Pancreas, Gallbladder & Bile Duct Disorders
Pancreas, Gallbladder & Bile Duct Disorder Care at UVM Health
The pancreas, gallbladder and bile ducts are part of your digestive system. Along with your liver, they produce, store and carry chemicals that help break down the food you eat (enzymes). Conditions that affect these structures (pancreaticobiliary conditions) can cause pain, inflammation and cancer.
Gastroenterologists at University of Vermont Health offer advanced care to protect your health and relieve symptoms caused by pancreaticobiliary conditions.
Why Choose UVM Health?
Our skilled providers use the latest technology to make an accurate diagnosis and provide effective treatment. Throughout your care journey, our team is by your side with kindness and support.
As a leading gastroenterology program in the region, we offer:
- Specialized expertise: Our board-certified gastroenterologists have extensive experience treating pancreaticobiliary disorders. If you need advanced care, you have access to physicians specialized in complex conditions and endoscopic procedures. When possible, we offer digital health appointments to bring care to you.
- Coordinated care: Your team includes dedicated colorectal surgeons, radiologists, pathologists, pharmacists and nutritionists, all of whom specialize in gastrointestinal (GI) diseases. Our gastroenterologists also work closely with a multidisciplinary team of GI cancer experts.
- Leading-edge research: As part of a health system anchored by an academic center, our physician-leaders have a rich history of research and innovation to improve care. Your provider may discuss participation in a clinical trial or research study.
Types of Pancreatic Gallbladder & Bile Duct Disorders
Pancreaticobiliary conditions fall into several categories:
Stones are hard formations, usually made of cholesterol, that can form in your gallbladder, pancreatic duct or bile ducts.
Strictures are narrowed sections of your bile or pancreatic ducts that prevent the flow of digestive enzymes and bile into the small intestine.
Cysts are fluid-filled sacs that may carry a risk of developing into cancer. They can form in your pancreas and bile ducts.
A pancreatic pseudocyst is a collection of fluid that does not have a membrane separating it from the surrounding tissue. Pancreatic pseudocysts are rarely cancerous.
Tumors are growths of tissue that can be noncancerous (benign), precancerous or cancerous (malignant). Cancer can occur anywhere in your gastrointestinal tract, including your pancreas, gallbladder and bile ducts.
Inflammation is an immune response that occurs when tissues are damaged. Specific inflammatory conditions include:
- Cholecystitis: Inflammation of the gallbladder, usually caused by a blocked bile duct.
- Pancreatitis: Inflammation of the pancreas that can be sudden (acute) or long term. Chronic pancreatitis is often caused by long-term alcohol use but may have other causes.
- Sclerosing cholangitis: Inflammation and scarring of the bile ducts that occurs most often in people with inflammatory bowel disease.
Wellness & Prevention
Evidence shows that proactive health care focused on preventing illness leads to better outcomes. We're here to help you live a healthier, happier life. We offer wellness and prevention services to empower you to take control of your health.
Diagnosing
We offer comprehensive evaluations for pancreaticobiliary diseases. Diagnosis may include:
Blood tests can give your provider information about your diagnosis and rule out other conditions. Depending on your symptoms, your provider may order blood tests to check pancreas or liver function or look for or infection or inflammation.
UVM Health offers state-of-the-art radiology services to help your provider make an accurate diagnosis. Common tests include X-ray, ultrasound, CT and MRI scans. We also offer GI-specific imaging tests that deliver high-quality images of organs in the GI tract.
Gastroenterologists often use endoscopic procedures of the upper GI tract to diagnose and treat pancreaticobiliary conditions. In an upper endoscopy, your provider inserts a thin tube with a camera at the end (endoscope) into your digestive tract through your mouth.
Using the camera and small tools passed through the endoscope, your provider can look inside your gastrointestinal tract, collect tissue samples (biopsies) and perform treatments. Endoscopic procedures of the pancreas, gallbladder and bile ducts are complex and not widely available. At UVM Health, you’ll find state-of-the-art endoscopic diagnostic procedures, including:
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ECRP combines upper GI endoscopy and X-ray imaging to diagnose and treat conditions of the gallbladder, bile ducts and pancreatic ducts. In ERCP, your provider:
- Guides an endoscope to the opening where the pancreatic and bile ducts empty into your small intestine
- Slides a narrower tube through the endoscope into the ducts
- Injects a dye that is visible with an X-ray and can show narrow or blocked ducts
Your provider may pass small tools through the main endoscope to collect a tissue sample for laboratory analysis (biopsy). Biopsies are particularly important in diagnosing cancer.
Endoscopic Ultrasound (EUS)
EUS uses an endoscope with an ultrasound probe at the end to view structures outside the GI tract, such as the pancreas and gallbladder. The proximity of the ultrasound probe to nearby structures enhances image quality and helps providers make a precise diagnosis. Using the ultrasound as guidance, your provider can pass a fine needle from the endoscope into a nearby structure to collect a biopsy.
Treatments
Pancreaticobiliary conditions can be complex. Your treatment options depend on your diagnosis, the severity of your symptoms and any underlying health conditions.
Some conditions may respond to medications or lifestyle changes, such as avoiding alcohol, quitting smoking or losing weight. Others may require an endoscopic or surgical procedure.
Our gastroenterologists consider all factors affecting your condition and partner with other specialists as needed to ensure you receive the care you need. Your care team works with you to create a customized treatment plan, which may include:
The endoscopic procedures we use to diagnose pancreaticobiliary conditions are also important for treatment.
In endoscopic retrograde cholangiopancreatography (ERCP), doctors pass small tools or lasers through the endoscope into the pancreatic or bile ducts. ERCP can be used to break up stones (lithotripsy) or insert tubes (stents) to open strictures.
In an endoscopic ultrasound (EUS), your provider may pass small tools through the endoscope from your stomach into nearby structures. Using ultrasound imaging, they may perform procedures such as:
- Celiac plexus block: The celiac plexus is a bundle of nerves that carries signals between your digestive system and your brain. We treat pain caused by pancreatic cancer by injecting medication into these nerves.
- Cystogastrostomy: We use stents to drain pancreatic fluid collection caused by a pseudocyst or walled-off necrosis into your stomach. Placement of the stent involves boring a hole through your stomach into the neighboring pancreas and inserting the stent. We use a similar procedure to place a stent between the gallbladder and stomach to bypass a blocked bile duct.
If surgery is your best treatment option, our gastroenterologists work with UVM Health GI surgeons to develop an effective treatment plan. Whenever possible, we use minimally invasive techniques that allow you to recover more quickly.
If you are diagnosed with cancer of the pancreas, gallbladder or bile duct, having an experienced team on your side is essential. Your care team includes gastroenterologists, surgeons, medical oncologists, radiation oncologists, radiologists and pathologists, all of whom specialize in GI cancer. They work together to deliver sophisticated treatment, in a compassionate and supportive environment.
Some diseases of the pancreas, gallbladder and bile ducts can affect your ability to break down food. If your provider is concerned about your nutritional status, our GI nutritionist can work with you to recommend foods and supplements to keep you healthy.
Locations Near You
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133 Park Street
Second Floor
Malone, NY 12953-1244
111 Colchester Avenue
Main Campus, Main Pavilion, Level 5
Burlington, VT 05401-1473
