Johns Hopkins Hospital is a NPF Center of Excellence for pancreatic cancer treatment, one of the best reputations in the country.

I'm going out on a limb and suggest you get the surgical consult there ASAP. Too much delay could be the difference between metastasis and resectable, and if you're off chemo too long while you shop around (like I was, apparently), you run the risk of metastasis.

The higher-volume centers of excellence not only have more experienced surgeons, but staff and post-op recovery nursing and dietary centers as well. Plus, if some complicating factor like an artery being in the way is only discovered after the surgeon opens you up, a more experienced Whipple surgeon may be able to continue while a less experienced surgeon has to abort the procedure and close you up.

A few more questions came to mind after my last post. You might also ask the surgeon:

12) How long you'll be under anesthesia

13) How long the surgery itself takes (from first cut to last stitch)

14) If they take and sample lymph nodes as a matter of course, not just if they see suspicious ones

15) How they ensure good intra-operative pathology... This is crucial. In a Whipple, they slice off some of the pancreas head, check it under a microscope for malignant cells, and then tell the surgeon whether he can stop cutting there or needs to cut off another slice and repeat the steps. This is apparently a very inexact process (as explained to me by two prominent surgeons discussing why my cancer "returned" at the original site).

16) How long they expect you to be in the hospital after surgery (ICU and regular recovery)

17) What dietary plan you'll be on while recovering in the hospital and then at home

18) If they provide you a phone number for the on-call surgery "support" team in case you have an urgent situation after you've gone home