Investigations of abnormal liver function tests

We do these investigations for patients in our Liver Unit. Liver function tests are blood tests that are used to help diagnose liver disease. It is vital to identify patients with liver disease earlier so we can assess how much scarring has occurred and to intervene to prevent progression to cirrhosis.

 

If a patient does have abnormal liver tests, the goal is to not only to identify why, using a standard panel of screening blood tests, but also to estimate the amount of scarring within the liver. New techniques allow for scarring to be estimated non-invasively, including techniques that estimate liver stiffness with Fibroscan and Echosens.

 

Other blood tests routinely available within our unit include a complete blood count (CBC), blood glucose (sugar) and blood clotting tests. Click here for more information on liver screening tests.

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Liver Cancer Treatments

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Liver Cancer Types and Symptoms

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Pancreatic Cancer Care

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Our internationally renowned team are supported by The Wellington Hospital’s up-to-date equipment, nursing care, anaesthetists and intensive care personnel to provide treatment services such as the following:

Cirrhosis

It is important to diagnose this condition, as it is a risk factor in developing cancer of the liver. Sometimes complications of cirrhosis can occur which need expert care and prompt intervention with 24 hour back-up and on-call facilities all of which are provided in our Liver Unit.

Interventional radiology

Imaging

 
Our specialist HPB radiologists undertake complex interventional procedures, supported by our highly experienced senior radiographers and specialist nurses who are familiar with caring for patients with liver disease. From CT, SPECT CT, 3T MRI, PET to liver ultrasound scans, we are able to deliver outstanding images which enable a speedy diagnosis and ultimately help your consultant identify the most appropriate treatment for you.

 

 

Biopsies

 
In addition to standard percutaneous liver biopsy for the diagnosis and monitoring of liver disease, we also offer Transjugular liver biopsy (TJ biopsy). An alternative to standard percutaneous liver biopsy, TJ biopsies are performed in our interventional radiology suite by our interventional radiologists and hepatologists and is suitable for patients with abnormal clotting or ascites due to liver disease. We also perform endoscopic ultrasound biopsies of the pancreas and biliary system.

 

 

24/7 cover

 
Our unit is fully supported by consultant interventional radiologists who are available 24 hours a day to accept referrals, support complex cases and manage emergency cases.

 

 

Chemotherapy

Intravenous or oral chemotherapy

 
Chemotherapy is also one of our common treatments. It is used to help stop or slow the growth of cancer and relieve symptoms. Chemotherapy may also be used to shrink the cancer so surgery can be done, or it may be given after surgery to lower the risk of the cancer coming back.

 

 

Chemoembolisation

 
Also known as transarterial chemoembolisation (TACE), a type of chemotherapy, where the drug is injected directly into the affected part of the liver to treat cancer cells and cut off the blood supply to the affected area. Once the blood supply is blocked, the cancer does not receive the oxygen and nutrients it needs to grow. This is a minimally invasive procedure to treat liver metastases and is carried out under a local anaesthetic and with sedation.

 

 

Surgical treatment options

Surgery for liver metastases

Surgery may be used to treat liver metastasis when one or a few areas of cancer are found. It is called a liver resection whereby the area of the liver that contains cancer is removed. We also perform laparoscopic (keyhole) liver resections, where our surgeons make several smaller incisions in the abdomen and then insert a laparoscope (a thin, tube-like instrument with a light and lens) to remove the cancer. Liver metastases from bowel cancer are commonly treated, but secondaries from other tumours are also considered for surgery, the commonest being neuroendocrine, breast and renal cancer.

Transarterial embolisation
Surgery for gallstones

We regularly perform a cholecystectomy for patients to remove gallstones. There are two types of cholecystectomy – laparoscopic (keyhole) and open. This type of operation is usually carried out laparoscopically, however, upon discussion with your consultant, and depending on your condition, it may be planned that you have an open cholecystectomy.

Surgery for pancreatic cancer

Pancreatic surgery for malignant and benign conditions is a core area of expertise within our unit at The Wellington Hospital. We routinely perform pancreatico-duodenectomy (known as the Whipple procedure) and involves removing the head of the pancreas and distal pancreatectomy operations for tumours at the head and body/tail of the pancreas.

Surgery for obstructive jaundice

If gallstones are diagnosed, endoscopic removal of the stones obstructing the bile duct is recommended and this can be done in our dedicated endoscopy centre by one of our interventional endoscopy specialists using Endoscopic retrograde cholangiopancreatography (ERCP) or Endoscopic ultrasound (EUS). Endoscopic stenting is sometimes necessary as a temporary measure to relieve the bile duct obstruction and clear any bacterial infection before surgery. Subsequent laparoscopic (keyhole surgery) cholecystectomy is advised.

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Adjuvant therapies

Radiofrequency ablation (RFA)

 
Ablation therapy - Radiofrequency ablation is a minimally invasive treatment for liver cancer, liver metastases and pancreatic cancers. It uses image-guided techniques such as ultrasound, CT or MRI to help guide a needle electrode into a cancerous tumour. High-frequency electrical currents or microwaves are then passed through the electrode, creating heat that destroys the cancer cells.

 

 
 
 
 

 

 

Endoscopic therapy for bleeding and biliary problems

A 24-hour emergency gastrointestinal bleeding service is provided by the on-call consultant gastroenterologist. The biliary diagnostic and therapeutic endoscopy service includes on-site endoscopic ultrasound scan (EUS) and ERCP, using the most up-to-date equipment, for conditions such as obstructive jaundice, as well as oesophageal stenting, for bleeding varices.

Within our endoscopy centre we also have a large team of dedicated endoscopy nurses and colorectal clinical nurse specialists. For more information about the full range of services available in our Endoscopy Centre at Wellington Hospital.

How to refer

Patients are referred to us not just from London but also from around the UK and overseas. A significant number are from patients who are seeking a second or a third opinion. If you would like to refer a patient or you are a patient who would like to book an appointment with The Wellington Hospital Liver Unit team, please call us on:

+ 44 (0) 20 7483 5933 (for HPB and Liver surgery enquiries)

+ 44 (0) 20 7483 5932 (for Liver medicine enquiries)

or email Liver.Unit@HCAHealthcare.co.uk

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