South Jersey’s Leader in Pancreatic Surgery

The number of South Jersey residents coming to Cooper for surgical treatment of pancreatic and hepatobiliary diseases has quadrupled in just two years. Cooper’s surgical oncologists now perform more hepatobiliary surgeries on South Jersey residents than any other hospital in the Delaware Valley.

Patients choose Cooper because of the advanced diagnostic testing offered by the Digestive Health Institute, and the skill and expertise of Cooper’s surgical oncologists and its medical and radiation oncologists. Patients also have access to groundbreaking clinical trials and the multidisciplinary team within Cooper Cancer Institute (CCI).


Francis R. Spitz, MD, FACS, Vice Chief, Department of Surgery, Head, General Surgery and Deputy Director, CCI, and Umur M. Atabek, MD, FACS, Head, Surgical Oncology, have performed more than 250 complex pancreatic and hepatobiliary operations at Cooper since 2009.

Considered some of the most technically challenging and high-risk of all surgical procedures in use today, Drs. Spitz and Atabek specialize in minimally invasive pancreatic resections, central and distal pancreatectomies, removal of intraductal papillary mucinous neoplasms (IPMNs) and mini-Whipple procedures.

“It is important that these complex surgeries, especially the mini-Whipple,are carried out by surgeons with ample experience,” says Dr. Spitz. “Numerous studies have shown that surgical volume is a strong predictor of patient outcome with perioperative mortality rates dropping from nearly 20 percent down to 1 or 2 percent when patients have the surgery in a high-volume facility.”


The mini-Whipple is a modification of the classic Whipple procedure, the pancreaticoduodenectomy. During Whipple surgery, surgeons remove a portion of the stomach, the head of the pancreas, the gallbladder, nearby lymph nodes and the duodenum. In the “mini” version, the procedure remains the same, yet the stomach remains intact.

“Studies have demonstrated no benefit in patient outcomes when the stomach is removed,” explains Dr. Spitz. “Keeping it intact helps patients maintain their quality of life. The surgery is also much easier on the patient, with less time in the OR, less blood loss, shorter length of stay and fewer complications.”


Pancreatic cancer is the fourth leading cause of cancer death in the United States and strikes one in 71 people. Most will die within the first year if the cancer is not caught early, before it invades the liver, bile ducts and nearby blood vessels.

“These cancers are often very difficult to diagnose at the earliest stages when there is the best chance for surgical cure,” says Adam B. Elfant, MD, FACG, Associate Head, Division of Gastroenterology and Liver Disease at Cooper. “Fortunately, we are able to utilize the most advanced techniques such as endoscopic ultrasound (EUS) with fine needle biopsy, endoscopic retrograde cholangiopancreatography (ERCP), and direct intraductal visualization of the biliary and pancreatic systems. These diagnostic tools can pick up cancers when conventional tests such as MRI and CT scans are inconclusive or do not demonstrate a tumor.”


Pancreatic and hepatobiliary cancers are complicated and difficult to manage, requiring the efforts of a multidisciplinary team of specialists working together to deliver the best possible outcomes for each patient.

According to Dr. Spitz, the success of the Cooper program lies not only with the skills of its surgeons, but also because of the collaborative approach within the CCI: “Experience counts and Cooper has the expertise in all aspects of care to make a difference for our patients.”

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