医疗专业人员

Feb. 28, 2025

As one of the country's highest-volume surgical programs for advanced pancreatic cancer, Mayo Clinic in Florida offers pioneering techniques that provide several advantages, including shorter hospital stays, quicker recovery times and improved outcomes.

For people with pancreatic cancers that are operable or potentially operable, the hepatobiliary (HPB) surgical oncology team focuses on offering pancreatic resections that provide the best chance of maintaining long-term recovery.

"We have the technology, skills and experience needed to help people with pancreatic cancer live longer and with a high quality of life," says John A. Stauffer, M.D., an HPB surgical oncologist at Mayo Clinic in Jacksonville, Florida.

Advanced options for care

Surgery has long been the only curative treatment for pancreatic cancer, but it's still risky and has a high mortality rate. Only about 20% of pancreatic cancers are resectable. Another 30% are locally advanced and therefore inoperable unless first treated aggressively with chemotherapy to downstage the disease.

Resection — whether it's a Whipple procedure or distal pancreatectomy — is the gold standard of care and aims to remove the tumor from the pancreas completely.

HPB surgical oncologists at Mayo Clinic in Florida are known for their willingness to conduct complex open operations, including those in people routinely turned down for surgery at other institutions. Their team uses progressive, minimally invasive robotic and laparoscopic techniques to perform surgeries with smaller incisions. This approach can result in fewer complications and faster recoveries.

To date, the team has successfully performed well over 1,000 pancreas resections.

"Florida and our campus partners in Minnesota and Arizona are national referral centers for pancreas resection," says Dr. Stauffer. "Many of our patients come to us after failed procedures or after they've been turned down for treatment elsewhere. We have the expertise and experience to take even the most complex cases."

To improve outcomes for those with more-severe disease, such as locally advanced pancreatic cancer with a high risk of return after tumor removal, Mayo Clinic surgeons are using novel techniques such as irreversible electroporation (IRE) and intraoperative radiation therapy (IORT) as complements to resection.

Both IRE and IORT target cancer cells after the tumor removal and require a radiation oncologist to be in the operating room, something unique to Mayo Clinic. During IRE, a series of high-voltage, low-energy current electrical pulses destroy the lipid bilayer structure of the cell membrane, producing nanopores that lead to cell death. In IORT, targeted radiation directly treats the tumor bed with high radiation doses while nearby organs are moved out of the way of the radiation.

"Intraoperative radiotherapy is a tool that helps optimize the surgical and disease control outcomes for our patients. It allows us to deliver high-dose radiation to the areas at highest risk of local disease recurrence. And we deliver that dose directly to the target, without going through normal tissues to get there," says Michael S. Rutenberg, M.D., Ph.D., a radiation oncologist who specializes in pancreatic cancer at Mayo Clinic in Jacksonville, Florida. "But ultimately, a technology is only as good as the team using it. I am fortunate to work with an extraordinary team of HPB surgeons, anesthesiologists, operating room staff, nurses and radiation physicists who make this program very successful."

Surgeons performing high-volume surgery with novel techniques combined with resection surgery report fewer major postsurgical complications and an increase in long-term survival rates. "A few percentage points increase in the average survival rate may not sound like much, but considering that these are high-risk patients, those numbers are meaningful, especially to the long-term survivors," says Dr. Stauffer.

Mayo Clinic protocols and a personalized model of care are keys to success

The HPB surgical oncology team makes heavy use of surgical protocols and a personalized approach to care.

While no two patients are the same and individual attention is given to each patient, the care team relies on a three-part protocol to ensure the best course of treatment is used.

• After consulting with a patient and before surgery is scheduled, a high-quality, preoperative MRI is taken (rather than CT scans or other techniques) to determine whether the patient is a candidate for pancreatic resection.
• During surgery, special steps are taken to manage anesthesia and liquids according to the patient's needs and the procedure being performed. When IORT is required, a radiation oncologist is in the OR to perform the procedure.
• After surgery, postoperative protocols are personalized to ensure quicker recoveries. All postop staff are trained in caring for patients who have undergone these advanced procedures. Once discharged, patients receive virtual and inpatient follow-up care. Through the patient portal, they also have full access to their medical team, educational resources and informational videos.

Despite the complexity of these high-risk surgeries, Mayo Clinic's protocols have proved to reduce complications and shorten hospital stays. Patients typically remain in the hospital for only 5 to 7 days, compared with 2 to 3 weeks as reported by other hospitals.

Success in numbers

Experience and volume matter to patients because it means a better chance for survival.

Dr. Stauffer averages 120 to 150 pancreatectomy procedures a year, as compared with the national average of 10 to 20 a year for other pancreas surgeons.

Performing a high volume of procedures breeds experience and drives practice efficiencies, both of which lead to improved patient outcomes.

"Our confidence isn't hubris. It's based on decades of experience with successful outcomes," explains Dr. Stauffer. "Everyone at Mayo Clinic is skilled in these complex pancreatic cancer cases, so we know how to care for these patients. It's this team experience combined with the highest quality equipment and technology that makes us excel at what we do."

Mayo Clinic in Florida remains one of the busiest national centers for pancreatic cancer surgery, with low complication rates, short hospital stays and strong patient outcomes.

For more information

Refer a patient to Mayo Clinic.