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Memorial Sloan-Kettering's Hepatobiliary Disease Management Team -- a multidisciplinary group of some 30 surgeons, gastroenterologists, radiologists, interventional radiologists, pathologists, medical oncologists, and radiation oncologists -- has seen several thousand patients with cancers of the liver, gallbladder, bile ducts, and pancreas over the past decade, making us a leader in treating hepatobiliary cancers. Our comprehensive approach to care ensures that every patient receives the most appropriate treatment depending on which organ is involved, how extensive the tumor is, and the patient's general health and age.
Our work is nationally and internationally recognized as being at the forefront of clinical knowledge in gallbladder cancer, liver cancer, and other cancers of the biliary tree. Our team also includes a group of specialized interventional radiologists who are on the forefront of using nonsurgical, minimally invasive procedures with the help of image guidance from computed tomography (CT) scanning and ultrasound. We also treat many patients with benign hepatobiliary diseases or conditions.
Leading Edge of Surgical Technique
For most biliary cancers, surgery is often the most effective therapy, and therefore early and proper surgical evaluation is an important part of devising a treatment plan. Our surgeons have developed a full range of techniques for effective and safe surgery, which often allow us to operate on patients whose conditions were considered inoperable elsewhere. If additional treatment is necessary after surgery, experienced gastroenterologists, interventional radiologists, radiation oncologists, and medical oncologists are on staff to provide it.
Memorial Sloan-Kettering has pioneered laparoscopic methods for both the diagnosis and treatment of biliary cancers. Laparoscopy is the insertion of a thin, lighted tube with a camera at its tip through a small incision in the abdominal wall. The instrument used is called a laparoscope. This technique can be used to inspect the inside of the abdomen and remove tissue samples for a biopsy. Surgical instruments can be used during laparoscopy.
Our investigators have shown that hepatobiliary surgery can be performed on elderly patients with good outcomes that are comparable to those of younger patients, and that age should not be the sole determinant when deciding whether an older patient is a candidate for surgery.
Advanced Imaging Technology
Diagnosing any kind of hepatobiliary cancer can be difficult because this part of the body is complex and includes several organs and major blood vessels. Planning surgical treatment or selecting other therapies for these tumors depends on high-quality diagnostic imaging. Memorial Sloan-Kettering has a team of radiologists who specialize in imaging for the hepatobiliary region of the body.
Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine scans are the primary noninvasive diagnostic methods used at Memorial Sloan-Kettering. Over time, these imaging techniques have become more sophisticated and are capable of revealing more details, such as the exact size, density, and nature of a newly diagnosed tumor, as well as a tumor's response to treatment.
Approaches to Image-Guided Therapies
At Memorial Sloan-Kettering, our team of interventional radiologists is a leader in percutaneous, minimally invasive procedures and treatments. These procedures are performed "through the skin" without conventional surgery or incisions into the body, with the help of image guidance such as CT or ultrasound. A range of procedures are performed at Memorial Sloan-Kettering, including embolization, thermal ablation, biliary drainage (to relieve jaundice), and chemical ablation. Our goal is to treat patients using methods that minimize the time spent in the hospital as well as overall recovery time.
Our doctors and researchers are actively involved in the development and study of many of these new treatment approaches. In some cases, diagnosis is performed invasively, by removing a small amount of tissue for a biopsy, or by inspecting parts of the interior of the abdomen using a laparoscope. Diagnosis can also be made by image-guided needle biopsy.
