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Leading Edge of Surgical Technique
For most hepatobiliary tumors, surgery is often the most effective therapy, and therefore 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 considered inoperable elsewhere. If additional treatment is necessary after surgery, experienced gastroenterologists, interventional radiologists, radiation oncologists, and medical oncologists are available.
Our surgeons, who perform roughly 300 liver operations each year (the most of any center in the United States), pioneered a surgical approach that significantly reduces blood loss and the need for potentially complication-causing blood transfusions. Our doctors are also developing "liver-sparing" surgical techniques that leave more of the normal liver intact. Partly as a result of these techniques, most of our liver surgery patients require a hospital stay of less than 10 days, and the majority of these patients do not require blood transfusions.
Memorial Sloan-Kettering is also pioneering laparoscopic methods -- these employ a special instrument that is passed through the abdominal wall and has a small camera at the end of a tube -- for removal of part of the liver (partial hepatectomy) in selected cases.
Our investigators have recently shown that hepatobiliary surgery can be performed in elderly patients with good outcomes comparable to those of younger patients, and that chronological age alone should not be the sole determinant when deciding upon surgery in patients over the age of 70.
Advanced Imaging Technology
Planning surgical treatment or selecting other therapies for hepatobiliary tumors depends on high-quality diagnostic imaging of the tumors. Memorial Sloan-Kettering has a team of radiologists who specialize in hepatobiliary imaging. Diagnosing hepatobiliary cancer can be difficult since this part of the body is complex and includes several organs and major blood vessels. Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine scans are the main noninvasive methods. Diagnostic imaging techniques have become more sophisticated, capable of revealing more details such as the exact size, density, and nature of a newly diagnosed tumor and response to treatment. 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 scope.
