Pancreas Disorders

Our gastroenterology team specializes in disorders that can harm the pancreas and disrupt its ability to help digest food. These include:

• Acute pancreatitis, a sudden inflammation of the pancreas. Although attacks are commonly caused by gallstones or alcohol abuse, in many cases the cause is uncertain. With proper medical care you may avoid potentially life-threatening complications, including lung or kidney failure, and prevent future attacks.
• Chronic pancreatitis, long-term inflammation that permanently damages the pancreas and increases your cancer risk. There is no cure for chronic pancreatitis, but the sooner you’re diagnosed the sooner you can get life-changing care. We offer treatments to relieve pain and lower your risk of problems such as malnutrition, diabetes, and bone fractures.
• Pancreatic cysts, fluid-filled sacs that grow on or in your pancreas. Some cysts are harmless, but others may become cancerous. If your type of cyst increases your risk for pancreatic cancer, we’ll create a plan for careful monitoring.
• Gallstones, hardened clumps of digestive fluid that form in the gallbladder. If gallstones grow, they can block the pancreatic duct and cause pancreatitis.

Some pancreas disorders, including diabetes and islet cell tumors, require care from hormone specialists, called endocrinologists. If you need endocrinology care, you can be confident in knowing Duke offers innovative medical and surgical treatments for most pancreatic endocrine problems.

Our goal is to diagnose your condition accurately and early. This may involve one or more of the following tests:

Endoscopic Pancreatic Function Test

Duke is one of a few health systems in the country to offer this minimally invasive test, considered the gold standard for diagnosing chronic pancreatitis. It detects damage by assessing whether your pancreas responds to a hormone called secretin. Your doctor injects secretin into your blood and collects the juices that are produced in your small intestines. This test can sometimes identify pancreatic inflammation years before it would appear in imaging tests.

Endoscopic Ultrasound (EUS)

EUS helps diagnose chronic pancreatitis, cysts, cancer, and other pancreatic disorders. Your doctor guides an endoscope fitted with a camera and ultrasound probe through your mouth and down your digestive tract. It captures high-quality images of your esophagus, stomach, pancreas, and surrounding tissue. During the exam, your doctor can also take tissue or fluid samples (biopsies).

Endoscopic Retrograde Cholangiopancreatography (ERCP)

This procedure combines endoscopy with a type of X-ray imaging called fluoroscopy. It allows your doctor to examine your pancreatic ducts and bile ducts.

Advanced Imaging

Imaging tests including CT and MRI help assess the extent of damage within your pancreas. They can also help diagnose conditions that increase your risk of pancreatitis, including gallstones and bile duct obstruction.​

One or more of the following may be part of your personalized treatment plan:

ERCP

ERCP is used for both diagnosis and treatment. By passing tiny tools through an endoscope, your doctor can open blocked or narrowed ducts by breaking up or removing gallstones, removing tumors, or inserting small plastic or metal tubes called stents.

Surgery

Duke offers surgical procedures to help prevent or treat pancreas disorders, including gallbladder removal and surgery to widen or bypass clogged ducts. Whenever possible, we use a minimally invasive approach to reduce pain and shorten recovery time.

Biliary Drainage and Stenting

Our interventional radiologists use tubes or stents to clear blockages, open narrowed ducts, or drain excess fluid from the biliary ducts.

A Team of Experts
Our gastroenterologists, radiologists, and surgeons specialize in pancreas and bile duct disorders, bringing extensive training and experience to your care. 

A Supportive Approach 
Living with a pancreas disorder can be challenging, but with the right medical and supportive care you can enjoy a full, productive life. Our team includes experts who specialize in pain management, nutrition, integrative medicine, and behavioral health.

Research-Driven Care
Our doctors participate in scientific research that may help improve the way we diagnose and treat pancreas disorders. Our team includes researchers who are working to understand the biology of pancreatic cysts, and doctors who are part of a clinical trial testing an experimental therapy for chronic pancreatitis. 

Leaders in Pancreatic Cancer Care
People with certain pancreas disorders have a higher risk of developing pancreatic cancer. Our oncologists and surgeons treat some of the highest numbers of pancreatic cancer patients in North Carolina. We’re also nationally recognized for our use of advanced imaging, including endoscopic ultrasound, to diagnose pancreatic cancer at the earliest possible stage.

National Recognition
We’ve been named a Center of Excellence by the National Pancreas Foundation, an advocacy group that funds research and supports people with pancreas disorders. We’re one of roughly 60 health systems in the country -- and only two in North Carolina -- to earn this designation. It confirms we offer comprehensive care with a focus on the best possible outcomes and an improved quality of life.

We Bring Care to the Community
Through our partnership with the National Pancreas Foundation’s North Carolina Chapter, Duke hosts free educational and networking events for families affected by pancreas disorders. Our annual workshop gives patients the opportunity to learn from pancreas experts, find local resources, and meet other people affected by pancreatic disease.