300 + Liver Operations

liver operation

Celebrating 300 Liver Operations by Dr. Iswanto Sucandy and Team in Tampa Bay

Last week, our team has reached an important milestone of completing 300th liver surgery for liver cancer, gallbladder cancer, and biliary tract cancer in Tampa Bay Area. Our liver surgery program formally began in early 2017 working collaboratively with a team of hepatobiliary surgeons, diagnostic radiologist, interventional radiologist, medical oncologist, and radiation specialist. Dr. Iswanto Sucandy came from University of Pittsburgh Medical CenterStarzl Institute to Tampa Bay Area to lead this program. We deliver an expert care for patients with benign and malignant liver, gallbladder, bile duct, and other complex gastrointestinal diseases with expertise in minimally invasive and robotic liver surgery. Dr. Sucandy, a liver specialist and a liver surgeon brought his minimally invasive surgery expertise to help patients in our area, who used to often travel out of state for their care.

We recognize the need for treatment of liver cancers, gallbladder cancers, and biliary tract cancers in our community by an expert team of experienced surgeons. It is very important to find the best liver surgeon to undertake such as complex operations to achieve cure. “Surgical treatment via liver resection, enblock gallbladder resection, and biliary resection & reconstruction is the only hope for cure”,  said Dr. Sucandy.  New research studies are being piloted everyweek in this arena, with surgical resection always serves as the mainstay of treatment. Chemotherapy and radiation therapy are used in combination to surgery. There are only very few centers in the United States that focus on the treatment of these diseases. Even fewers centers that can offer minimally invasive surgical techniques for liver surgery within the United States.

Since the first year of our liver surgery program, we have been treating patients with benign liver tumors such as hepatic adenoma to malignant liver tumors such as colorectal liver metastasis, neuroendocrine tumor metastasis, cholangiocarcinoma, and hepatocellular carcinoma. With a high prevalence of colon cancer with liver metastasis, robotic liver resection for this disease is the most common type in our program. In about 85% of patients, we are able tosuccesfully perform robotic liver resection with a complete tumor removal. We routinely treat patients with gallbladder cancers, also using robotic liver surgery with enblock gallbladder removal.

In about 15% of patients, we undertook traditional open liver resections due to the need for major vascular resection and reconstruction such as inferior vena cava (blood vessel that brings blood to the heart) or main portal vein (blood vessel that feeds the liver). Today, our center performs more than 100 liver resections annually and liver operation has become routine in our hands. We do not have week without a liver resection. Our anesthesiologists, nurses, and ancillary staffs are no longer foreign to complex patients undergoing liver surgery, gallbladder surgery, biliary tract surgery, and other complex abdominal GI surgery. 30% of our liver, gallbladder, and bile duct patients come from other surgeons such as community general surgeons and colorectal surgeons, as far as 300 miles away.  In the past week for example, we undertook an extended liver resection, enblock diaphragm resection, right adrenal gland resection for a 21 cm right sided hepatocellular carcinoma liver cancer in a 65 year old man.  The tumor was completely removed and surgical cure was achieved. Two days later, we removed a 14 cm left sided bile duct cancer (liver biopsy confirmed intrahepatic cholangiocarcinoma) from a 71 year old woman from New Port Ritchey. The tumor was so large, compressing  her inferior vena cava requiring repair/reconstruction. Both were doing well and they were discharged home after 6 days.

We are excited with our current success and we are looking forward to serve more patients in need.  It is absolutely critical to find the best liver surgeon in your area for treatment of liver, gallbladder and biliary cancers because the operating surgeon’s experience plays a significant role for outcomes and prognosis. Liver cancer treatment can be very difficult requiring the best liver specialist. Similarly, gallbladder cancer and bile duct cancer treatment can also be very challenging involving interventional radiologist and advanced endoscopist which are only available in tertiary referral centers. Nothing more important than findings the best gallbladder surgeon or bile duct surgeon for treatment.

Aside from handling major liver tumors, our center also receives a high volume of patients needing laparoscopic cholecystectomy (gallbladder surgery/gallbladder removal)  for various gallbladder diseases. Gallstones are seen in majority of them. Many patients came with anticipated technical difficulties such as morbid obesity, liver cirrhosis, ascites, or prior open upper abdominal operations. Many patients come with issues such as bile leak after a laparoscopic cholecystectomy done at other facilities in the region. Few patients a year come with surprising results of laparoscopic liver biopsy indicating liver or gallbladder cancers,  during an operation for other reasons.  We are happy to deliver care to all these very complex cases and help with the journey toward recovery.

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