The term "hepatobiliary" refers to the liver, the gallbladder, bile ducts or bile. Disease of the liver and biliary system may be caused by viral, bacterial, or parasitic infections, neoplasia, toxic chemicals, alcohol consumption, poor nutrition, metabolic disorders, and cardiac failure. The incidence of liver disease continues to grow in the United States largely due to an aging population, obesity, and the increasing number of patients diagnosed with hepatitis C. Because of this, the interdisciplinary Hepatobiliary Program at White Plains Hospital is answering the need for advanced liver care.
Common conditions treated:
- Liver failure
- Liver cancer
- Liver tumors
- Bile duct constriction
- Gallbladder cancer
- Cysts in the liver, bile ducts or pancreas
- Pancreatic tumors
Diagnosis and treatment
The Hospital utilizes FibroScan Technology, which measures the stiffness or elasticity of the liver, to assess the condition of the liver and better inform physicians of proper liver disease treatment following diagnosis. A multidisciplinary liver disease team, consisting of gastroenterologists, hepatologists and surgeons, works alongside medical and radiation oncologists to tailor individual liver disease care plans which may include surgery, ablation and embolization procedures, advanced endoscopy and medical and radiation oncology.
Interventional Oncology (IO), the most recent development in interventional radiology, is a critical component of the multidisciplinary cancer team at the White Plains Hospital Center for Cancer Care.
IO therapies fall into two main categories:
- Arterial-based treatments. Arterial-based treatments block blood vessels leading to tumors by using tiny beads dosed with chemotherapy or radiation. These procedures essentially starve the tumor of blood while killing cancerous cells directly without causing side effects in the rest of the body. The two most common treatments are transarterial chemoembolization (TACE) or transarterial radioembolization (TARE). Radioembolization is also known as selective internal radiation therapy (SIRT) or Y90 treatment. These therapies are primarily used to treat liver cancer or metastatic disease that has emerged in the liver.
- Ablative therapies. Ablation is the minimally invasive use of small probes to direct heat or cold in a very controlled manner to destroy tumors through a tiny puncture in the skin. The tumor subsequently dies and then is reabsorbed by the body. The two common treatments, microwave ablation and cryoablation, can be used to treat a variety of primary tumors including liver, lung, kidney and almost any metastatic process that affects these organs.
Individualized treatment plans are created for patients, whether for complex liver, bile duct and pancreas surgery, laparoscopic liver and pancreas resections or laparoscopic ablations of liver tumors. If needed, portal vein embolization is a process to block blood flow to a portion of the liver identified for resection. Tumors confined to the head of the pancreas can be treated by the Whipple procedure, a complex surgery in which the head of the pancreas, the first part of the small intestine, the gall bladder and the bile duct are removed. The remaining, healthy organs are then reconnected to allow normal digestion.
Transplant patients receive assessment, testing, pre-transplant care and follow-up care at White Plains Hospital, while the procedure and some pre- and post-surgical testing takes place at Montefiore Medical Center. This is the result of a collaborative decision by both institutions to make these services available locally so that patients can be cared for in their own community.
Our team of physicians
Dr. Roayaie brings unique surgical skills for patients needing complex liver, bile duct, and pancreas surgery, including the Whipple procedure. Dr. Schwartz is a board-certified hepatologist trained in treating patients with acute and chronic liver diseases, including those that require liver transplantation. Dr. Burshteyn is the Director of Interventional Oncology, a subspecialty of interventional radiology that uses image guidance and minimally invasive procedures to treat and cure many types of cancer by shrinking and destroying tumors. This liver disease team heralds a new chapter in advanced cancer care for Westchester County.