The bile ducts and the liver are closely interconnected. We offer the following surgical procedures to manage problems in this region of the body:
Excision of choledochal cysts
When we need to remove the bile duct because of a problem called a choledochal cyst, we first remove the bile duct and the gallbladder. The bile duct must then be reconnected to the smal intestine to perform its important role in digestion.
Resection of bile duct cancers
This procedure involves removing part of the bile duct. In many cases, we collaborate with other specialists to perform radiation therapy, chemotherapy, or both in the same operation. Learn more.
Repair of bile duct injury
If you sustain a bile duct injury during gallbladder surgery, you will need to undergo a second operation to repair it. We tailor the repair of the bile duct to the injury. At times, you will need part of your liver removed. Very rarely, you’ll need a liver transplant. Most often, you’ll just need an operation to reconnect the bile duct to your intestines.
When it is clear that the narrowing of the bile duct is not cancerous, we have a few options in treatment. One long-term solution would be to perform a surgical procedure to re-route the bile duct so that it drains the bile into the intestine above the level of a stricture.
In order to remove masses from the liver, we need to remove the portion of the liver where the mass is located. The liver is one of the few organs that can grow after part of it is removed in a process called regeneration. Liver resection can be necessary for primary liver, bile duct, or gallbladder cancers, metastatic liver lesions, or benign lesions of the liver. In addition to open surgery, we can perform this procedure through minimally invasive techniques including laparoscopic and robotic approaches. These approaches can decrease pain, shorten hospital stay, and speed up recovery time.
Ablation is a procedure to destroy a tumor without removing it. It can be done percutaneously (through the skin) by an interventional radiologist using imaging (either ultrasound or CT scan) to localize the tumor and then pass a needle through the skin directly into the tumor. We can perform a similar technique surgically, with minimally invasive techniques when necessary.
Enucleation of benign hepatic tumors
Enucleation is where the tumor is removed without also removing a portion of the liver. For example, when a hemangioma needs to be removed, in some cases you can remove only the lesion without removing any normal liver. This procedure cannot be done with malignant tumors.
Hepatic cyst fenestration
Fenestration is opening the cyst cavity widely so that the fluid that was under pressure can be drained. The goal of the procedure is to prevent fluid from re-accumulating. Fenestration involves removing the part of the cyst that is outside of the liver and using a variety of techniques to prevent the cyst from coming back. We can perform this procedure laparoscopically or robotically.