Frequently Asked Questions about Hepatobilary Surgery

What are shunt procedures?

When medication or endoscopic therapy to control bleeding varices are not successful, transplant surgeons perform surgical shunt procedures to stop the hemorrhaging. There are various types of shunt surgeries, but the basic concept is to reroute blood from the liver and in so doing, lower the pressure in the surrounding varicose veins. Some patients with advanced liver disease may not tolerate this surgery very well and others may be more at risk for developing liver failure or encephalopathy (mental confusion because of accumulated toxins in the blood) following the surgery.

What does the gallbladder do and what are gallstones?

A pear-shaped sack located under the liver, the gallbladder collects bile. Bile is the digestive agent that the liver produces. Gallstones are tiny masses that form either in the bile duct or gallbladder, blocking the flow of bile and causing the gallbladder to swell.

How do you treat gallstones?

If you have no pain or other symptoms, gallstones often can be simply watched and followed. However, if you have pain (biliary colic) or an infection (cholecystitis) then the gallbladder may need to be removed. This should be discussed with your doctor.

Whether I have a history of liver disease or not, shouldn't I just see a general surgeon, instead of a transplant surgeon, if I need liver, gallbladder or bile duct surgery?

There are many benefits to seeking care at our Transplant Institute if you have hepatobiliary disease, whether or not you may need a solid organ transplant. Transplant surgeons complete training as general surgeons first, and then go on to concentrate in solid organ transplantation including liver transplantation. Because of our experience and expertise in caring for patients with liver disease and operating on the liver, we are highly proficient in all matters pertaining to the hepatobiliary system, including surgery and mastering the complexities of the liver and biliary system. We also understand and value the importance of nurturing a long-term relationship with our patients who may need lifelong monitoring and treatment for hepatobiliary illness. Many times, working together with other BIDMC specialists, we can manage liver and other hepatobiliary conditions to help prevent further complications, including delaying transplant, should it be necessary, for as long as possible.

Whom do I call for more information?

For more information about the Transplant Institute and hepatobiliary surgery at Beth Israel Deaconess Medical Center, please call 617-632-9700.

Additional links for frequently asked questions:

American Association for the Study of Liver Diseases:

American Liver Foundation:

Liver Transplantation at BIDMC