Helical CT scans at our institution preclude the necessity for diagnostic laparoscopy in most cases at our institution.

This study is being done to find out if an endoscope passed down the throat, through the stomach, and into the abdomen can quickly and accurately examine the organs and tissue of the abdomen and take biopsies if needed.

This study is being done to find out if an endoscope (a small, flexible tube with a camera mounted on the end) passed down the throat, through the stomach, and into the abdomen can quickly and accurately examine the organs and tissue of the abdomen and take biopsies if needed. We wish to determine if this endoscopic route is as fast and efficient as the laparoscopic route, which is the current standard of care.

Inclusion Criteria:

• Age range 18-80
• Radiographic diagnosis of resectable pancreatic head mass presumed to be pancreatic adenocarcinoma

Exclusion Criteria:

• Inability to obtain informed consent
• Pregnancy
• Intra-abdominal adhesions that preclude endoscopy
• Contraindication to upper endoscopy such as stricture, stenosis of the foregut
• Previous gastric surgery
• Diagnosis of pancreatic body or tail tumor
• History or current diagnosis of gastric ulcer
• Metastatic disease diagnosed by CT, EUS, MRI, or nuclear imaging
• Patient is not a candidate for resection based upon CT, EUS, MRI, or nuclear imaging
• Antiplatelet medication not stopped at least 7 days prior to procedure
• Anticoagulant medication not stopped at least 5 days prior to procedure