With over 20 years of highly-specialized experience, Dr. Fraiman successfully performs biliary surgery in Baltimore, MD for many patients.
Biliary Procedures Performed
- Common bile duct reconstruction (Roux-N-Y Hepaticojejunostomy)
- Resection and reconstruction of biliary tumors (Klatskin tumors)
- Laparoscopic cholecystectomy
St. Joseph’s Medical Center offers hepatobiliary surgery to treat benign and malignant diseases of the pancreas, liver, bile duct and gallbladder. This encompasses a broad spectrum of diseases including lesions, cysts, gallstones, bile leaks and cancer.
Working closely with other specialists, our hepatobiliary surgeons provide an individualized, multidisciplinary approach to patient care. Their focus when treating every patient is to help them understand their diagnosis and come up with the best treatment plan.
As one of the most complex surgical procedures, hepatobiliary surgery calls for a great degree of skill and precision. Our board-certified surgeons, led by Dr. Mark Fraiman, perform more pancreas and liver surgeries than any other team of doctors in Baltimore, MD. We offer the newest techniques and utilize the latest in technology and minimally invasive surgical approaches.
What Is Hepatobiliary Surgery?
Hepatobiliary surgery is used to treat patients who have cancers and diseases of the pancreas, liver, gallbladder and bile duct. It involves the removal (resection) of primary and metastatic tumors in these organs. It is also used to treat benign diseases such as cysts, lesions, bile duct injuries, gallstones and portal hypertension.
What Is the Function of the Hepatobiliary System?
The hepatobiliary system involves the functions of the liver as well as bile ducts or bile and the gallbladder. The word hepatobiliary combines two medical terms — hepato-, relating to the liver, and -biliary, which is related to the bile ducts, bile and the gallbladder.
The hepatobiliary system has two main roles:
- Ensure waste products are drained from the liver into the duodenum, which is the first part of your small intestine just past the stomach
- Assist in the digestive process by controlling the release of bile
Bile consists of waste products, cholesterol and bile salts. This greenish-yellow fluid is secreted by liver cells to carry waste away and break down fat during digestion. Bile is excreted from your body in the form of feces, giving it its dark brown color.
The hepatobiliary system is important to your overall health and well-being, as it provides a number of essential functions:
- Processes and metabolizes nutrients and other substances
- Stores and distributes these items to the blood or bile
- Detoxifies your body by removing unwanted or harmful chemicals
- Breaks up fats and other components of your diet
- Aids in digestion and absorption of essential nutrients
- Produces about a liter of bile daily
Diagnosis
Tumors in the liver typically present with non-specific symptoms and are diagnosed with CT or MRI scans of the abdomen. Sometimes, we may also use a biopsy to confirm the diagnosis. But often just the blood work and imaging is enough to discern the exact type of liver tumor.
Pancreas, bile duct and gallbladder tumors mostly present with jaundice and other vague abdominal symptoms. They also require CT and MRI scans to make the initial diagnosis and sometimes endoscopy to pinpoint the exact problem.
What Is the Purpose of Hepatobiliary Surgery?
Hepatobiliary surgery is necessary to treat cancers and other diseases that affect your liver, gallbladder or bile duct. This process could include the removal of tumors from your liver, bile duct or gallbladder. Hepatobiliary surgery could also be used to treat benign conditions such as:
- Cysts
- Bile duct injuries or blockages
- Portal hypertension
- Gallstones
- And more
Major resections to remove tumors affecting your liver, gallbladder or bile duct may also call for complex reconstructive procedures involving the bile duct, hepatic artery or portal vein. For this reason, you should be sure your surgeon is well-versed in the complexities of the hepatobiliary system.
Surgical procedures involving the hepatobiliary system require a multidisciplinary team that can devise an individualized treatment approach for each patient. Dr. Fraiman and the team at St. Joseph’s Medical Center bring their specialized knowledge to each and every patient requiring hepatobiliary surgery to ensure the highest level of care.
Biliary Procedures Performed
Biliary procedures include:
- Common bile duct reconstruction (Roux-N-Y Hepaticojejunostomy): Bile duct reconstruction surgery becomes necessary if the bile duct is accidentally injured during a laparoscopic cholecystectomy, a procedure involving the removal of the gallbladder through several keyhole incisions in the abdomen. Fortunately, bile duct injury is rare and happens in only 0.1% of all laparoscopic cholecystectomies.
- Resection and reconstruction of biliary tumors (Klatskin tumors): When removing a diseased portion of the bile duct, the surgical approach always involves a procedure known as biliary reconstruction. In this surgery, a surgeon reshapes a piece of intestine to help attach the remaining portion of the bile duct to the small intestine and restore the flow of bile juices from the liver to the small intestine.
- Laparoscopic cholecystectomy: This is a procedure in which the gallbladder is removed through laparoscopic techniques with the assistance of a small video camera and tiny surgical instruments. The benefits of laparoscopic cholecystectomy include minimal scarring, less blood loss, quick recovery times, and shorter hospital stays.
Recovery
As with all major operations, recovering from hepatobiliary surgery takes time. Complete recovery requires an average of two months. Depending on the type of surgery, you’ll be hospitalized for one to three weeks to allow us to monitor your progress carefully. Some common complications after this surgery include leakage from the numerous intestinal connections made during the operation, bleeding and infection. These complications are managed with a combination of antibiotics and drainage tubes.
Success Rate
When used to treat cancer, hepatobiliary surgery has a success rate of 80 percent, a complication rate of 20 percent and a mortality rate of less than two percent. The complications arising from hepatobiliary surgery are more or less the same as any other operation depending on the severity of the tumor and the overall health of the patient.
Where Is Hepatobiliary Surgery Available?
At St. Joseph’s Medical Center, we are committed to giving you individualized care. Our multidisciplinary team of surgeons, therapists and nurses are here to walk with you through the entire treatment and recovery process. Patients will benefit from St. Joseph’s Medical Center’s latest equipment and facilities.
To learn more about how Dr. Fraiman may be able to help you or about other procedures offered, such as liver resections, Whipple procedures, and pancreatic cancer surgery, call 410-427-2024 to schedule a consultation today.
