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Methodist Richardson Medical Center

All of our surgeries are performed at Methodist Richardson Medical Center

Our services

Our surgeons specialize in treatment of complex GI surgeries ranging from pancreatic, liver, bile duct, stomach, and esophageal conditions in addition to other GI and general surgery conditions. Finding your best treatment option is our priority and our surgeons will work with your gastroenterologist, pathologist, and oncologist to help you fight your battle.

Below, you will find a generalized outline of what you can expect with your fight.

Esophagus

Esophagus

Preoperative workup includes an Endoscopy (EGD), Endoscopic Ultrasound (EUS), Upper GI, CT scan of the Chest, Abdomen, and Pelvis, PET scan, labs, cardiology consult, colonoscopy, possible Mediport and feeding tube placement for patients who need chemotherapy and radiation prior to surgery.

Surgery involves removing the tumor and surrounding esophagus and lymph nodes, and pulling the stomach up to make a new connection and allow you to eat and drink normally. Surgery can be done laparoscopically or open and your doctor will discuss which the safest option is for you. In some cases, depending on the location of the tumor, the esophagus and stomach are both removed and the colon is used to make a new connection. Surgery generally takes 3-4 hours.

After surgery, you will spend likely the first day in the intensive care unit to be monitored very closely by nursing, and then transfer to the surgical floor once you are stable. While you’re asleep, the anesthesiologist will place a tube in your nose that goes down the back of your throat, which ends in your stomach that stays in place for 5 days after surgery to allow your connection to heal. An upper GI will be done on post-op day 5 to check the connection, and if it has healed with no leak you will start with a clear liquid diet and work your way up to eating solids again. Patients are generally in the hospital for 7-10 days.

You will be seen in the office approximately 2 weeks after discharge to have your staples, drains, and possibly feeding tube removed. It generally takes 6-8 weeks for the incision to heal completely and for you to have the same strength and stamina you did prior to surgery.

Depending on the pathology results you may need to see a medical oncologist or radiation oncologist for further chemotherapy or radiation treatments. You can also expect to follow up with your surgeon with a CT scan every 3 months for two years, then every 6 months for years 3, 4, and 5. You will likely be considered cured at 5 years and will be seen yearly thereafter.

Gastric

Gastric

Preoperative workup includes a CT scan of your Chest, Abdomen, and Pelvis, PET scan, Upper GI endoscopy (EGD), endoscopic ultrasound (EUS), barium swallow, labs, and cardiology evaluation. You may also need a Mediport placed if you are to have chemotherapy prior to surgery.

Surgery will include removal of all or part of the stomach depending on the location of the tumor. You will likely have a temporary feeding tube placed in your abdomen at the time of surgery as well.

You will spend 5-7 days on the surgical floor.

You will be seen in the office approximately 2 weeks after discharge to have your staples, drains, and possibly feeding tube removed. It generally takes 6-8 weeks for the incision to heal completely and for you to have the same strength and stamina you did prior to surgery.

Depending on the pathology results you may need to see a medical oncologist or radiation oncologist for further chemotherapy or radiation treatments. You can also expect to follow up with your surgeon with a CT scan every 3 months for two years, then every 6 months for years 3, 4, and 5. You will likely be considered cured at 5 years and will be seen yearly thereafter.

Pancreas

Pancreas

Preoperative workup includes a CT scan of the Chest, Abdomen, and Pelvis, Endoscopic ultrasound (EUS), MRCP- a special MRI to look at the pancreatic ducts, possible ERCP to unblock any ducts, PET scan, labs, cardiology consult, and possible Mediport for patients who need chemotherapy and radiation prior to surgery.

Depending on the location of your tumor, you will either have the Whipple procedure, a distal pancreatectomy and splenectomy, or a total pancreatectomy. The Whipple procedure involves removing the head of the pancreas, the first part of the small intestine called the duodenum, the end part of the bile duct, and a small part of the stomach. A distal pancreatectomy involves removing the tail of the pancreas and often the spleen. A total pancreatectomy involves removing the entire pancreas. The surgery generally takes 3-5 hours.

After surgery, you might need to spend a night or two in the ICU but then will likely spend the majority of your stay on the surgical floor. You can expect to stay in the hospital for 7-10 days and can expect your pain to be controlled, spend plenty of time out of bed, and have your diet slowly advanced from clear liquids as you tolerate eating.

You will be seen in the office approximately 2 weeks after discharge to have your staples and drains removed. It generally takes 6-8 weeks for the incision to heal completely and for you to have the same strength and stamina you did prior to surgery.

Depending on the pathology results you may need to see a medical oncologist or radiation oncologist for further chemotherapy or radiation treatments. You can also expect to follow up with your surgeon with a CT scan every 3 months for two years, then every 6 months for years 3, 4, and 5. You will likely be considered cured at 5 years and will be seen yearly thereafter.

Liver

Liver

Preoperative workup includes a CT scan of the Chest, Abdomen, and Pelvis, an MRI of the liver, bone scan, liver biopsy, labs, and a cardiology consult.

Surgery will include removing the specific part or parts of the liver that are involved by tumor.

After surgery, you will likely spend a night or two in the ICU but then spend the majority of your stay on the surgical floor. You can expect to stay in the hospital for 5-7 days and can expect your pain to be controlled, spend plenty of time out of bed, and have your diet slowly advanced from clear liquids as you tolerate eating.

You will be seen in the office approximately 2 weeks after discharge to have your staples and drains removed. It generally takes 6-8 weeks for the incision to heal completely and for you to have the same strength and stamina you did prior to surgery.

Depending on the pathology results you may need to see a medical oncologist or hematologist for further treatments. You can also expect to follow up with your surgeon with an MRI every 3 months for two years, then every 6 months for years 3, 4, and 5. You will likely be considered cured at 5 years and will be seen yearly thereafter.

Bile duct

Bile duct

Preoperative workup includes a CT scan of your Chest, Abdomen, and Pelvis, Liver ultrasound, MRI, MRCP and ERCP to evaluate the ducts, Percutaneous transhepatic cholangiography (PTC) tube, labs, cardiology clearance.

Surgery will possibly include removal of involved part of the bile duct, removal of part or parts of the liver, the Whipple procedure, a biliary bypass, or stent placement.

Depending on the specific operation that you had performed, you may spend the first night or two after surgery in the ICU, otherwise you will spend 5-7 days on the surgical floor.

You will be seen in the office approximately 2 weeks after discharge to have your staples and drains removed. It generally takes 6-8 weeks for the incision to heal completely and for you to have the same strength and stamina you did prior to surgery.

Depending on the pathology results you may need to see a medical oncologist or radiation oncologist for further chemotherapy or radiation treatments. You can also expect to follow up with your surgeon with a CT scan every 3 months for two years, then every 6 months for years 3, 4, and 5. You will likely be considered cured at 5 years and will be seen yearly thereafter.

Colorectal

Colorectal

Preoperative workup includes a colonoscopy, endoscopy (EGD), CT scan of the Chest, Abdomen, and Pelvis, water soluble enema, labs, and a cardiology consult.

Surgery will include removing the specific part or parts of the colon that are involved by tumor.

After surgery you will stay on a surgical floor for approximately 5-7 days until your bowels resume function and your pain is controlled.

You will be seen in the office approximately 2 weeks after discharge to have your staples and drains removed. It generally takes 6-8 weeks for the incision to heal completely and for you to have the same strength and stamina you did prior to surgery.

Depending on the pathology results you may need to see a medical oncologist or radiation oncologist for further chemotherapy or radiation treatments. You can also expect to follow up with your surgeon with a CT scan every 3 months for two years, then every 6 months for years 3, 4, and 5. You will likely be considered cured at 5 years and will be seen yearly thereafter.

Pancreas, Liver, and Bile Duct Cancer Support Group

Second Tuesday of the even months; February, April, June, August, October, and December 5:30pm – 6:30pm Methodist Richardson Cancer Center conference room Contact: Alyssa Chapates, 469.204.6132