Department of Hepatobiliary Surgery @ Ospedale San Raffaele
Clinical and research activities are dedicated to improve both diagnosis and treatment for hepatobiliary diseases, with a particular commitment to oncological patients, affected by benign and malignant tumours.
The Hepatobiliary Surgery Unit is dedicated to the treatment of malignant and benign liver diseases of surgical interest, with a specific focus on primary tumours (such as hepatocellular carcinoma, intrahepatic and perihilar cholangiocarcinoma, rare tumors) and secondary tumors (hepatic metastases coming from colorectal cancer, neuroendocrine tumour or non-colorectal non-neuroendocrine tumors) of the liver and the biliary tract.
More than ever before, liver surgery needs high-level, specific knowledge and expertise, both to exploit the most recent improvements in surgery techniques and technologies as well as to address properly the complexity of liver tumour pathology.
For this reason, at the San Raffaele Hospital there is a Hepatobiliary Surgery Unit exclusively dedicated – since more than a decade – to liver surgery, where over 3.700 hepatic resections have been performed, including all types of conventional hepatic resections, as well as specific programs for extensive resections and mini-resections, both with laparoscopic and robotic approach.
The program of Mini-Invasive Liver Surgery has been active for over 15 years, making the Hepatobiliary Surgery a national and international recognized leader in this field. The volume of the surgical activity is modulated on the number of patients, so that waiting times are limited and adequate to the severity of the diagnosis and the consequent need for a prompt, efficient, and effective treatment.
A multidisciplinary team (including hepatic surgeons, oncologists, hepatologists, interventional radiologists and radiotherapists) defines the diagnostic-therapeutic procedure for each patient during a specific weekly meeting (MMEB - Multidisciplinary Hepatobiliary Meeting). Thanks to this approach, the Hepatobiliary Surgery Unit of the San Raffaele Hospital has been able to constantly optimize the oncological results, mitigating surgery risks. A specific meeting for biliary tumors (DUCA – Disease Unit ColAngiocarcinoma) is held every two weeks, to specifically discuss about patients with intrahepatic and perihilar cholangiocarcinoma and gallbladder cancer.
Between January 2004 and November 2021, 3763 liver resections were performed at the Hepatobiliary Surgery Unit of the San Raffaele Hospital. Details regarding open procedures are shown in Figure 1, below. In particular, 190 patients had an inadequate volume of the remnant liver at the moment of diagnosis and therefore required procedures to induce hypertrophy of the liver remnant (Portal vein embolization/ligation, hepatic deprivation, two stage hepatectomy, ALPPS procedures).
Details regarding minimally-invasive liver resections are provided. The number of laparoscopic resections has progressively increased from 2005 (when it constituted 5.8% of the whole series of liver resections) to 2020 (now it constitutes 65% of the whole activity).
Our excellence in numbers
Conditions we take care of at this Department
Notable advanced technological equipment
- da Vinci robot
- Endowrist® technology
Meet our team
Head physician
Luca Aldrighetti
Featured physicians
The San Raffaele Research Hospital is a highly specialized multi-disciplinary medical center of world importance, which embodies the integrity of the treatment, clinical research and teaching activities. San Raffaele provides treatment in all existing medical fields, which allows this center to take care of the most complex patient cases. The Hospital is recognized as IRCCS (Scientific Institute for Research and Healthcare) for its research in molecular medicine and innovative treatments application, such as the gene therapy.
The hospital is a multi-specialty center with more than 50 clinical specialties available and with over 1600 beds; it is accredited by the Italian National Health System to provide care to both public and private, Italian and international patients. In 2018 the San Raffaele Hospital performed over 51,000 patient admissions, 72,000 emergency room encounters and delivered over 1.5 million outpatient medical services. It is widely regarded as the most celebrated hospital in the country and among the most reputable medical centers in Europe. San Raffaele’s wards and operating theatres are equipped with the most advanced machines, such as PET, PET/CT, Gamma Knife, Cyber Knife, Rapid Arc, Tomotherapy. San Raffaele’s Radiotherapy Unit was the first place in Europe to install Tomotherapy in 2004. Nowadays this Unit confirms to be one of the most experienced worldwide; it has developed numerous protocols for cancer treatment of the prostate, breast, central nervous system, brain, liver, pancreas, gastrointestinal tract, lungs, and others. The Oncological Board of the Hospital consisting of diagnosticians, clinical oncologists, immunologists, surgeons and radiotherapists, hold weekly meetings to discuss oncological patients’ pathways in a multidisciplinary manner.
Beside its Cancer Center, San Raffaele is well-known for its medical know-how in cardiology and cardiac surgery, neurology and neurosurgery, gastroenterology and gastrointestinal tract surgery, liver surgery, pancreas surgery, transplant medicine, gynecology and obstetrics, urology, dermatology, ophthalmology, immunology, rheumatology and pediatrics.
San Raffaele is a pioneer in the field of gene medicine and treatment of rare immunologic and genetic diseases. San Raffaele Scientific Institute is where the first in the world gene therapy with stem cells was created, named Strimvelis, for patients affected by ADA-SCID syndrome.
The Research at the San Raffaele Hospital focuses on integrating basic, translational and clinical research to provide the most advanced care to the patients. It counts on over 1,500 scientists, working in state-of-the-art facilities covering a surface of 130,000 square meters, and have produced over 1,446 scientific publications in 2018. Research at San Raffaele aims at understanding the mechanisms underlying a variety of important human diseases and at identifying new targets and new therapeutic strategies to treat them.
The San Raffaele Hospital hosts the Università Vita-Salute San Raffaele, a fully private university with a complete Medical School (including specialty courses and residencies), Nursing School, a Psychology graduate and post-graduate programs, and Allied Health Professions School. The mission of the Vita-Salute San Raffaele University is to answer the question "Quid est homo?" in the belief that the human being is a biological, psychological and spiritual unicum. Since 2010 the San Raffaele Hospital also hosts the International MD Program, the only graduate program accredited to license Medical Doctors in both Europe and North America.
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