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Hepatobiliary Surgery

What is the Hepatobiliary System?

The hepatobiliary (HPB) system is made up of the liver, pancreas, bile ducts, and gallbladder. Each of these organs in the HPB system has a specific function to aid in digestion.

 

Liver

  • Breaks down food to energize the body
  • Removes toxins from the body
  • Stores iron, vitamins, and minerals
  • Creates bile, a substance used for digestion
 

Pancreas

  • Creates fluids to break down food
  • Produces hormones to stabilize blood sugar levels
 

Bile Ducts and Gallbladder

  • Moves and stores bile that aids in digestion

 

Experts in Hepatobiliary Care

There are diseases and disorders that can affect these organs and cause digestive problems. UT Health North Campus is the only healthcare facility in the region that has the expertise and technology to treat diseases of the HPB system. When it comes to treating HPB cancers, our radiologists, surgeons, and oncology experts work together as a team to provide patients with a care plan to help ensure the best outcomes.

 

Conditions and Treatment

Liver Conditions

Liver cancers that develop in and around the liver:

  • Hepatocellular carcinoma (HCC) – the most common primary liver tumor
  • Intrahepatic cholangiocarcinoma (ICC) – the second most common primary liver tumor
  • Metastatic liver lesions – cancer that has spread from other cancers in the body, including:
    • Colorectal cancer
    • Neuroendocrine tumors
    • Breast cancer
    • Testicular cancer

Benign liver lesions that may require treatment:

  • Liver abscess – a pus-filled sore inside the liver caused by an infection
  • Liver cysts – abnormal fluid-filled sacs
  • Adenomas – a benign tumor that’s caused by hormones
  • Hemangiomas – a common type of benign liver tumor that’s made up of tangled blood vessels and can occur at any time

 

How We Treat It
  • Intraoperative ultrasound – produces high-resolution images to locate and treat tumors to allow resection while preserving the vascular pedicles.
  • Partial hepatectomy – surgical technique used to remove only the diseased section of the liver by segmental/subsegmental resection.
  • Formal hepatectomy – removal of half the liver or more if the tumor is large.
  • Radio frequency ablation (RFA) – a burning technology that uses heat to destroy tumors under ultrasound guidance.
  • Microwave ablation (MA) – another burning technology that uses microwaves to destroy tumors; applies faster heating and higher temperatures than RFA and can work around large vessels.

 

 

Pancreatic Conditions

  • Adenocarcinoma – type of tumor that starts inside the glands of the pancreas and is the most common type of pancreatic cancer.
  • Neuroendocrine tumors (islet cell tumors) – tumors that form in the cells that make hormones.
  • Cystic neoplasms – fluid filled cysts that are benign, precancerous, or contain cancer.
 
How We Treat It
  • Open and laparoscopic distal pancreatectomy – surgical procedure to remove tumors located in the body and tail of the pancreas.
  • Whipple procedure (pancreaticoduodenectomy) – a complex surgical procedure that is most often used to remove pancreatic cancer that is at the head of the pancreas. This procedure can also be used to treat tumors in the distal bile duct. We perform vascular resection and reconstruction for borderline tumors (tumors abutting the main blood vessels supplying the intestines).

 

Bile Duct and Gallbladder Conditions

  • Hilar cholangiocercinoma – a specific type of bile duct cancer.
  • Choledochal cysts – cysts of the bile duct.
  • Gallbladder cancer – a type of cancer that often produces no symptoms; can be hard to treat when diagnosis is discovered in its later stages.
 
How We Treat It
  • Bile duct resection – removing the sections that are affected and reconnecting the ducts.
  • Radical gallbladder surgery – removing the gallbladder and a portion of surrounding liver as well as the surrounding lymph nodes.