Liver Disease Clinic

There are many diagnostic tests used to determine how serious your liver disease may be and what type of treatment you may need. Some tests can include blood testing, imaging testing such as CT scans or MRI, needle biopsy or exploratory surgery.

A late-stage liver disease. This occurs when healthy liver tissue is replaced with scar tissue and the liver is permanently damaged. The scar tissue blocks the flow of blood through the liver and slows its processing functions. There are a wide range of conditions that may cause liver cirrhosis. The most common causes are: chronic alcohol abuse, chronic viral hepatitis B, C and D and fat accumulation in the liver.

An increase in the pressure within the portal vein. This vein carries blood from the digestive organs and spleen to the liver. The most common cause of portal hypertension is cirrhosis (scarring) of the liver. Portal hypertension can be managed through diet, medications, endoscopic therapy, surgery, or radiology treatment. These options are determined by the severity of the symptoms and on how well your liver is functioning.

There are four main types of hepatitis, which is inflammation of the liver.  Viral hepatitis is the most common type. It is caused by one of several viruses, viruses A, B, C, D, or E. In the United States, hepatitis A, B, and C are the most common. Another type is alcoholic hepatitis which is caused by heavy alcohol use. Toxic hepatitis is caused by certain poisons, chemicals, medicines, or supplements and autoimmune hepatitis is a chronic condition when your body’s immune system attacks your liver. The cause is not known, but genetics and your environment may play a role.

The two most common types of genetic liver disease are Hemochromatosis and Alpha 1 Antitrypsin Deficiency. Some examples of autoimmune liver disease are auto-immune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis.

Can help diagnose liver abnormalities including hepatitis, inflammation or cancer. Liver biopsies may be obtained by an interventional radiologist, a gastroenterologist or a surgeon. There are different ways in which a liver biopsy can be performed. One way is percutaneously (when a small needle is inserted through the skin and into the liver to collect a small tissue sample). This technique is combined with ultrasound or CT to help see the specimen better. Another method is by laparoscopy. This is when a narrow tube with a camera is placed through an incision in the side of the body followed by a needle to remove a sample of the liver. The Transvenous method is done when the patient has problems with blood clotting, has a great deal of fluid in the abdomen, or when pressure measurement in the liver is required. A biopsy needle is inserted through a blood vessel in the neck called the jugular vein, then a catheter is advanced all the way down to the liver to take the sample.

A liver resection, or hepatectomy, is a surgical procedure to remove part of your liver. Surgeons mostly perform a partial liver resection to remove a cancerous, precancerous or benign (noncancerous) tumor.

Laparoscopic surgery is a minimally invasive surgical technique used in the abdominal and pelvic areas. Instead of the 6-12 inch cut necessary for open abdominal surgery, laparoscopic surgery uses two to four small incisions about 1/2 inch or less. One is for the camera, and the others are for the surgical instruments. This procedure is usually done for diagnostic purposes, to look for problems that imaging tests haven’t been able to identify.

A minimally invasive treatment that targets a specific area and destroys liver tumors or abnormal cells. This technique uses extreme heat to destroy cancer cells while sparing healthy tissue. It can be used in patients with a few small tumors or when surgery is not a good option. An interventional radiologist typically performs ablation procedures, however surgeons can use laparoscopy or open surgery to perform ablation procedures as well.

A minimally invasive procedure which combines embolization (blockage of an artery or vein) with radiation therapy. It is used to cut off the blood supply to cancer cells by injecting small beads (called microspheres) that are filled with the radioactive isotope yttrium-90 or Y-90. Once infused, the beads lodge in the blood vessels near the tumor, where they give off small amounts of radiation to the tumor site for several days.

Usually the first type of embolization used for liver cancers that cannot be treated with surgery or ablation. It combines embolization (blockage of an artery or vein) with chemotherapy. Most often, this is done by giving chemotherapy through the catheter directly into the artery, then plugging up the artery, so the chemo can stay close to the tumor.

A procedure that may be used to reduce portal hypertension and its complications. An interventional radiologist uses ultrasound and X-rays while passing a specialized needle through the inside of the liver and into the portal vein. A covered stent is placed to create a shunt from the portal vein to the hepatic vein, bypassing the liver and relieving the elevated portal vein pressure.