For Referring Physicians

Coordinated, Academic-Level Surgical Oncology Care

Patients with complex gastrointestinal and hepatopancreatobiliary (HPB) malignancies benefit from early multidisciplinary evaluation, disciplined treatment sequencing, and technically advanced operative care. Optimal outcomes in pancreatic, liver, biliary, and upper gastrointestinal cancers depend not only on technical resection, but also on thoughtful integration of tumor biology, systemic therapy response, and longitudinal oncologic strategy.

As a fellowship-trained robotic surgical oncologist and hepatopancreatobiliary (HPB) surgeon, Dr. Geoffrey W. Krampitz provides consultation and surgical management for complex gastrointestinal malignancies within a coordinated multidisciplinary framework aligned with contemporary academic cancer programs.

Care is delivered through collaboration among medical oncology, gastroenterology, radiology, pathology, genetics, and interventional specialists to ensure that surgical decision-making occurs within the broader context of disease biology and systemic therapy sequencing.

Referring clinicians can expect timely access, direct physician-to-physician communication, and structured care coordination across the continuum of cancer treatment.

Referral Coordination

Patients with suspected or confirmed cancer are prioritized for timely evaluation. When clinically appropriate, consultations can often be arranged within several days and frequently the next business day.

Referring physicians may contact the office directly to coordinate consultation or multidisciplinary evaluation.

Phone: (650) 652-8787
Fax: (650) 652-8770
Email (non-urgent coordination): geoffrey.krampitz@sutterhealth.org

For transmission of protected health information, secure or encrypted communication options are available. Please contact the office to arrange appropriate electronic transfer.

Direct physician-to-physician discussion is encouraged for clinical questions, imaging review, operative planning, or multidisciplinary sequencing considerations.

Common Referral Indications

Referrals are welcomed for patients with suspected or confirmed malignancies involving the hepatopancreatobiliary system and complex gastrointestinal tract, particularly when multidisciplinary sequencing may influence operative timing.

Hepatopancreatobiliary (HPB)

  • Pancreatic ductal adenocarcinoma (resectable, borderline, or locally advanced)

  • Pancreatic cystic neoplasms and neuroendocrine tumors

  • Hepatocellular carcinoma and intrahepatic cholangiocarcinoma

  • Extrahepatic cholangiocarcinoma and gallbladder carcinoma

  • Liver-dominant metastatic disease, including colorectal liver metastases

Upper Gastrointestinal

  • Gastric and gastroesophageal junction cancers

  • Esophageal adenocarcinoma and squamous cell carcinoma

  • Duodenal and small bowel malignancies

Colorectal and Peritoneal Surface

  • Colon and rectal cancers requiring complex surgical management

  • Oligometastatic colorectal cancer

  • Peritoneal surface malignancies, including pseudomyxoma peritonei

Retroperitoneal and Adrenal Tumors

  • Retroperitoneal sarcoma

  • Adrenal cortical carcinoma

  • Functional adrenal tumors (pheochromocytoma, aldosteronoma, cortisol-producing tumors)

  • Indeterminate adrenal masses requiring endocrine and oncologic evaluation

  • Isolated adrenal metastases in selected patients

Early referral is encouraged—even when diagnostic workup or staging remains in progress—to allow integration of systemic therapy, operative planning, and multidisciplinary review.

Information Helpful for Consultation

When available, the following information can help facilitate efficient consultation:

  • Recent clinic notes and relevant medical history

  • Pathology and biopsy reports

  • Prior operative reports

  • Most recent imaging (CT, MRI, PET) and radiology reports

  • Endoscopy or interventional procedure reports (EUS, ERCP, colonoscopy)

  • Pertinent laboratory studies, including tumor markers

If elements of the workup are pending, referral should not be delayed. Additional diagnostic evaluation and staging can be coordinated when appropriate.

For biomarker and genomic considerations, please see:

Molecular Oncology and Biomarker-Driven Surgical Strategy →

Rapid Evaluation for New or Urgent Cancer Diagnoses

Patients with new or suspected cancer diagnoses are prioritized to minimize delays in multidisciplinary treatment planning.

Many consultations can be scheduled within days when clinically appropriate, and urgent oncologic concerns are triaged for expedited evaluation.

Examples of time-sensitive referrals include:

  • Suspected malignancy with biliary obstruction

  • Symptomatic pancreatic or liver masses

  • Bleeding or obstructing gastrointestinal tumors

  • Rapidly progressive disease requiring coordinated evaluation

For urgent cases, please call the office directly.

Multidisciplinary Integration

Complex oncologic care is delivered through structured collaboration and, when appropriate, multidisciplinary tumor board review involving:

  • Surgical oncology

  • Medical oncology

  • Radiation oncology

  • Gastroenterology and advanced endoscopy

  • Radiology and pathology

This consensus-driven approach supports evidence-based treatment planning aligned with disease biology and clinical context.

Ongoing Communication

Referring physicians receive timely updates throughout evaluation, operative care, and postoperative recovery to support continuity of care.

Communication typically includes:

  • Consultation notes

  • Operative reports

  • Pathology results and staging information

  • Postoperative recovery updates

  • Follow-up plans and coordination of adjuvant therapy when indicated

Direct physician-to-physician communication is welcomed at any stage of care.

Physician Resources

Additional resources for referring clinicians:

Physician FAQ →
Logistics regarding referral coordination, consultation scheduling, and communication.

Molecular Oncology and Biomarker-Driven Surgical Strategy →
Integration of tumor genomics and biomarker data into surgical decision-making.