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Liver

Transjugular intrahepatic porto systemic shunt (TIPS)

Patients with cirrhosis or scarring of the liver can present with life threatening bleeding from esophageal or gastric varices. They can also develop life limited fluid on the abdomen, known as ascites. A TIPs procedure can be performed under anesthesia to reduce the life-threatening elevated pressures in these abnormal veins. The TIPs procedure offers a relief valve to help alleviate the life-threatening bleeding or life limiting ascites. Patients stay in the hospital overnight after this procedure.

Microwave ablation

Patients with metastatic disease to the liver can be treated using a small 17-gauge needle. This needle produces significant heat used to kill abnormal cancer cells. Using CT guidance, liver lesions up to 6 cm in size can be successfully treated with microwave ablation. The procedure is performed under general anesthesia. The patient is admitted for 23-hour observation.

Pre-surgical portal vein embolization or arterial radio embolization

Patients with tumors or malignancy localized to one side of the liver can see marked improvement in survival if the disease section of the liver is removed. The interventional radiologist can shut down the blood flow to the affected side of the liver. The procedure is performed with a small catheter in the liver artery or vein. This procedure in turn causes the normal side of the liver to grow and the diseased portion of the liver to get smaller, which makes the surgery safer for the patient.

Balloon-occluded retrograde transvenous obliteration (BORTO)

Patients with cirrhosis or scarring of the liver can present with life threatening bleeding from esophageal or gastric varices. A BRTO procedure can be performed under anesthesia to shut off or embolize the abnormal bleeding veins around the stomach and/or esophagus. Patients stay in the hospital overnight after this procedure.

Chemo embolization

Patients with primary liver cancer, as well as metastatic disease to the liver, can be treated with chemo embolization. In this procedure, the arterial supply to the tumor is mapped out. Chemotherapy is administered directly into the blood vessels that feed the tumor. The medicine stays within the tumor itself and not having the systemic effects of traditional chemotherapy. This procedure is performed under conscious sedation. The patient is admitted for 23-hour observation.

Radioembolization

Patients with primary liver cancer, as well as metastatic disease to the liver, can be treated with review embolization. In this procedure, the arterial supply to the tumor is mapped out. Radiation is administered directly into the blood vessels that feed the tumor. The medicine stays within the tumor itself, avoiding the systemic effects of traditional chemotherapy. This procedure is performed in an outpatient setting, with the patient leaving four hours after the conclusion of the examination.

Liver mass biopsy

Using CT guidance, a small needle is placed into the patient’s liver lesion so a sample can be obtained and sent to the pathology department for diagnosis. The patient is discharged four hours after the procedure.

Percutaneous biliary tube placement

Patients can present with a stone or a mass obstructing the duct draining bile from the liver to be small bowel. Access can be achieved through the skin to help of the open these ducts. Stones can be removed or a sample of the mass can be obtained for diagnosis. This procedure can also be used to help repair a leak of the biliary system.

Cholecystostomy tube

Patients can present with an infection within their gallbladder, which can lead to life threatening infection within the blood stream. Often, these patients are too sick for an operation. In this case, CT and ultrasound can be used to direct a small tube to drain the bacteria from the infected gallbladder, which will greatly reduce the risk for life threatening infection.