Liver, Pancreas and Gallbladder Surgery
The Tulane Hepatobiliary Surgery Center is a resource for patients that require surgical management for diseases of the liver, pancreas, gallbladder, or bile duct. Our multidisciplinary team approach, combined with advanced diagnostic and surgical capabilities, ensures that each patient receives a comprehensive evaluation of their disease in order to develop the most effective treatment plan possible.
The most commonly performed liver procedure is a removal of a portion of the liver (referred to as a liver resection or hepatic resection); resections of a large portion of the liver are possible because the remaining liver grows to compensate for the part that was removed. Liver resections are necessary to address cancerous (malignant) and non-cancerous (benign) tumors of the liver and may be performed laparoscopically, using minimally invasive techniques, or by using the traditional open surgical methods. The surgical approach depends on a variety of factors, such as the type of tumor, its location and the patient's overall health status. Liver resections are a complicated surgery that require a surgeon that specializes in hepatobiliary surgery.
Malignant tumors can develop in the liver (primary) or may develop in another organ and then migrate to the liver (metastatic). The success of a liver resection for tumor removal depends on the location of the tumor, the number of masses, the distribution of the masses, and the amount of liver left after tumor removal. Liver resections are also performed as part of our Liver Transplant - Living Donor Program at the Tulane Transplant Institute.
Radiofrequency ablation / microwave ablation is an effective option for addressing primary liver tumors or for tumors that have metastasized to the liver from another location. It may be used in addition to chemotherapy or radiation therapy, or as an alternative to surgical treatment for patients whose liver tumors are unsuitable for a liver resection. During this procedure a small ablation probe is placed directly into the impacted tissue and uses an electrical current to create heat in a precise location, at a specific temperature and for a specific period of time, in order to kill the cells in the targeted tumor. Monitoring devices allow the surgeon to continuously evaluate the temperature of the impacted area and maintain a constant level of heat, resulting in an effective means of killing diseased tissue with minimal impact to the surrounding healthy tissue. The process is rapid, typically requiring 10 to 15 minutes exposure time for a 3 cm ablation area.
Pancreas disorders are categorized by those that are caused by cancerous (malignant) or non-cancerous (benign) tumors and those that are caused by acute or chronic inflammation such as pancreatic cysts and duct strictures or blockages. Chronic pancreas disorders may require surgery to help treat pain, bile duct obstruction (jaundice), and other symptoms.
Not every pancreas disease requires surgery; each patient is evaluated by our multidisciplinary specialty team to determine if surgical intervention is necessary. If surgery is required it is most often performed as a resection (removal) of only the portion of the pancreas that is diseased.
The bile duct system and the gallbladder are involved in the drainage and delivery of bile from the liver into the intestine; together this is referred to as the Biliary Tree. Bile is produced in the liver and is necessary for the appropriate absorption of nutrients in the intestine. Disorders of the bile duct system or the gallbladder can impact this function. The most common disorder of the biliary tree is gallstones (cholelithiasis). Gallstones are usually located in the gallbladder and are addressed when the gallbladder is removed. Most often this procedure can be performed laparoscopically.
The biliary tree, or bile ducts, can become blocked. This can occur in several ways incuding injury, narrowing, and benign or malignant tumors. Our team can addressing all biliary tree disorders. Bile duct tumors may require the removal of a portion of bile duct; depending upon the location of the tumor this surgery may also involve a corresponding resection of the liver or the pancreas. Routine gallbladder surgery can be performed by a general surgeon but because bile duct surgery complications can be severe and life-threatening any bile duct surgery should be performed by a hepatobiliary specialist. The surgeons of the Tulane Hepatobiliary Center can address all biliary tree issues, including the reconstruction of bile ducts injured by disease or trauma.
Tulane Surgical Oncologists work in conjunction with the Hepatobiliary surgeons as part of the multidisciplinary approach to liver, pancreas and biliary tree / gallbladder disease management.
The Liver Transplant and Living-Donor Program at the Tulane Transplant Institute combines compassionate and cutting edge medical care with advanced surgical techniques and innovative surgical research. Liver transplant surgery is a complex surgical event during which the diseased liver is removed and replaced with a liver from a recently deceased donor or from a living donor. Both living-donor and cadaveric liver transplants are available through the Tulane Transplant Institute. For more information about Liver transplants please refer to the Tulane Transplant Institute.
The Pancreas Transplant Program at the Tulane Transplant Institute combines compassionate and cutting-edge medical care with advanced surgical techniques and innovative surgical research. A pancreas transplant may help to offset the organ damage that results from insulin-dependent Type 1 diabetes, eliminating the need for insulin injections, and reduce or eliminate the dietary and activity restrictions that often accompany diabetes. Patients with Type 2 diabetes are usually not candidates for a pancreas transplant because they are likely to be insulin-resistant and consequently will not benefit from the advantages of a new pancreas that can produce insulin. For more information about pancreas transplants please refer to the Tulane Transplant Institute.