Division of HPB Surgery

HPBThe Division of Hepato-Pancreato-Biliary (HPB) Surgery serves as a center of excellence with a focus on advancing innovation in care for all conditions of the pancreas, liver, and biliary system.

With telehealth and clinic expansion in Nexton, Myrtle Beach and Beaufort, the new division provides greater opportunity for our patients to have seamless access to care. HPB surgeons work with multidisciplinary teams at the Hollings Cancer Center in the treatment of cancers of the liver, stomach, bile duct, and pancreas and are nationally-recognized experts in the treatment of pancreatitis. 

 

FIRST IN LOWCOUNTRY TO PERFORM ROBOTIC WHIPPLE PROCEDURE

The Whipple Procedure, a highly complex surgery performed predominantly for pancreatic cancer patients, is typically done through a traditional open surgery. A leader in pancreatic surgery, Katy Morgan, M.D. has a high level of expertise in performing the traditional Whipple Procedure. Now, after intensive training on the da Vinci robot, she is the first pancreatic surgeon in the Lowcountry to perform the Whipple Procedure robotically. The robot provides the surgeon with more degrees of rotational freedom, rotating and bending beyond the capabilities of a human hand. And, the robot technology provides more precise movement, allowing for dissecting and sewing in tight areas. With the least invasive, more precise surgery, patients not only have faster recoveries, they have better outcomes. For cancer patients, they can now move more quickly to other treatments they may need.

IMPROVING CARE FOR PATIENTS WITH LIVER DISEASE

Surgery is often the best treatment for primary liver cancer when it's at an early stage and hasn't spread to nearby blood vessels. Traditionally, the surgery involves an open procedure with substantial morbidity. At MUSC Health, HPB fellowship-trained surgeon William Lancaster, M.D.is the first in the state to perform a robotic liver resection for the treatment of cancer. The expanded capabilities of the da Vinci Surgical System (robot) allow for decreased morbidity and a quicker recovery than traditional open surgery, providing an opportunity for patients to begin their postoperative chemotherapy sooner. Most secondary liver cancers start in the colon and rectum. Approximately 20 to 30 percent of patients with colorectal metastasis have disease confined to the liver, and this can be managed with surgery. Working with a multidisciplinary team at the Hollings Cancer Center and in collaboration with our colorectal surgeons, our HPB surgeons offer simultaneous colectomy and hepatectomy both robotically and open surgery. The simultaneous procedure allows the patient to have one operation versus two, reducing risk and improving recovery time.

LEADERS IN ISLET CELL TRANSPLANTATION FOR THE TREATMENT OF CHRONIC PANCREATITIS

For patients with chronic pancreatitis, islet cell auto-transplantation in combination with complete pancreatectomy treats the intense pain that coincides with the condition, but without the likelihood of developing diabetes that would occur with removal of the pancreas alone. With an islet cell transplant, a patient’s own islet cells are extracted from their pancreas and transplanted into their liver to continuously provide blood glucose regulatory function. MUSC surgeons have performed more than 275 islet cell transplant procedures since the program’s inception in 2009. The high volume islet cell transplantation is ranked the number 2 islet cell transplant program in the world by case load. Program clinical director Katy Morgan, M.D., and her partner David Adams, M.D., who has since retired, started the program over12 years ago, and since then have been joined by William Lancaster, M.D. Between Morgan and Lancaster, MUSC Health performs between 20 and 25of these surgeries per year. The multidisciplinary team that cares for patients undergoing islet transplantation includes Kelsey Cook, RN, nurse coordinator, Stephanie Owczarski, PA-C, patient care coordinator, as well as dieticians, interventional radiologists and therapeutic gastroenterologists.

MOVING NOVEL THERAPEUTICS FROM BENCH TO BEDSIDE

Hongjun Wang, Ph.D. is a nationally-recognized research scientist with an expertise in islet cell transplantation and cellular therapy. Her lab focuses on bench to bedside translational research for the prevention and treatment of diabetes and chronic pancreatitis. Major problems associated with islet cell transplantation are poor islet engraftment and survival after intraportal infusion. Because of these issues, only less than 30% of the non-diabetic chronic pancreatitis patients remain insulin-independent after surgery. Currently, interventional protocols to increase the survival of the islet graft following transplantation are empiric. The ongoing projects in the Islet Cell Transplantation Lab led by Dr. Hongjun Wang are focused on solving these problems. Working closely with surgeon-scientists Katy Morgan, M.D. and William Lancaster, M.D., and building on the strong foundation of the islet cell transplantation program built by David B. Adams, M.D., Wang and her research team are developing interventional procedures to improve islet yield quantity and quality in order to prevent onset of surgical diabetes after TP-IAT in patients with chronic pancreatitis. In FY 22, they are awarded a 3.2M grant by the NIDDK to enroll 42 chronic pancreatitis patients to assess the safety and efficacy of autologous bone marrow mesenchymal stromal cells and islet co-transplantation in TP-IAT patients.