Liver, gall bladder, bile duct & pancreatic tumor surgeries can be performed by conventional open method or by laparoscopy. Laparoscopic or Keyhole cancer surgery has several advantages over conventional open surgery with same cure rate. Only surgery is curative in these tumors and cancers. Additional therapies (chemotherapy & radiotherapy) are mostly supportive. But, many patients and their relatives try to avoid surgery for the fear of the immense trauma for their loved ones, resulting in patient getting wrong or less effective treatment. With laparoscopy the trauma is much less and makes the treatment more acceptable. The Team MACS precisely addresses all these issues and works relentlessly for a better life.
The advantages of laparoscopic cancer surgery over conventional open surgery (MACS Advantages) include:

  • Least PAIN & DISCOMFORT
  • Less BLOOD LOSS
  • COSMETICALLY BETTER (Smallest wound & scar)
  • NO PROLONGED STARVATION; Bowel movements recover much quicker
  • SHORT hospital stay
  • Quicker return to NORMAL LIFE & WORK
  • Least wound COMPLICATIONS.
  • AVOID unnecessary major surgery
  • Get all the advantages of ROBOTIC surgery.
  • Best possible CURE RATE.
  • ABOUT LIVER, GALL BLADDER, BILE DUCT & PANCREAS.

    Liver, gall bladder, bile duct & pancreas are closely related organs. The affliction of one can affect the function of the other. That is the reason why these need to be dealth with together.
    Liver is the largest gland in the body weighing about 3 kg. Liver is located under the right rib cage. It is one of the most important organs involved in cleaning blood. It produces bile which is needed to digest fat. Liver is also involved in clearing many toxic chemicals form blood. Apart from primary cancers, liver is a common place of spread of cancer forms other cancers like colon & rectum (metastasis).
    Gall bladder stores bile and releases it only when food reaches intestine.
    Common Bile Duct (CBD) transmits the bile from liver to intestine. In doing so the duct passes through the pancreas, where the pancreatic duct joins it. The duct from gall bladder (cystic duct) also joins the CBD.
    Pancreas is a gland located behind the stomach. It secretes both digestive juices and hormones like insulin. Both these functions are very important for the normal functioning of the body. Common bile duct passes through pancreas and joins the duct of the pancreas before joining intestine.

  • SYMPTOMS AND DIAGNOSIS

    The most common symptom of cancers of liver, gall bladder, common bile duct & pancreas are:

    The diagnosis is reached based on investigations which include various blood tests including liver functions tests and imaging tests like CT scan and MRI scan. A needle biopsy should never be performed on a suspected gallbladder cancer as this can spread the disease. Rarely a biopsy is needed. If the investigations shows a cancer far too progressed for a curative procedure, then only a needle biopsy is planned.

  • WHAT IS JAUNDICE?

    Jaundice is when eyes turn yellow. It is caused by accumulation of bile in the body. The detection of the cause of jaundice is important in its treatment. It results from interference in the normal flow of bile.

    Jaundice may result from:

    The first three treated with medicines. However, conditions affecting the common bile duct needs to be corrected using some form of procedure. The bile from all the tiny bile ducts in the liver drains into the common bile duct. If the common bile duct becomes narrowed or blocked (obstructed) then bile which contains bilirubin can seep out into the bloodstream and cause jaundice. This is sometimes called obstructive jaundice or post-hepatic jaundice (hepatic is another word for liver). Common conditions that can cause this include:

    • Gall bladder stones. Stones can form in the gallbladder. Usually they do not cause any problem. Jaundice is an uncommon complication of gallstones. It occurs if a gallstone comes out of the gallbladder, but gets stuck in the common bile duct. Bile then cannot pass into the gut, and so seeps into the bloodstream.
    • Cancer of Pancreas. Cancer in the head of the pancreas can block the flow of bile.
    • Cancer of Bile Duct anywhere between its exit from liver to the entry into intestine.
    • Cancer of the gallbladder may grow to block the common bile duct (late).
  • TREATMENT OF LIVER TUMORS

    Surgery is the only treatment that can cure liver cancer. Surgical removal of cancer bearing portion of liver is the treatment of choice when it is feasible. This is the same for both primary liver cancers & for metastasis (spread from cancers of colon, rectum & some other tumors). Surgery is feasible when the liver tissue left behind after surgery (FLR) is sufficient for patient's survival. This is calculated using CT scan. Surgery can range from a wedge resection of the tumor to major liver resections like right or left hepatectomy. Most these surgeries can be performed by conventional open method or laparoscopically with similar results.

  • TREATMENT OF GALL BLADDER CANCERS

    This cancer is very often diagnosed at the time of surgery for gall bladder stones or thereafter in the biopsy report. Sometimes this may be suspected on ultrasound examination or CT scan. A needle biopsy should never be performed on a suspected gallbladder cancer as this can spread the disease unless it is already confirmed to be spread. The treatment involves removal of a gallbladder along with portion of liver and lymph nodes (radical cholecystectomy). Sometimes bile duct may also have to be removed. If the gall bladder has already been removed, a completion radical cholecystectmy is necessary. These surgeries can be performed by conventional open method or laparoscopically with equal results.

  • TREATMENT OF BILE DUCT CANCER

    These are called cholangiocarcinoma. They present with jaundice. Treatment depends on which portion of the duct the cancer has affected. If upper part is affected, a portion liver has to be removed with the cancer (right or left hepatectomy). If lower portion is involved, pancreas will have to be removed along with the cancer (pancreatico-duodenectomy or Whipple's Surgery) similar to pancreatic head cancer.

  • TREATMENT OF PANCREATIC CANCERS

    Tumors of pancreas may arise in any part of pancreas.
    Head of Pancreas: The tumors or cancers arising in and around the head of the pancreas usually cause (obstructive) jaundice as they block the bile duct.
    Pancreatico-Duodenectomy or Whipple's Surgery is the treatment that is performed for these conditions. This surgery is a complex surgery and is associated with complications. The recent advances in the technique have reduced the complications. The Laparoscopy Assisted Surgery combined with specialized techniques of anastomosis (Hindenburg technique) have reduced the complications for less than 3%.
    Body and Tail of Pancreas: Various types of tumors and cancers arise in this region of pancreas. Tumors of this region need to undergo total or distal pancreatectomy. This procedure involves removal of both body and tail of pancreas. Laparoscopic distal pancreatectomy is a standard procedure.

  • FURTHER READING

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MACS Clinic

TRIMACS HEALTHCARE LLP,
#180, 1st Floor, 5 th Main Road,
Jayanagar 4 th Block west,
Bengaluru, Karnataka 560011
  200mts from Jayanagar metro station

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HCG (Center for Robotics)

Ground Floor, Tower 3, HCG Hospital,P.Kalinga Rao Road, Sampangiram Nagar, Bengaluru, Karnataka 560027

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Fortis Hospital

154/9, Bannerghatta Road, Opposite IIM-B, Bengaluru, Karnataka 560076

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