The Interventional Endoscopy Clinic at Penn State Health Milton S. Hershey Medical Center offers expert, coordinated care for disorders of the pancreas, biliary system and esophagus, as well as world-class diagnostic and advanced therapeutic endoscopy.
Our team of highly trained physicians and physician assistants is respected nationally for its capabilities, experience, research and innovation. We provide general care and highly specialized tertiary diagnosis and treatment for:
- Diseases of the pancreas, biliary system and esophagus
- Precancerous and certain cancerous conditions of the gastrointestinal tract in collaboration with Penn State Cancer Institute groups, such as the Liver Pancreas Foregut Group and Penn State Health Colorectal Surgery.
- Pancreatic Cyst Evaluation and Surveillance Clinic
Patients have access to leading-edge interventional endoscopy procedures:
- Endoscopic ultrasound (EUS), including fine needle aspiration (EUS-FNA) for the detection, diagnosis and staging of abnormalities and cancers of the central mediastinum, esophagus, stomach, pancreas, rectum and adjacent areas
- Endoscopic retrograde cholangiopancreatography (ERCP), including cholangioscopy and intraductal radiofrequency ablation for the evaluation and treatment of biliary and pancreatic disease
- Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the removal of gastrointestinal premalignant conditions and early limited cancers, such as large colon polyps/masses, Barrett’s esophagus, intramucosal esophageal cancer, gastric and small bowel mucosal lesions and certain submucosal tumors
- Endoluminal stenting with fluoroscopy or balloon dilation for a complex range of strictures, obstructions, fistulas and leaks of the gastrointestinal tract
- Evaluation of the small bowel with video capsule endoscopy and double-balloon endoscopy
- Transluminal endoscopic drainage and debridement of pancreatic fluid collections and other associated fluid collections of the GI tract
- Ablation therapy, including cryotherapy and radiofrequency ablation (RFA) for the treatment of hemorrhagic or premalignant conditions of the GI tract, such as Barrett’s esophagus and GAVE, as well as EUS-guided chemoablation of mucinous pancreatic cysts and certain GI tumors.
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Our specialists use innovative techniques to diagnose premalignant and malignant conditions of the gastrointestinal system and can often help patients avoid major surgeries and achieve the best outcomes.
Patients with gastrointestinal premalignant lesions and malignancies typically require a multidisciplinary approach to care offered by academic medical centers like the Milton S. Hershey Medical Center. Here, surgeons, medical and radiation oncologists, interventional endoscopists, pathologists and radiologists collaborate and tailor personalized treatment plans for patients with esophageal, gastric, pancreatic, colorectal, liver, neuroendocrine and other gastrointestinal cancers. In contrast to early tumor boards that were retrospective in nature, current weekly conferences, such as that of the Liver, Pancreas and Foregut Group at Penn State Cancer Institute, are prospective and give patients multiple physician opinions about their cases without the need to travel to other offices, ensuring timely diagnosis and treatment.
Interventional Endoscopy Clinic team members work closely with numerous Penn State Cancer Institute multispecialty groups, making it possible for patients to easily transition to the appropriate group if they present with more than a precancerous or possibly cancerous lesion that cannot be treated endoscopically.
Barrett’s esophagus with precancerous and cancerous changes that lead to esophageal cancer: Our providers are specialists both in the diagnosis and treatment of premalignant diseases of the esophagus such as Barrett’s esophagus, as well as the treatment of certain types of early esophageal cancers, making it possible for patients to avoid major surgery. We also offer endoscopic treatment of esophageal obstruction through endoscopically delivered stenting. When required, we can facilitate an early and seamless transition to Penn State Cancer Institute.
Pancreatic cancer is the second most common gastrointestinal malignancy and the fourth leading cause of cancer-related death in the U.S. Because the majority of patients are diagnosed late in the course of the disease, their prognosis is poor. Our gastrointestinal specialists are committed to the early detection and proper staging of this disease. We also offer palliative approaches to the disease, such as endoluminal stenting of duodenal and gastric outlet obstruction and EUS-guided celiac plexus neurolysis.
Colorectal cancer remains the third leading cause of cancer death in the U.S., making its early detection and prevention a major goal. We also assist with more advanced disease in conjunction with the Division of Colorectal Surgery and Penn State Cancer Institute.
Submucosal tumors: This broad spectrum of neoplasia ranges from the completely benign to the high risk. The accurate diagnosis and staging of these lesions requires high-level training and technology, such as that provided by the Division of Gastroenterology and Hepatology’s specialized physicians expertly trained in EUS-FNA.
Pancreatic Cyst Evaluation and Surveillance Clinic
Pancreatic Cyst Evaluation and Surveillance Clinic: Pancreatic cysts are common with a spectrum of types extending from routinely discovered, low-risk cysts to cysts that require immediate treatment. Those that require evaluation, surveillance and treatment receive specialized expertise in this clinic. Patients with complex or high-risk cases that may require treatment receive a multispecialty approach at the Liver, Pancreas and Foregut Group. We also provide one of the few clinical protocols that allows a minimally invasive treatment for pancreatic cysts: the NIH-funded Penn State CHARM II trial for EUS-guided chemoablation of mucinous (precancerous) cysts.