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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Thursday, May 3, 2007

Pancreatic surgery up close

The program promised high-definition images of pancreatic surgery. What it delivered was part of the organ itself.

About 40 doctors crowded into a conference room at Massachusetts General Hospital today to watch a live broadcast of surgery to remove a growth from a patient's pancreas, to see whether it was malignant or benign. They were there to learn about finding early forms of pancreatic cancer as the hospital introduced its new pancreatic-biliary program.

During the operation, surgeon Dr. Carlos Fernandez-del Castillo asked Dr. Gregory Lauwers, a pathologist who had gone to the conference room, to return to the operating room to examine part of the pancreas he had just cut out and solve the mystery.

A few minutes later, Lauwers, director of gastrointestinal pathology at MGH, appeared back in the conference room with the answer -- and the reddish tissue in a metal tray. Wearing gloves, he turned the tissue with a metal instrument to show the group.

The doctors rose from their chairs to crowd around and peer at the piece of pancreas, about the size of a child's fist. It turned out to be benign, in the judgement of Lauwers and another pathologist who later examined a frozen section under a microscope.

Then the doctors, including the one who had sent the patient for surgery, discussed how hard it is to know in advance who needs to have such growths removed.

Pancreatic cancer is the fourth leading cause of cancer death, in part because it is so difficult to detect before it has grown and spread. A small subset of tumors are benign growths, some of which later become malignant. The challenge is to know which ones, they said.

Posted by Elizabeth Cooney at 07:40 PM
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