Biliary Surgery

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.


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.

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.


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.

Dr. Fraiman explains bile duct cancer and his surgical procedures based out of the Liver and Pancreas Center of St. Joseph Medical Center in Baltimore, MD.
Dr. Mark Fraiman describes his methods for preventing common bile duct injuries. He also discusses some of the reasons that the injuries can occur.