"Pancreatic and hepatobiliary surgery" is surgery of the pancreas, liver, and bile ducts, including the gallbladder.
We at Maryland Surgeons believe that the relationship between patient and surgeon is crucially important to providing top-notch and personalized care.
Our surgeons work closely with our patients to ensure that the best possible treatment is provided in a caring and compassionate setting. We aim to ensure our patients understand clearly their disease and how each treatment option will benefit them.
Maryland Surgeons are highly skilled in pancreatic and hepatobiliary surgery and use state of the art equipment and advanced techniques when they perform surgery. Depending upon the patient, our surgeons can perform minimally invasive (laparoscopic or robotic) surgery. These surgical techniques offer easier recovery, increased precision, and improved cosmetic outcomes.
Saint Agnes is a high-volume pancreatic and hepatobiliary surgery center and both Dr. Patel and Dr. Cunningham are board-certified, fellowship-trained experts.
We specialize many pancreatic and hepatobiliary procedures, including the following:
Q. What is a "lesion"?
A. A "lesion" of the pancreas is just a fancy word for a spot, or any abnormal area of the pancreas or liver (or any organ). Lesions are often found in the pancreas and liver and may be benign (not cancer) or malignant (cancer).
Q. What are the pancreas, liver, and bile ducts, and what do they do?
A. Pancreas: Even though to the naked eye it looks like just one organ, the pancreas is really two organs in one, and the difference is obvious under a microscope. One “organ” or part of the pancreas serves an exocrine function and the other part an endocrine function. The exocrine cells of the pancreas secrete digestive enzymes into the intestine that help to break down your food into useful parts that can be absorbed by your intestines into your bloodstream. The endocrine cells of the pancreas secrete hormones like insulin directly into your bloodstream to help your body handle sugar.
A. Liver: The liver the largest solid organ in the abdomen. The main functions of the liver are to produce the many proteins that perform important bodily functions, to make the bile that helps to digest food, to store energy, and to metabolize chemicals, medicines, and other molecules. It is the only organ that has such a tremendous ability to regenerate itself. Sometimes, because of tumors, infections, or injuries, a surgeon may have to remove, or resect, part of the liver. Eighty percent of an otherwise healthy liver may by safely removed without major change in liver function. From the remaining 20%, all or most of the missing 80% will grow back again, much like the remaining branches of a pruned tree or bush will get bigger after pruning. The liver will not need to regenerate if only a small portion is removed.
A. Bile ducts: The gallbladder functions to store and concentrate bile, which is a solution mostly of salts and fats. When you eat a meal, the gallbladder squirts the stored bile out through the gallbladder’s bile duct (aka the cystic duct) to the main bile duct, then into the intestines to help digest your food.
Q. What are pancreatic and hepatobiliary cancers?
A. Pancreatic cancers may arise from one of two parts of the pancreas, the part that makes digestive enzymes (adenocarcinomas) and the part that makes insulin (neuroendocrine tumors). Hepatobiliary cancers are those of the liver and bile ducts. Liver cancers include both primary cancers of the liver (that start in the liver) and metastatic cancers of the liver (that spread to the liver from some other place, usually in the GI tract). Bile-duct cancers include those that arise from the gallbladder as well as the bile ducts themselves. All of these types of cancers are treated surgically.
Q. What is pancreatitis?
A. Pancreatitis is inflammation of the pancreas gland. It is usually treated without surgery, but in some cases of very severe pancreatitis, surgical help is essential. Our expert pancreatic surgery team has experience with the full range of state-of-the-art surgical treatments for pancreatitis, as well as pancreatic and hepatobiliary cancer.
Q. What are some common risk factors for pancreatic cancer?
A. Pancreatic cancer is one of deadliest cancers due to the symptoms not arising until the later stages of the disease. Patients often present with yellowing of the skin and eyes, commonly referred to as jaundice. The most common risk factors include current smokers and those with a history of smoking, a family history or pancreas cancer, a personal history of chronic pancreatitis, and increased age. You can lower your risk by quitting smoking.
Q. What are the different kinds of pancreatic lesions?
A. There are many different types of pancreatic lesions:
Q. What are pancreatic cysts and should I be worried about mine?
A. Pancreatic cysts are common and may be found incidentally on tests done for other reasons or may cause symptoms leading to imaging that may reveal their presence in your pancreas. There are many different kinds of pancreatic cysts:
Q. How is the pancreatic cancer treated?
A. Pancreatic cancer is typically treated through surgery, radiation, chemotherapy or a combination of these treatments. All pancreatic cancers are treated with a multidisciplinary approach. The experts that are typically involved in a multidisciplinary team include:
Surgery is the most common method of treatment. Your surgeon may recommend removal of the part of the pancreas that has the cancer or precancerous area. Some pancreatic operations can be done in a minimally invasive fashion, including laparoscopy and robotic surgery.
The most common surgical treatment is called the Whipple procedure, which is done for cancers or precancerous areas in the head of the pancreas. In this operation, part of the pancreas, part of the stomach, the gallbladder, the first 10% or so of the small intestine and the lower bile duct are removed.
For cancers or precancerous areas in the body or tail of the pancreas, a distal pancreatectomy is often performed. Both are complex procedures that require an experienced surgeon.
Chemotherapy is often used for pancreatic cancer, sometimes before surgery, sometimes after, and sometimes both. Our multidisciplinary team will help you figure out which is right for you.
Radiation treatment is sometimes used to shrink the tumor before it can be removed with surgery. Similar to chemotherapy, radiation is sometimes used before and sometimes after surgery.
Q. What are the warning signs of liver cancer?
A. Some common indicators include weight loss, nausea and pain, swelling or tenderness in the liver, and yellowing of the skin or the whites of the eyes (jaundice). Consult your doctor immediately if any of these symptoms occur.
Q. How is liver cancer detected?
A. Liver cancer is detected using blood tests or imaging exams like a CT scan, MRI scan or ultrasound.
Q. What causes liver cancer?
A. There are several risk factors for liver cancer:
Q. What are the different kinds of liver lesions?
A. Just as for the pancreas (see above) there are many different kinds of liver lesions:
Q. How is liver cancer treated?
A. At Maryland Surgeons, we take a multidisciplinary team approach to find the right diagnosis, and to design the best individual plan for you personally. We will help you understand your diagnosis and treatment options. The experts that are typically involved in a multidisciplinary team include:
Our patients are offered a full range of multidisciplinary state-of-the-art diagnostic and treatment modalities:
Q. What is a bile-duct cyst?
A. A bile-duct cyst is a choledochocele [ko-lee-DOUGH-ko-seal], a precancerous cystic enlargement of the bile duct. They are uncommon but the most common type is called type 1. These cysts have an unknowable exact risk of developing cancer within the cyst, although it is probably between 5% and 30%.
Q. What causes gallbladder problems?
A. Just like a supersaturated solution of salt water will tend to form crystals of salt, stones can form from the concentrated bile in the gallbladder and then can block the gallbladder duct, which causes pain, and can cause inflammation and even infection. Some risk factors include being female, pregnant, and overweight, but gallbladder disease is very common in all kinds of people.
For more than 150 years, Saint Agnes Hospital has been dedicated to the art of healing by providing exceptional care to the greater Baltimore area. Built on a strong foundation of excellent medical care and compassion, Saint Agnes is committed to providing the best care for our patients for many years to come.