Your Surgery__________________
Surgical removal of hepatobiliary and pancreatic cancers offers the best chance of cure. The doctor's interpretation of your imaging studies (CT scan, MRI, PET, etc.) and your overall condition, determine if you are a candidate for surgery.
Open Surgery
All surgery is performed under general anesthesia. Depending on the operation to be performed, an incision will be made down the middle of your abdomen, or under the right or left ribcage. Some patients will undergo diagnostic laparoscopy (placement of a camera through small incisions) to make sure there is no spread of the cancer prior to making the incision.
For all liver operations and some pancreas operations, Drs. Heckman and Keim use an ultrasound machine to examine the organ thoroughly and help with the operation. The operation proceeds meticulously.
Most hepatobiliary operations do not require a blood transfusion.
At the completion of some operations, a plastic drainage tube that exits the skin may be put in place. This drain is generally removed prior to discharge but may stay in longer if necessary. We do recommend epidural catheter placement for pain control after surgery. An anesthesiologist will place this prior to the operation. If this cannot be done, you will be given a patient-controlled analgesia pump.
Resumption of diet will begin when the doctor orders. Most hepatobiliary operations take a minimum of three hours; longer if you require a complex operation. Your length of stay in the hospital will usually be five to ten days.
Laparoscopic Surgery
Drs. Heckman and Keim will determine if you are a candidate for laparoscopic surgery, or minimally invasive surgery. Laparoscopic surgery is performed through small incisions using special instruments and technology. The benefits of laparoscopic surgery are:
- less pain, smaller incisions;
- shorter hospital stay; and,
- earlier return to baseline function.
Your length of stay in the hospital will usually be one to five days for laparoscopic hepatobiliary surgery.
Liver Tumor Ablation
LIver Tumor Ablation is a technology that uses heat to destroy tumors. Drs. Heckman and Keim will determine if you are a candidate for this procedure. It can be performed through the skin, laparoscopically or during open surgery. Your length of stay in the hospital will usually be one to two days.
Intrahepatic Chemotherapy and Radiation Therapy
This treatment involves infusing chemotherapy or radiation directly into the liver. It will be used if you have inoperable liver tumors and preserved liver function. You will be admitted to the hospital the day before the procedure for intravenous hydration, and you will be seen by an oncologist who will prescribe the chemotherapy. An interventional radiologist will perform the procedure. Generally, patients stay one night in the hospital and are discharged home the following day. Common side effects are pain, fever and nausea.