Liver, Pancreatic and Biliary Surgery

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Liver Pancreas Gallbladder
& Bile Duct General Surgery

Welcome to the Wessex Hepatobiliary Surgery

Hepatobiliary surgery is dedicated to the treatment of diseases of the

liver
bile duct
gallbladder
pancreas
duodenum

This is a highly specialised branch of surgery that is generally practiced in large teaching hospitals. I am one of a small team of surgeons, based in Southampton, who are referred patients from a large area ranging from Dorchester, through Poole and Bournemouth in the West, to Portsmouth

and Chichester in the East. Patients also come from Basingstoke, Winchester and Salisbury and the Isle of Wight and Channel Islands in the South.

In Southampton, we see and treat hundreds of patients every year and this critical mass of expertise means that you will receive comprehensive treatment based on the latest research. Every patient that I see, with a complex hepatobiliary problem, will benefit from having their case discussed by a team of doctors comprising oncologists, hepatologists and radiologists. This ensures that treatment is tailored to each patient and provided by a highly experienced team.

Interesting Facts: Regional Services

I am part of a team of 5 surgeons who provide a regional hepatobiliary surgical service for approximately 4 million patients. It has been found that concentrating treatment for these conditions improves outcomes.

Interesting Facts: Pancreatic Cysts

There are a variety of cysts that can form in the pancreas. Some are considered pre-cancerous, whilst others are as a result of a benign condition called pancreatitis. It is vital to identify the type of cyst to determine how to treat it and this done with an investigation called an endoscopic ultrasound (EUS). It involves an endoscopy, performed while you are sedated.

Interesting Facts: Lymph Glands

Lymph glands (or nodes) are removed during cancer surgery because cancer cells can spread to them from the main tumour. Removing these glands not only removes the cancerous cells but also gives information on how the tumour is behaving. They are normally situated around blood vessels, which are completely exposed when the surgery is performed properly.

Interesting Facts: Neuroendocrine/Carcinoid Tumours (NETS)

These tumours are a rare form of tumour that can occur in the pancreas. They do not behave like pancreatic cancer but follow a more indolent course. I am part of a team in Southampton who have a special interest in treating these tumours. NETS can be visualized with a radiolabelled drug during a procedure called and octreotide scan.

Interesting Facts: Benefits of seeing a specialist hepatobiliary surgeon

The anatomy of the bile ducts is extremely variable. If the bile duct is damaged during removal of the gallbladder it can have lasting consequences and require further surgery to resolve. Specialist hepatobiliary surgeons operate around the bile duct during every case and are more likely to recognise these anatomical variations making this complication less likely.

Interesting Facts: The liver is the only organ in the body that can regenerate

This was recognised in Greek Mythology in the legend of Prometheus. As a punishment, Prometheus is chained to a rock by Zeus. He is visited daily by an eagle, which feeds on his liver. He survives only by virtue of the liver regenerating by night. The reality is that it does not happen this quickly but the liver starts regenerating soon after a part of it is surgically removed. This quality allows us to achieve some quite remarkable liver surgery.

Interesting Facts: Liver tumours can be destroyed using microwaves (Microwave Ablation)

Technology now permits the use of microwaves to ablate liver tumours. We use this technique as part of the surgical approach. It can be done during surgery or as a separate procedure is done by a radiologist.

Interesting Facts: What is cancer?

Throughout this website I refer to tumours. A tumour is essentially a growth or a lump that should not be there. Because they arise from within the body, they are not seen as ‘foreign’ are not therefore attacked and eradicated by the body’s immune system. Tumours can be defined as benign or malignant. A tumour is a cancer when it is malignant. We can tell if a tumour is malignant by looking at it with a microscope. Malignant tumours have the ability to spread by growing into adjacent organs or through the blood stream. A benign tumour does not have the ability to spread but they are often regarded as precursons of malignant tumours and usually need to be removed.

Interesting Facts: You can have your hernia repaired as an NHS patient in a private hospital

In recent years the government has introduced a system called ‘Choose & Book’, which gives you the choice as a patient to decide where you have treatment. If you wish to have your hernia repaired at the Spire Hospital in Southampton, please ask your GP to refer you to me via the choose and book service.