Hepatobiliary-Pancreatic Surgery at Maimonides

At Maimonides Health, our Hepatobiliary-Pancreatic (HPB) Surgery program—called the Liver, Bile Duct & Pancreatic Surgery Program—offers Brooklyn’s highest level of surgical care to patients with advanced digestive, gallbladder, pancreatic, and liver disease. These conditions can be challenging to treat. So, our expert surgeons take a multidisciplinary approach. We deliver the convenient, comprehensive care you need.

With Brooklyn’s most experienced team of board-certified hepatobiliary and gastrointestinal surgeons, we can diagnose and treat your HPB condition. Through a collaborative approach to care, we offer the most advanced diagnostics. And we provide the most innovative, minimally invasive treatment options.

As Brooklyn’s only fully integrated HPB surgery program, we treat thousands of patients with HPB disease every year. We’re your healthcare partner and will walk you through your HPB journey. Learn more about the conditions we treat and the therapies we offer.

What is the Maimonides Difference?

When you have HPB disease, you need individualized attention. We work with a wide variety of specialists to create a personalized plan for your pre-surgical, surgical, and post-surgical care. In addition to our expert surgeons, our team of providers focuses on all aspects of your specific needs. Our integrated team can include experts in:

• Cancer Care (Oncology)
• Gastroenterology
• Hematology
• Interventional radiology
• Pathology
• Radiology

We rely on advanced diagnostic imaging tools like leading-edge CT scans to detect and identify your condition. Together, we deliver targeted care for benign (non-cancerous) and malignant (cancerous) conditions. Our surgeons use laparoscopic, minimally invasive, and robotic techniques to perform simple procedures like hernia repairs or more complex surgeries.

With us, you can be confident you’ll receive leading-edge, comprehensive care.

What Conditions Do We Treat?

HPB disease can affect your bile ducts, gallbladder, liver, pancreas, or other parts of your digestive system. For the best care, you need a team with advanced training and expertise in all HPB conditions, including complex and rare cases. Our expert surgeons have special training to offer treatment for:

• Bile duct injury, infection, or obstruction (blockage) and cancerous bile duct tumors
• Gallbladder diseases, including cholecystitis (chronic inflammation), gallstones and cancer
• Gastrointestinal stromal tumors
• Liver disease, including cirrhosis or liver cysts and benign liver tumors and cysts
• Neuroendocrine tumors
• Pancreatic conditions, including chronic or severe pancreatitis, pancreatic cancer
• Retroperitoneal abdominal soft tissue sarcomas

Gastrointestinal & HPB Cancer

If you receive a gastrointestinal or HPB cancer diagnosis, surgery could be part of your treatment plan. Our surgeons use the most advanced tools to perform the full spectrum of simple and complicated HPB procedures. You can be confident that we’ll help you reach your best outcome.

We specialize in treating these cancers:

• Gastrointestinal (GI) tract, such as esophageal, small intestine (small bowel), and stomach cancer
• HPB system, including bile duct, gallbladder, liver, and pancreatic cancer
• Neuroendocrine cells that cause neuroendocrine tumors to develop in your GI tract or pancreas

What HPB Treatments Do We Offer?

In the Liver, Bile Duct & Pancreatic Surgery Program, we offer many HPB treatment options. With access to the most sophisticated tools, our surgeons complete procedures that are only available in a few other hospitals nationwide. Your care team will work with you and your physician to determine the best treatment for your condition.

Bile Duct Surgery

When you have blocked or inflamed bile ducts, waste products can build up in your bloodstream. When this happens, you can experience pain and jaundice, a condition where your skin and the white part of your eyes turn yellow. To relieve these symptoms, our surgeons frequently perform:

• duct repair – This procedure, called Roux-en-Y hepaticojejunostomy, creates a new path for bile (digestive fluid produced by your liver) in your body. This technique can fix a blockage, injury, or narrowed section of your biliary system.
• Bile duct resection – This removal of all or part of your bile duct can treat cancerous and non-cancerous tumors, infection, inflammation, or complications from another surgery.
• Biliary bypass – To unclog a bile duct, this procedure re-routes the flow of bile in your body.
• Biliary stent placement – Our surgeon uses a small tube (called a stent) to open your bile duct.

Gallbladder Removal

If you have gallstones (small stones of hardened bile) or gallbladder inflammation, we may need to remove your gallbladder. This procedure is called a cholecystectomy. Based on your unique case, our bile duct surgeons can remove your gallbladder in two ways:

• Laparoscopically – making several small incisions and using tiny surgical instruments
• Open procedure – making one large incision in your abdomen to remove the organ

Liver Surgery and Treatments

If you have liver disease—like cancer, cirrhosis, or hepatitis—that other treatments can’t control, surgery may be your best option. Our liver surgeons are skilled in using the most advanced surgical techniques for a full range of liver procedures. The surgeries we offer include:

• Liver ablation – This procedure targets liver tumors with a needle to shrink or destroy them.
• Liver resection – Also called a hepatectomy, this procedure removes all or part of your liver.
• Liver transplant – If your liver no longer works, our surgeons remove it and replace it with one from a healthy donor.
• Radioembolization – Also called selective internal radiation therapy or Y-90, this interventional radiology procedure uses X-ray guidance and a thin tube (called a catheter) to deliver radioactive beads that can shrink your liver tumor.

Pancreatic Surgery Services

Pancreatic disease can range from mild to life-threatening. So, convenient care is critical. Whatever your condition, Maimonides delivers state-of-the-art care that’s close to home. Our HPB program offers:

• Pancreatectomy – This procedure removes all or part of your pancreas.
• Puestow procedure – Also called lateral pancreaticojejunostomy, this procedure drains the ducts in your pancreas to relieve pancreatitis-related pain.
• Total pancreatectomy with islet autotransplantation (TPIAT) – This procedure removes all or part of your pancreas to reduce or eliminate pancreatitis-related pain.

Whipple Procedure

The Whipple procedure, also called pancreaticoduodenectomy, is a complex surgery. During this procedure, our surgeons remove the head of your pancreas, part of your small intestines, your gallbladder, and the bile duct. The goal is to remove cancer to stop it from growing or spreading. For many cancers, the Whipple procedure is the only treatment option that can offer long-term survival or a cure.

Frequently, we perform this procedure to treat pancreatic cancer that hasn’t spread. But this surgery can also treat:

• Ampullary cancer
• Bile duct cancer
• Neuroendocrine tumors
• Pancreatic cysts
• Pancreatic trauma
• Pancreatic tumors
• Pancreatitis
• Small intestines (small bowel) cancer
• Small intestines trauma

What Should You Expect?

We understand that facing surgery can be overwhelming, and it’s natural to feel nervous. We are here to help you through the process. Our surgeons will thoroughly explain your procedure, ensuring you understand what to expect. Our patient navigators can also answer any questions and help coordinate your care.

Before your surgery, you can expect:

• A pre-operative assessment to ensure you are ready for surgery.
• Consultation with an anesthesiologist to ensure your safety and comfort during the procedure.
• Detailed instructions on how to prepare for surgery.
• Emotional support if you’re feeling anxious.

After your surgery, you can expect:

• Recovery room monitoring, where our team will monitor your vital signs and ensure you are comfortable as the effects of anesthesia wear off.
• Pain management with appropriate medications and techniques to ensure you recover comfortably.
• Post-operative care instructions and schedule follow-up appointments.
• Support for a successful recovery and what you can expect in the days, weeks, and months ahead.
• Rehabilitation services to help you regain strength and function.