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Treatments

Our Innovative and Advanced Treatment Approaches

As pioneers in hepato-pancreato-biliary surgery, our doctors perform innovative techniques including:

Minimally Invasive Pancreatectomy

Pancreatectomy is the surgical removal of all or part of the pancreas. At Johns Hopkins Medicine, several types of pancreatectomy exist:

The Whipple Procedure

The Whipple procedure, known in technical terms as a pancreaticoduodenectomy, is the operation that is necessary to remove tumors of the head and neck of the pancreas, lower portion of the bile duct, and the ampulla of Vater (a small opening that enters into the first portion of the small intestine, known as the duodenum). The operation, which can be done robotically or laparoscopically, removes the entire duodenum, the head of the pancreas, bile duct, gallbladder and surrounding lymph nodes. In the pylorus-preserving version of the Whipple procedure, the entire stomach is left behind. In the standard version of the Whipple procedure, one-third of the stomach is removed. The intestinal tract is reconnected through the pancreas, bile duct and stomach.

Snippet of the whipple procedure infographic. Click to view full infographic.
Snippet of the minimally-invasive whipple procedure infographic. Click to view full infographic.

Distal Pancreatectomy

A distal pancreatectomy is the removal of the body and tail of the pancreas. During this procedure, the head of the pancreas is left in tact.

Total Pancreatectomy

A total pancreatectomy is the removal of the entire pancreas.

Irreversible Electroporation

Irreversible electroporation (IRE) is a minimally invasive surgical procedure where inoperable tumors are destroyed by using electrical energy. This process is ideal for patients who have tumors that are close to blood vessels, nerves or ducts. During this procedure, holes are irreversibly poked in the cell membrane of the cancer tissue, causing cells to instantly die (leaving healthy tissues, structures and vessels unharmed). The IRE treatment has proven effective for liver cancer and is now being used at The Johns Hopkins Hospital for pancreatic cancer.

Minimally Invasive Liver Surgery

Currently, there are two options for minimally invasive liver surgery at Johns Hopkins, including a total laparoscopic liver resection and total robotic liver resection. The type of liver surgery offered is based on a variety of factors, such as the biology, size, and location of lesions in the liver and whether or not someone is an overall good surgical candidate. These options will be discussed with you by your surgeon and all available information will be considered before making the most appropriate decision together.
A successful minimally invasive liver resection will typically leave a patient with smaller incisions, less surgical pain, a quicker recovery and potential earlier adjuvant treatment, if needed.

Auto Islet Surgery

Auto islet surgery is used to treat pancreatitis, which usually requires a total pancreatectomy. In many cases, patients who are candidates for auto islet transplant surgery are also candidates for the laparoscopic, or minimally invasive, approach. Pancreas surgeon Marty Makary, M.D. performed the first completely laparoscopic pancreas removal with auto islet transplant in the United States. Johns Hopkins has the largest amount of experience with this type of operation in the nation. Your surgeon will determine if you are a good candidate for laparoscopic islet transplant surgery.