of the physicians who originally helped develop the technique, and who now performs these procedures along with his colleagues Nuzhat Ahmad, MD, and Gregory Ginsberg, MD.

“We've demonstrated highly accurate diagnosis and staging of pancreatic adenocarcinoma through the use of EUS and fine-needle biopsy to confirm and establish the diagnosis,” says Dr. Ginsberg, director of endoscopic services at the Hospital of the University of Pennsylvania. “We are one of the most highly regarded centers in the world for application of and training in EUS for digestive diseases and
related disorders.”

Backed by NCI-designated Care
Further, pancreatic cancer patients are also supported by physicians and staff from the Abramson Cancer Center of the University of Pennsylvania, one of a select group of cancer centers in the country awarded the prestigious designation of Comprehensive Cancer Center by the National Cancer Institute (NCI).

"We offer a multidisciplinary approach that includes gastroenterologists, diagnostic radiologists, interventional radiologists, and medical and radiation oncologists, in addition to expert surgeons,” says Dr. Drebin. “Our physicians regularly engage in collaborative team meetings to review cases and ensure that the individualized treatment plan offers the best possible options for the patient.”

Among the Lowest Mortality Rates
At Penn, mortality rates are below 1 percent for pancreatic surgery – much lower than mortality rates at most other institutions in the country. Pancreatic surgery is clinically difficult and positive outcomes correlate to high surgical volume; the more experienced the surgeon and the more experienced the center, the better the likelihood of success.

The Penn Pancreatic and Biliary Center is actually the highest volume pancreas cancer center in the Philadelphia region and among the top 10 in the United States. This surgical experience combined with the leading edge research currently performed at the center is a significant advantage for patients.

The Latest Treatments
Among the newest advances for pancreatic cancer patients, Penn surgeons are developing protocols to convert locally advanced tumors into resectable tumors using novel chemotherapies and chemoradiation. “These are state-of-the-art techniques that are clinically available now,” says Dr. Drebin.

In addition, Penn offers the latest, most advanced treatments for patients presenting with chronic pancreatitis; bile duct strictures/injuries; and cystic neoplasms and pseudocysts of the pancreas. Diagnosis of chronic pancreatitis, for example, can be difficult. However, Penn's gastroenterologists expertly use EUS to detect early and subtle changes in the pancreas which could also be a concern in early pancreatic carcinoma.

“We have one of the largest screening programs in the country for those who have significant family histories of pancreatic carcinoma,” says Dr. Kochman. For those patients who require it, the center's surgeons offer options ranging from traditional, such as pancreaticojejunostomy, to novel procedures, including the Frey procedure. A relatively new surgical treatment, the Frey procedure involves local resection of the pancreatic head combined with lateral pancreaticojejunostomy.

“We also offer programmatic evaluation and management of acute and chronic pancreatitis including enhanced imaging techniques such as MRI and EUS,” says Dr. Ginsberg. “Accurate diagnosis and management are central to treatment planning and having such an experienced team further helps us offer the best possible options to our patients.” Treatment options may include repairing bile duct injuries and leaks with stents or performing surgical repairs as appropriate. The center's surgeons have additional expertise in liver resection, a more difficult and unusual measure that can be taken to repair bile duct injuries and may also involve the liver transplant surgeons as needed.

Your Partner in Patient Care
For physicians with patients who might be helped by the Penn Pancreatic and Biliary Center, Dr. Drebin says: “We have one basic goal and that is to help you care for your patients and help them achieve the best possible outcomes. If you have questions or need a consult on a case, we are here to help. You have direct access to our staff throughout the patient's course of care.”

For more information about the Penn Pancreatic and Biliary Center or to refer a patient, call Penn's physician referral line, PENNHealth, at 1-800-789-PENN.

	Referring Physicians: To speak with a Penn physician or refer a patient, contact PennHealth through the secure online referral form or by calling 1-800-789-PENN (7366).