Book An AppointmentWhat is hepato biliary system?
Hepatobiliary system involves combination of liver and its ductal system(hepatic ducts, bile duct and gall bladder) draining bile (juice secreted by liver) from liver to intestine.
What are diseases that can affect hepatobiliary system that require surgery?
Hepato biliary disease treatment is best achieved by multimodality approach with involvement of Medical gastroenterologist, Interventional radiologist and Hepatobiliary surgeon. Diseases that require surgery are
- Liver cancer
- Cysts of liver
- Cancer from other organs that have spread to liver
- Stones in liver and bile duct ( can be treated with endoscopy also)
- Neuroendocrine tumor in liver.
- Liver abscess
- Tumors of bile duct ( cholangiocarcinoma)
- Gall bladder cancer
- Shunt surgery for bleeding varices;
- Bile duct stricture and fistula
How hepatobiliary surgeon can score over general and oncosurgeons in treating these diseases?
Hepato biliary system is very complex system that involves not only dealing with liver but also its complex blood supply and bile ductal system. As surgery is main modality of treatment so every effort is made to convert the unresectable tumors to resectable stage with help of radiology and other interventions. This is possible only if case is initially assessed by hepatobiliary surgeon who can plan resection in such a way that tumor is also removed completely and adequate amount of liver is also left that is compatible with survival.
How much liver can be removed safely?
In patients with normal liver around 75% of liver can be removed safely and person can lead normal life. However in case of diseased liver e.g cirrhosis , jaundice etc ,more amount of liver needs to be left behind for person to lead normal life.
Is it safe to operate on patients with jaundice or with liver disease?
Before operating upon patient with jaundice every effort is made to lower jaundice by various means e.g stenting, putting catheter in liver to drain bile duct. After bilirubin decreases to near normal levels then surgery is planned.
Why liver or biliary surgery complex?
Liver is a solid organ in which complex network of small bile ducts and blood vessels are hidden. Also bile duct and blood vessels are very closely associated outside liver. So tumors of liver and bile duct very commonly involve these blood vessels thus making surgery complex. Moreover as they are hidden inside liver, surgery is planned by preoperative imaging and intraoperative marking that is possible for surgeon regularly involved in doing hepatobiliary surgery. These planes have to be followed otherwise lot of bleeding can happen that is dangerous for patient.
Who should consult hepatobiliary surgeon?
Any patient suffering from any of diseases mentioned above should always consult hepatobiliary surgeon before starting upon any form of treatment. As assessment by hepatobiliary surgeon increases chance of cure by resecting even advanced tumors.
Do hepatobiliary surgeon treat gall baldder diseases also?
Yes. Gall bladder is an important component of hepatobiliary system is most commonly diseased organ due increased prevalence of stone disease. Hepatobiliary surgeon treats gall bladder diseases more effectively as he is ready for all surprises that can be encountered with gall bladder diseases that are not detected before surgery e.g complicated gall bladder disease, ruptured gall bladder detected during surgery, gall bladder cancer detected during surgery etc. Hepatobiliary surgeon would be able to deal with all this during surgery.
Does hepatobiliary surgeon treat CBD Stones also?
Majority of stones in bile duct are managed by endoscopy done by medical gastroenterologist but in some cases stones are very large in size and are very high in numbers then surgery can be better choice of treatment in form of removal of stones or providing bypass to prevent recurrent stone formation.