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Hepatobiliary Surgery
ECMC is the only medical center in the Buffalo area to offer a new liver and bile duct surgery. Dr. Ahmad Zaaroura, transplant surgeon, discusses hepatobiliary surgery.
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Learn more about Ahmad Zaaroura, MD
Ahmad Zaaroura, MD
Dr. Zaaroura is a multi-organ transplant surgeon who specializes in complex liver and bile duct surgery. His multiorgan transplant training was gained at the Ohio State Wexner Medical Center followed by additional focused expertise in hepatobiliary surgery and liver and bile duct reconstruction techniques at Duke University Medical Center. Dr. Zaaroura practices at Erie County Medical Center, Buffalo General Medical Center, and the John R. Oishei Children’s Hospital.Learn more about Ahmad Zaaroura, MD
Transcription:
Bill Klaproth (Host): Good news. ECMC is the only medical center in the Buffalo area to offer a new liver and bile duct surgery called hepatobiliary surgery. So, let’s learn more about this with Dr. Ahmad Zaaroura, a Surgeon and Multi-transplant Surgeon at ECMC. Dr. Zaaroura, thank you for your time. So, you specialize in hepatobiliary surgery. Can you explain to us what that is?
Ahmad Zaaroura, MD (Guest): Thank you. So, hepatobiliary surgery is the surgery which is done on the liver and biliary tree. So, that usually would include any type of surgery done on the liver or biliary tree for benign or malignant tumor and diseases.
Host: Got you. Then who is a good candidate for this type of surgery?
Dr. Zaaroura: So, the patients who require hepatobiliary surgery, those types of patients are the patients who have liver tumor from benign origin or a malignant origin like if they have a hepatoma or have anabcess in the liver or have tumor in the liver. Or the other type of patients who have biliary tree problems which they have like cysts or difficult type of biliary tree disease like when they have some sort of stricture and they need to have a reconstruction and do a new connection between the biliary tree and the continue that with the bowel instead of going through the strictures.
Host: So, can you tell us about this type of surgery? Is this minimally invasive?
Dr. Zaaroura: So it has two parts usually. So, some operations can be done minimally invasively like when we do liver resections, small liver resection or a little bit, depends how and where is the tumor or the benign mass we need to excise. So, the left lateral segment of the liver, we usually do that through the laparoscope, through small incisions and we make small incisions down in the lower abdomen to get the specimen out because the specimen will be 15 to like 20 centimeters sometimes. But we do all our dissections through the small holes which each one is like about a half centimeter or one centimeter. And then we put the tumor or the piece of the liver inside a bag and extract that bag from the lower abdomen incision. And that will not affect how it will look like from outside.
Host: So, how is this procedure different from traditional open procedures? What are the main benefits of hepatobiliary surgery?
Dr. Zaaroura: So, we still it, sometimes we need to do it open when there is a tumor or a cancer that is near the major vessels and the risk for bleeding is high. So, those times we need to do an open procedure. But the good thing that now we can do like part of the liver surgery through the minimal invasive technique which decreases the hospital stay, decreased requirement for pain medicine, and go back to work earlier. So, the hospital stay will be less, pain management will be less need for narcotics, and going back to work and normal life will be just quicker.
Host: Less pain, shorter recovery time; that’s always a benefit. So, you are building the only biliary practice in Buffalo, as this type of surgery is only available at ECMC in our area. Can you tell us about that?
Dr. Zaaroura: Yes so, Buffalo area, before a couple of years, there was no one doing liver surgery here. and we start building hepatobiliary, hepatopancreaticobiliary practice here which means doing all type of liver surgery and pancreas tumor surgery. We built this unit between me and Dr. Butsch and Dr. Curtis. Between the three of us, we will cover any type of tumor that is in the pancreas or in the liver or any type of foregut or GI system, gastrointestinal system. And that will go through multidisciplinary approach. So, we get the referral for a case, we discuss this case usually in big meeting once a week and during that meeting, we will have oncology, and radiology and interventional radiology and genetics people, and hepatology and gastroenterology people also in the same conference. So, we will approach any type of tumor through all those expert people.
So, we have most of the expertise in the same place and then we put a plan for management. Like if this patient requires to go to surgery first or we can do – sometimes we need more information like we ask our colleague through the interventional radiologist to get us a tissue to know what is the exact type of tumor that is, that will help us to decide which approach we need to do.
Host: Right. Which is really important. So, I guess the good news is people don’t have to drive out of town now to get this type of surgery. They can get it right here.
Dr. Zaaroura: Yeah before we start building this practice; patients required to travel for at least five to six hours to go to the closest center that can do this type of surgery. And the good thing, I started to do that hepatobiliary practice for the pediatric age group which no one was able to do that here. Most of the cases were transferred to different states to do this type of surgery. But nowadays, almost all the liver cases I have been doing those cases here and there is no need for sending those types of patients to another center or far away practices.
Host: Right. So, last question Dr. Zaaroura and thank you so much for your time. You specialize in kidney, complex liver and bile duct surgery. Can you tell us a little bit about yourself and your background?
Dr. Zaaroura: Sure. So, after I did my general surgery, I did a fellowship for two years, fellowship in transplant of the male organ transplant. That was in Ohio state. I was specialized there in kidney transplant, pancreas and vascular access and did also liver transplant. And I actually like working with the liver and on the liver also. So I did another fellowship which was in Duke University that was more concentrated about more complex cases of liver transplant and hepatobiliary practice for adult and pediatric age group which that gave me more experience to work on the pediatric age group in this category of disease. Like the liver tumors, or the liver malignancies, benign disease and also, I got the experience to practice them or to learn the new technique about the reconstruction for biliary tree to build a new connection between the liver and the gut.
Host: Very impressive and we’re glad you’re here and offering this surgery. Dr. Zaaroura, thank you for your time.
Dr. Zaaroura: Thank you sir.
Host: that’s Dr. Ahmad Zaaroura. For more information or to book an appointment call 716-898-5001, 716-898-5001 or visit www.ecmc.edu. And if you found this podcast helpful, please share it on your social channels. And check out the entire podcast library for topics of interest to you. This is the True Care Healthcast from Erie County Medical Center. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): Good news. ECMC is the only medical center in the Buffalo area to offer a new liver and bile duct surgery called hepatobiliary surgery. So, let’s learn more about this with Dr. Ahmad Zaaroura, a Surgeon and Multi-transplant Surgeon at ECMC. Dr. Zaaroura, thank you for your time. So, you specialize in hepatobiliary surgery. Can you explain to us what that is?
Ahmad Zaaroura, MD (Guest): Thank you. So, hepatobiliary surgery is the surgery which is done on the liver and biliary tree. So, that usually would include any type of surgery done on the liver or biliary tree for benign or malignant tumor and diseases.
Host: Got you. Then who is a good candidate for this type of surgery?
Dr. Zaaroura: So, the patients who require hepatobiliary surgery, those types of patients are the patients who have liver tumor from benign origin or a malignant origin like if they have a hepatoma or have anabcess in the liver or have tumor in the liver. Or the other type of patients who have biliary tree problems which they have like cysts or difficult type of biliary tree disease like when they have some sort of stricture and they need to have a reconstruction and do a new connection between the biliary tree and the continue that with the bowel instead of going through the strictures.
Host: So, can you tell us about this type of surgery? Is this minimally invasive?
Dr. Zaaroura: So it has two parts usually. So, some operations can be done minimally invasively like when we do liver resections, small liver resection or a little bit, depends how and where is the tumor or the benign mass we need to excise. So, the left lateral segment of the liver, we usually do that through the laparoscope, through small incisions and we make small incisions down in the lower abdomen to get the specimen out because the specimen will be 15 to like 20 centimeters sometimes. But we do all our dissections through the small holes which each one is like about a half centimeter or one centimeter. And then we put the tumor or the piece of the liver inside a bag and extract that bag from the lower abdomen incision. And that will not affect how it will look like from outside.
Host: So, how is this procedure different from traditional open procedures? What are the main benefits of hepatobiliary surgery?
Dr. Zaaroura: So, we still it, sometimes we need to do it open when there is a tumor or a cancer that is near the major vessels and the risk for bleeding is high. So, those times we need to do an open procedure. But the good thing that now we can do like part of the liver surgery through the minimal invasive technique which decreases the hospital stay, decreased requirement for pain medicine, and go back to work earlier. So, the hospital stay will be less, pain management will be less need for narcotics, and going back to work and normal life will be just quicker.
Host: Less pain, shorter recovery time; that’s always a benefit. So, you are building the only biliary practice in Buffalo, as this type of surgery is only available at ECMC in our area. Can you tell us about that?
Dr. Zaaroura: Yes so, Buffalo area, before a couple of years, there was no one doing liver surgery here. and we start building hepatobiliary, hepatopancreaticobiliary practice here which means doing all type of liver surgery and pancreas tumor surgery. We built this unit between me and Dr. Butsch and Dr. Curtis. Between the three of us, we will cover any type of tumor that is in the pancreas or in the liver or any type of foregut or GI system, gastrointestinal system. And that will go through multidisciplinary approach. So, we get the referral for a case, we discuss this case usually in big meeting once a week and during that meeting, we will have oncology, and radiology and interventional radiology and genetics people, and hepatology and gastroenterology people also in the same conference. So, we will approach any type of tumor through all those expert people.
So, we have most of the expertise in the same place and then we put a plan for management. Like if this patient requires to go to surgery first or we can do – sometimes we need more information like we ask our colleague through the interventional radiologist to get us a tissue to know what is the exact type of tumor that is, that will help us to decide which approach we need to do.
Host: Right. Which is really important. So, I guess the good news is people don’t have to drive out of town now to get this type of surgery. They can get it right here.
Dr. Zaaroura: Yeah before we start building this practice; patients required to travel for at least five to six hours to go to the closest center that can do this type of surgery. And the good thing, I started to do that hepatobiliary practice for the pediatric age group which no one was able to do that here. Most of the cases were transferred to different states to do this type of surgery. But nowadays, almost all the liver cases I have been doing those cases here and there is no need for sending those types of patients to another center or far away practices.
Host: Right. So, last question Dr. Zaaroura and thank you so much for your time. You specialize in kidney, complex liver and bile duct surgery. Can you tell us a little bit about yourself and your background?
Dr. Zaaroura: Sure. So, after I did my general surgery, I did a fellowship for two years, fellowship in transplant of the male organ transplant. That was in Ohio state. I was specialized there in kidney transplant, pancreas and vascular access and did also liver transplant. And I actually like working with the liver and on the liver also. So I did another fellowship which was in Duke University that was more concentrated about more complex cases of liver transplant and hepatobiliary practice for adult and pediatric age group which that gave me more experience to work on the pediatric age group in this category of disease. Like the liver tumors, or the liver malignancies, benign disease and also, I got the experience to practice them or to learn the new technique about the reconstruction for biliary tree to build a new connection between the liver and the gut.
Host: Very impressive and we’re glad you’re here and offering this surgery. Dr. Zaaroura, thank you for your time.
Dr. Zaaroura: Thank you sir.
Host: that’s Dr. Ahmad Zaaroura. For more information or to book an appointment call 716-898-5001, 716-898-5001 or visit www.ecmc.edu. And if you found this podcast helpful, please share it on your social channels. And check out the entire podcast library for topics of interest to you. This is the True Care Healthcast from Erie County Medical Center. I’m Bill Klaproth. Thanks for listening.