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Hepatobiliary Surgery Hepatobiliary surgery consists of highly technical challenging procedures that deal with all pathological conditions that affect the liver, gallbladder, bile ducts, pancreas, and duodenum. These conditions can be the result of congenital abnormalities, inflammation, infection, benign or malignant tumors, or the result of traumatic injuries. Over the past 20 years, hepatobiliary surgery has made tremendous improvements. Before, this type of surgery was very risky, with high morbidity and mortality rates. Now, due to a better understanding of the anatomy and improvement of surgical techniques, hepatobiliary surgery has become very safe and common with a very low death rate. One reason for improved surgical outcome is the multidisciplinary approach that the transplant and hepatobiliary staff, together with various other specialties, including internal medicine, oncology, infectious disease, pathology, and radiology, have formed a better and comprehensive service dedicated to properly diagnose, treat, and manage any liver condition. Major liver resections are now routinely performed with great successes and long term cures, often without the need for blood transfusions. Tumors that cannot be removed for various reasons can be destroyed with alternative methods such as radiofrequency ablation technique or alcohol injections into the tumor. Other effective modalities include chemotherapy with embolization of the vessels nourishing the tumor, or through a hepatic artery pump. Improvements in surgical technique and perioperative care have contributed to the success of hepatobiliary surgery and better outcomes for the patients. Services dedicated to treating liver conditions including liver resection, chemoembolization, radiofrequency ablation, alcohol injection, and transjugular intrahepatic portosystemic shunting are available under the guidance of Dr. Wu, who uses advanced techniques to treat hepatobiliary diseases. Liver resection is an operation to remove a portion of the liver. This operation is usually done to remove various types of liver tumors that are located in the portion of the liver that is removed. The goal of liver resection is to completely remove the portion of the liver where the tumor is located and 2 to 3 cm of liver tissue that immediately surrounds the tumor. After liver resection surgery, the remaining liver can grow back to its original size in 1 to 2 weeks. Chemoembolization is a treatment option for patients with liver cancer. With the aid of an x-ray, a small catheter is inserted in an artery through the groin. The catheter is then threaded into the hepatic artery, the artery that provides blood into the liver as well as the liver tumor. Then a high concentration of chemotherapy is injected directly into the tumor. In addition to the chemotherapy, the blood supply to the tumor is blocked, or embolized, by injected particles. Over time, this treatment causes the tumor to decrease in size or break down completely. Radiofrequency ablation (RFA) is used to treat tumors that cannot be surgically removed because of tumor size or location. RFA is a process in which an electrical current (radiofrequency energy) is delivered to the liver tumor. Ultrasound is used to precisely place the electrical current. This electrical current produces heat which destroys the tumor (ablation) without harming surrounding healthy liver tissue. Ethanol injection is used to treat liver tumors that may be difficult to surgically remove. The injection of alcohol into tumors can be beneficial because the alcohol is toxic to tumors and causes them to dry out and eventually disintegrate. With the assistance of ultrasound, alcohol is injected through the skin into the liver tumor. Ethanol injection has been proven beneficial in helping patients with liver cancer. Transjugular intrahepatic portosystemic shunt (TIPS) is a non-surgical procedure used to control bleeding from varices and reduce portal hypertension, which results from scarring or other blockage that increases the pressure in the portal vein in the liver. A radiologist performs this procedure using an x-ray. A tunnel is formed in the liver that connects the portal vein to a hepatic vein. The stent is then placed in the tunnel to keep it open. This tunnel serves as a new pathway from the portal vein to the hepatic artery that helps reduce portal hypertension and bleeding from varices.
Transplant Surgery Office
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