Diagnosis & Treatment of Pancreatic and Biliary Disorders

Our team of experts from multiple disciplines is dedicated to the diagnosis and treatment of all types of pancreas and bile duct disease, from gallstones to pancreatic cancer. Virginia Mason Franciscan Health is a high-volume pancreatitis referral center, treating 2,100 people with pancreatitis over a 10-year period with good outcomes and a focus on managing them with a team approach.

Our gastroenterologists, surgeons, interventional radiologists, hospitalists, clinical nurse specialists, and dietitians who meet regularly and work together to develop and implement quality improvement initiatives for the complex care of people with pancreatitis, particularly severe acute pancreatitis. 

Recent advances in endoscope technology give our providers the tools to visualize and diagnose pancreatic and biliary disorders in less time and with more precision. Specialized treatment protocols, along with innovative techniques done only at Virginia Mason Franciscan Health, means significantly improved outcomes for people with pancreatitis and impressive survival statistics for people with pancreatic cancer.

Virginia Mason Medical Center is the only hospital in Washington state to be named a National Pancreas Foundation Center.

Our experts diagnose and treat complex conditions of the pancreas and biliary tract every day, and you benefit from our depth of experience as a high-volume center for digestive health. Your gastroenterologist may order the following tests to better understand your symptoms:

• Blood tests may be used to test for abnormal levels of pancreatic enzymes in the blood.

• Abdominal ultrasound is a non-invasive procedure that may reveal the presence of gallstones and other blockages within the biliary tract. During this procedure, an ultrasound probe is passed over the abdomen and images are sent to a computer monitor. Abdominal ultrasound is commonly used in women who are pregnant. 

• Abdominal CT SCAN or MRI of the abdomen also can identify gallstones and other blockages within the biliary system. Both scans are noninvasive procedures, during which the bile duct images are shown on a computer monitor.

• Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized endoscopic technique used to study the gallbladder, pancreas and bile ducts, and has the added benefit of being a therapeutic tool. ERCP has been used for more than 30 years, and is considered the standard for diagnosing disorders of the biliary tract. During ERCP, an anesthetic is used to numb the throat along with a mild sedative. A gastroenterologist will then pass a flexible endoscope with a miniature TV camera inside through the mouth and into the stomach and small intestine. Then the gastroenterologist will pass a thin ultrasound probe through the ERCP. Endoscopic ultrasound uses ultrasound images in place of X-rays for better viewing of the bile and pancreatic ducts. Special preparations are required for this endoscopic procedure. 

• Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive diagnostic procedure performed in Radiology using MRI technology (magnets and radio waves) to produce computer images of the gallbladder, pancreas, and bile ducts. A contrast dye is injected first through the skin to enhance the images. MRCP is primarily used in those who are not good candidates for ERCP or who do not want to undergo an endoscopic procedure and in individuals considered to be at low risk of having a pancreatic duct or bile duct disorder.

• Percutaneous transhepatic cholangiogram, a procedure performed by a radiologist, is an X-ray of the bile ducts inside and outside of the liver, and shows drainage of bile from the liver. After a local anesthetic is administered, a long, thin needle is inserted through the abdominal skin and into the liver. The needle injects a contrast dye near the ducts to be studied and images are shown on a fluoroscopic monitor. The images can reveal whether the bile ducts are enlarged, indicating that a stricture or stone may be blocking the duct.