Hepatobiliary, pancreatic and advanced gastrointestinal care

Sharp HealthCare offers comprehensive inpatient and outpatient liver and digestive care management:

• Board-certified physicians trained in all aspects of liver, pancreas, gall bladder and bile duct conditions, including pre- and post-liver transplantation

• The latest technology to manage the symptoms of liver failure

• Phase I and II clinical trials to investigate new drug therapies

Sharp HealthCare provides interventional radiology (IR) procedures called locoregional therapies, which include angiogram-based and thermal-ablation procedures, and are performed without surgical incisions. IR procedures have been especially helpful in treating hepatomas or hepatocellular cancers (HCC), which start in the liver. There are currently no effective oral or intravenous chemotherapeutic agents to treat HCC. Only about 20% of patients are candidates for surgical resection; and traditional external beam radiation therapy has a limited treatment role.

• Angiogram procedures — Y90 radioembolization and transarterial chemoembolization (TACE) procedures deposit either tiny radioactive particles or chemotherapy-loaded beads directly into the tumors via the blood vessels that supply them. Y90 and TACE are done under sedation.

• Thermal ablation procedures — Specialized probes are passed through the skin and into the tumor. The probes are precisely guided using CT or ultrasound imaging. When activated, the probes destroy the tumor by heating or freezing it. The heating is typically produced with microwave energy, while the freezing is the result of flowing a cryogenic gas (argon) through the probe. Ablations are typically done with general anesthesia. The goal of locoregional therapy depends on the stage of the cancer. Many patients can have their cancer eliminated completely with these therapies, while others are improved enough to make them candidates for a final goal of liver transplantation.

Sharp HealthCare offers comprehensive surgical management, including options for general surgery, advanced liver surgery, and hepatic resections of primary and secondary tumors.

Patients with liver or digestive diseases who require surgery are at greater risk for surgical and anesthesia-related complications than those who are healthy. Surgical procedures for patients with advanced disease may be high risk related to the potential for coagulopathies, bleeding and multi-organ failure. Even patients undergoing typically low-risk general surgeries, such as cholecystectomies, should be referred to a surgical specialist for care. The level of the risk depends on the type of disease, its severity, the surgical procedure and the type of anesthesia administered.

Conditions and services

• General surgery on cirrhotics

• Liver biopsy

• Liver, pancreas, gall bladder and bile duct cancer

• Portal hypertension

• Tumor ablation

• Tumor resection

Sharp HealthCare offers advanced endoscopic ultrasound (EUS) that has potentially significant clinical applications for the diagnosis and treatment of liver and digestive disorders. It provides high-resolution, unobstructed, real-time imaging, enabling surgeons to have improved visualizations of the liver and digestive tract. Other tools, such as Doppler, elastography and contrast, can be used to improve its diagnostic yield. EUS-guided interventional procedures that measure portal hepatic pressure, ablate hepatic tumors and cysts, and drain abscesses have great potential to be patient-friendly, cost-effective treatment alternatives with limited risk of complications.