Department_of_Surgery

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Prof. Chung Mau LO
(Division Chief)

Hepatobiliary & Pancreatic Surgery and Liver Transplantation

Contact phone number: 2255 4748
Fax number: 2817 5475

STAFF

Members photo

Members photo

Clinical Service

The Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation is renowned internationally for its excellence in clinical service and research. The Division is dedicated to strive for the highest standard of clinical care for Hong Kong and the region. A comprehensive service, including surgery and endoscopy for various hepatobiliary and pancreatic diseases, is provided by the same team. Through high-quality clinical and laboratory research, important achievements have been made in the following clinical areas:

  • Liver cancer
  • Liver transplantation
  • Acute cholecystitis, cholangitis and pancreatitis
  • Endoscopic and laparoscopic surgery
  • Recurrent pyogenic cholangitis

Liver cancer

Liver cancer is the second leading cause of cancer death in Hong Kong and the Department of Surgery at Queen Mary Hospital is the largest tertiary referral centre. Refining treatment through clinical research to improve the outcome of patients with liver cancer is ranked as the top priority in the activities of the Division. With the application of laparoscopic and intraoperative ultrasound, ultrasonic dissector, perioperative nutritional support, and intensive surveillance and treatment for intrahepatic recurrence, the mortality rate of hepatic resection for hepatocellular carcinoma is approaching 0% and the 5-year survival rate 48.5%. Nearly 90% of the resection sections can be performed without blood transfusion.


Number of hepatic resections performed over the past 17 years

 


Hospital mortality and proportion of operations with no blood transfusion
in patients undergoing hepatic resection

For patients with unresectable disease, the advent of radiofrequency ablation (RFA) and transarterial oily chemoembolisation (TOCE) offers an effective treatment option. From December 2006 onwards, High Intensity Focus Ultrasound (HIFU) Treatment Centre starts its clinical service to all potential candidates with unresectable liver tumors. Vast amount of basic research into the significance of hepatitis B virus activity and angiogenesis in affecting the outcome of patients with liver cancer are now being conducted.


Radiofrequency ablation (open approach)


High intensity focus ultrasound

Liver transplantation

The Division performed the first successful liver transplant in Hong Kong in October 1991. Since then, the Liver Transplant Service at Queen Mary Hospital has developed into the largest program in China and Southeast Asia. By the end of October 2008, a total of 659 liver transplants have been performed with a 1-year, 3-year and 5-year survival rates of 92%, 87% and 84% respectively. Living donor liver transplantation for pediatric patients was introduced in 1993. The Division pioneered the application of living donor liver transplantation to adult patients using both left lobe and right lobe grafts, particularly for high-urgency situations in 1994 and 1996 respectively. Such innovative technique provides an option to save desperately ill patients when deceased donors are scarce.

right lobe graft from
living donor

Donor operation

Recipient operation

Patients' Guide to Post-Liver Transplantation Care


Acute cholecystitis, cholangitis and pancreatitis

Through active clinical research and randomized control trials, the management protocol for patients with acute cholecystitis, cholangitis and pancreatitis are modified based on evidence-based medicine. The approach of early intervention using endoscopic papillotomy within 24 hours of admission for patients with severe acute cholangitis and biliary pancreatitis significantly reduces the morbidity and mortality.

Endoscopic and laparoscopic surgery

The Endoscopy Centre of the Department of Surgery provides a comprehensive 24-hour endoscopic service and Division of Hepatobiliary and Pancreatic Surgery offers a full range of diagnostic and therapeutic procedures using flexible endoscopes:

Endoscopic procedure No. of procedures in 2005
ERCP 814
Endoscopic papillotomy 200
Endoscopic biliary stent insertion 377
Endoscopic variceal banding/ sclerotherapy 243

The Department of Surgery has been recognized internationally as a centre of high repute in the field of endoscopy as a result of its achievements in the early endoscopic treatment of acute biliary pancreatitis and acute cholangitis.

The benefit of key-hole surgery has been extended to patients with hepatobiliary diseases using laparoscopic ultrasonography, laparoscopic cholecystectomy, laparoscopic common bile duct exploration, laparoscopic splenectomy, and laparoscopic marsupialization of liver cysts. Special achievements have been made in the optimal timing of laparoscopic cholecystectomy for acute cholecystitis, the value of laparoscopic ultrasonography in patients with hepatocellular carcinoma, endoscopic ultrasonography for idiopathic pancreatitis.

Recurrent pyogenic cholangitis

The division excels in the management of recurrent pyogenic cholangitis or hepatolithiasis. Using a combination of liver resection, construction of hepaticocutaneous jejunostomy, flexible choledochoscopy, and electrohydraulic lithotripsy, excellent long-term results are obtained.

Research Activities

Liver cancer

  1. Surgical techniques in hepatic resection for liver cancers
  2. Radiofrequency ablation of hepatocellular carcinoma and liver metastasis
  3. Transarterial chemoembolization for hepatocellular carcinoma using novel chemotherapeutic agent
  4. Novel systemic chemotherapy for metastatic hepatocellular carcinoma
  5. Hepatitis B activities and hepatocellular carcinoma
  6. Postoperative adjuvant therapy after curative resection of hepatocellular carcinoma
  7. Identification of biomarkers for hepatocellular carcinoma
  8. Genome-wide expression study of liver cancer by cDNA microarray
  9. Angiogenesis and hepatocellular carcinoma
  10. Novel anti-cancer strategy for hepatocellular carcinoma

Liver transplantation

  1. Living donor liver transplantation using right lobe graft
  2. Liver transplantation for chronic hepatitis B
  3. Liver transplantation for hepatocellular carcinoma
  4. Ischemic reperfusion injury in liver transplantation
  5. Small-for-size orthotopic liver transplantation in a rat model
  6. Gene transfer in rat model of liver transplant
  7. Transplantation immunology
  8. Identification of novel mechanism and therapeutic strategy to induce liver transplantation tolerance

Acute pancreatitis

  1. Endoscopic ultrasonography
  2. Timing of laparoscopic cholecystectomy for acute gallstone/pancreatitis
Endoscopic and Laparoscopic Surgery
  1. Early endoscopic retrograde cholangiopancreatography for acute cholangitis
  2. Laparoscopic and endoscopic ultrasonography
  3. Somatostatin prophylaxis for post ERCP prophylaxis
  4. Laparoscopic hepatic resection for liver cancers

Others

Pancreatic duct drainage after pancreaticoduodenectomy

Ongoing Clinical Trials

Examples

Principle Investigator
Professor Ronnie Poon
Email: poontp@hkucc.hku.hk

Enquiries
Miss Ida Choi
Email: cychoia@hkucc.hku.hk
Tel: (852) 2255 3635
Fax: (852) 2817 5475

  
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