Hepatobiliary and Pancreatic Surgery

The Brown University Health hepatobiliary and pancreatic surgery team treats patients with disorders of the liver, bile ducts, and pancreas. We are recognized nationally and internationally for our advanced, innovative research and efforts to improve patient care. 

Many liver and pancreatic surgeries can now be done laparoscopically, using small "keyhole" incisions. When surgeries are performed using this minimally invasive approach, patients often experience less post-op pain, a shorter hospital stay, and faster recovery than with a more traditional, “open” surgery. Ask your surgeon if you are a good candidate for a laparoscopy.

Liver

The liver is a large, vital organ that performs hundreds of essential functions to keep your body alive and balanced. The liver:

• Filters and detoxifies blood
• Helps with digestion
• Processes nutrients
• Makes important proteins
• Supports immunity

The liver is unique as it can regenerate, meaning it can grow back after part of it is removed.

Conditions, Surgeries, and Procedures

If you have been diagnosed with a liver tumor, the hepatobiliary surgeons at Brown University Health can help determine what type of tumor you have and whether you would benefit from having your tumor surgically removed. Surgery to remove a tumor can relieve symptoms and restore your health with potentially excellent long-term results.

If your tumor cannot be removed surgically our team has extensive experience with tumor ablation. Instead of cutting the tumor out, ablation uses extreme heat, cold, or energy to kill cancer cells in place. Over time, the body clears away the dead tissue.

At Brown University Health we treat:

• Liver Cancer: The most common liver surgery is to remove a cancerous tumor. Tumors of the liver may be metastatic, meaning they started at a different site (such as the colon or kidney) and spread to the liver, or they may be primary, meaning they arise from within the liver (such as hepatocellular carcinoma or cholangiocarcinoma).
• Benign Liver Tumors: Liver adenoma is a benign tumor but is considered precancerous. Other benign liver tumors include hemangioma and focal nodular hyperplasia (FSH). Benign tumors may need to be removed surgically if they are precancerous, or when they cause symptoms such as pain or difficulty eating.
• Liver Cysts: These are fluid-filled growths within the liver. These cysts are generally benign and do not often require surgery. When cysts are large, they may cause pain or difficulty eating. Surgery can be used to cure symptoms when they impair your quality of life or lead to weight loss.

Bile Ducts

Bile ducts are a network of small tubes that carry bile (a digestive fluid) from the liver to the small intestine. Bile helps you absorb food and provides the brown color of your stool. Blockage of the bile ducts can lead to yellowing of the skin (jaundice) and light-colored stools. Surgery can help clear these.

Conditions, Surgeries, and Procedures

The presence of bile duct cysts (choledochoceles) are a risk factor for bile duct cancer. That is why treatment for most bile duct cysts includes surgical removal of the bile duct combined with a liver bypass.

Other reasons you may require surgery of the bile duct includes blockage due to gallstones or as a result of a previous surgery.

Pancreas

The pancreas is a vital organ that helps your body digest food and control blood sugar levels. Without it you body Your body couldn’t properly digest food and blood sugar would become dangerously unbalanced. Without a pancreas, you can live a full life, but you must:

• Take insulin regularly
• Monitor blood sugar closely
• Take enzyme supplements with every meal
• Follow a structured diet

Conditions, Surgeries, and Procedures

At Brown University Health we treat:

• Pancreatic cancer affects almost 60,000 people each year in the United States. It is one of the most common reasons surgery on the pancreas is performed. You may be a candidate for pancreatic surgery to remove the tumor depending on the stage of the cancer when diagnosed. 
• Pancreatic neuroendocrine tumors (islet tumors) are more slow-growing tumors of the pancreas that can be either benign or cancerous. Neuroendocrine tumors should be removed surgically when they are at risk of being cancerous or when they cause severe symptoms, such as pain, weight loss, diarrhea, flushing, lightheadedness, ulcers, skin rash, and low blood sugar.
• Pancreatic cysts are fluid-filled growths within the pancreas. These can be benign such as pseudocysts and serous cyst adenoma or precancerous such as mucinous cystic tumors and intraductal papillary mucinous neoplasms (IPMN).
  • Pancreatic cysts should be removed when they are large; when they cause symptoms including pain, the inability to eat, and weight loss; or when they become cancerous. Your surgeon can help determine which type of pancreatic cyst you have and whether you might benefit from having your cyst removed.
• Pancreatitis refers to inflammation of the pancreas, another common reason surgery on the pancreas is performed.
  • Pancreatitis can be sudden and severe (acute pancreatitis) or chronic.
  • Pancreatitis can lead to blockage of the duct that drains the pancreas, resulting in diarrhea and weight loss. Other complications of pancreatitis include a buildup of fluid around the pancreas (pseudocyst) and chronic pain. In cases of complicated pancreatitis, surgery may be helpful to treat your symptoms.