LIVER HEPATOBILIARY

LIVING DONOR LIVER TRANSPLANTATION (LDLT)

LDLT is a procedure that involves a living donor who is willing to give a portion of his or her liver to a family member or close friend in need of a liver transplant.

One of the biggest advantages of LDLT over deceased donor liver transplantation (DDLT) is that the doctors can schedule the patient’s procedure. Thus, patients in a compromised medical condition can be optimized prior to transplant surgery in order to achieve better outcomes.

Additionally, doctors can ensure that the quality of the liver graft is preserved since it is retrieved from a healthy donor at the same time as the recipient operation, and the cold ischemic time (the time the donated liver has no blood supply) in LDLT is usually much shorter. Stringent measures are taken to thoroughly vet a donor’s suitability for each patient as the safety of both the donor and the recipient are extremely important.

 

DID YOU KNOW?

Our body sends signals when the organs are malfunctioning. Symptoms do not always relate to the seriousness of your disease. You may have no symptoms at all and have severe heart disease, requiring prompt treatment. People often take a wait-and-see approach, delaying because they think that what they are feeling is due to something else.

HPB SYSTEM – THE PANCREAS 

The pancreas is a gland located at the upper back of the abdomen below and behind the stomach. It contains exocrine cells, which produce enzymes for digestion of food, and endocrine cells, which produce hormones for regulation of blood sugar levels. The pancreas has three main parts; head, body and tail. The head of the pancreas is next to the common bile duct (which drains bile from the liver) and duodenum (the first part of the intestine).

 

PANCREATITIS 

Pancreatitis is the inflammation of the pancreas. There are two types of pancreatitis, acute pancreatitis and chronic pancreatitis. Acute pancreatitis is a sudden inflammation of the pancreas, often accompanied by severe abdominal pain, and it is most often caused by gallstones. Chronic pancreatitis tends to develop over the years as a gradually growing inflammation that damagers the pancreas.

PANCREAS CYSTS

A cyst is a closed sac formed by tissues and usually contains fluid or semi-solid material. In the pancreas, cysts are formed in reaction to inflammation or are due to cystic growths. The incidence of pancreatic cysts in the general population is less than 5%.

Nowadays, due to increasing use of computed tomography (CT) or magnetic resonance imaging (MR) scans for various indications, many pancreatic cysts are discovered incidentally in patients who have no symptoms. As the cyst grows, the following symptoms may be experienced pain upper abdomen or back, yellowing of the eyes and skin (jaundice), tea-colored urine, pale stools or diarrhea, swelling in the upper abdomen, poor appetite, weight loss, nausea and vomiting.

Once the nature of the cyst and its risk for malignancy (or cancer) have been determined, the doctor will then advise how best to manage the cyst. Typically, for low-risk cysts, surveillance by a pancreatic doctor will suffice. However, in the case of high risk cysts, surgery is the treatment of choice to eradicate the problem, as well as, to avoid the possibility of the cyst becoming malignant in the future.

PANCREATIC CANCER 

Pancreatic cancer occurs when cells within the pancreas grow without order or control. This malignant growth has the potential to increase in size, invade surrounding structures and spread to other parts of the body. The most common type of pancreatic cancer is adenocarcinoma.
There are no known causes of pancreatic cancer, but studies have identified some risk factors that can contribute to people suffering from pancreatic cancer:

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Smoking accounts for 40% of all pancreatic cancer in the US

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Regular intake of soft drinks can account for 87% higher risk of developing pancreatic cancer

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People over the age of 60 are more likely to develop pancreatic cancer

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Chronic pancreatitis can cause pancreatic cancer

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Diabetes patients are more likely to develop pancreatic cancer

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People who are overweight have a slightly higher risk of suffering from pancreatic cancer

Pancreatic cancer usually does not have recognisable symptoms in the early stage. In addition, the small size of the pancreas means that tumours can be hard to discover with a physical examination. Other symptoms of pancreatic cancer are often misattributed to other conditions, and the majority of pancreatic cancer cases are diagnosed in the advanced stage. A comprehensive health screening that includes a CT scan of the abdomen can help to diagnose pancreatic cancer in the early stages. Symptoms of pancreatic cancer that one can look out for include unexplained weight loss, indigestion and jaundice.

Treatment of pancreatic cancer depends on how far the cancer has progressed. In cases where the cancer has been discovered early and is confined to the head of the pancreas, a procedure known as the Whipple procedure can be used to remove the affected part of the pancreas and reattach the remaining pancreas with the bile duct and intestine. Chemotherapy and radiation therapy can also be used to shrink the cancer, reduce the symptoms and prolong life.

DOCTOR IN CHARGE

Dr. David Khoo Sin Keat

Dr. David Khoo Sin Keat

Consultant Cardiovascular & Thoracic Surgeon

Dato Dr. Tan Kai Chah

Dato Dr. Tan Kai Chah

Consultant Hepatobiliary & Liver Transplant Surgeon

Dr. Yap Yee Guan

Dr. Yap Yee Guan

Consultant Interventional Cardiologist

Dr. Chong Yoon Sin

Dr. Chong Yoon Sin

Consultant Interventional Cardiologist

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