The Hepato-Pancreatic-Biliary (HPB) service in East Lancashire Hospitals NHS Trust has an expert multi-disciplinary team (MDT) that provides the latest treatments for all conditions, including cancers, affecting the liver, bile ducts, gallbladder and pancreas.
Our HPB Centre is both a local and regional service offering specialist care to the Lancashire and South Cumbria Cancer Network as well as for patients throughout the UK. We now perform over a 100 major liver and pancreas operations each year with excellent outcomes.
The specialist team consists of Consultant Surgeons, Liver Specialists and Stomach and Bowel Specialists, Oncologists, Diagnostic and Interventional Radiologists, Pathologists, Anaesthetists and Intensivists, as well as Clinical Nurse Specialists, a dedicated operating theatre team and ward staff including nurses, dieticians and physiotherapists.
The team holds weekly meetings where patients treatment plans are discussed and agreed by every member of the team. This ensures that all the necessary tests and treatments are carried out as quickly as possible. The meeting is conducted via a video conferencing link so that clinicians at your local hospital can directly discuss your case confidentially during the meetings.
The team continually incorporates new technologies and innovative approaches to the care of patients with HPB problems. We have been one of the first HPB Centres to establish an Enhanced Recovery Programme for patients undergoing major liver and pancreas surgery. The Enhanced Recovery Programme is about improving patient outcomes and speeding up a patient's recovery after surgery. We have presented our outcomes at conferences around the country to inform other Hospitals about our good work.
We participate in international and national clinical research trials and perform basic science research with our partners in the University of Lancaster to help find new ways of diagnosing and treating cancers that affect the liver and pancreas. The surgical team also continues to develop laparoscopic (keyhole) techniques for performing many of the HPB operations.
The types of problem we deal with include :
Liver disease
• Primary cancer
• Secondary cancer (metastasis)
• Liver trauma (HPB Trauma Centre for Lancashire & S Cumbria)
Biliary disease
• Gallstones
• Gall bladder cancer
• Bile duct cancer
Pancreatic disease
• Pancreatitis
• Pancreas cancer
• Pancreatic cysts
Neuroendocrine Tumours – this is the umbrella term given to a group of uncommon cancers. These types of cancer are found in the neuroendocrine system. This system is made up of numerous glands throughout the body that produce and secrete hormones. They are found in organs throughout the body but most commonly in the respiratory and digestive tracts.
The types of treatment we offer include :
• Liver resections - This is the surgical removal of part of the liver usually for cancers but also for some benign conditions which give rise to symptoms.
• Pancreatectomies - This is the surgical removal of part of the pancreas (commonly known as a Whipples procedure when the head of the pancreas is removed) usually for cancers or pre-cancerous conditions. Other parts of the pancreas can also be removed.
• Complex laparoscopic (keyhole) procedures – As well as performing keyhole surgery for gallstones (cholecystectomies and exploring common bile ducts) we also carry out selected liver and pancreas operations through the keyhole method. This allows us to use smaller incisions leading to a faster recovery.
• Radiofrequency ablation – This is an alternative method of treating liver tumours, using a special needle, which is used when an operation is not feasible or sometimes in addition to surgery.
• Chemoembolisation – This is targeted chemotherapy for liver tumours that cannot be removed with an operation.
• Portal vein embolisation - This is a technique to stimulate the growth of parts of the liver to enable the surgeons to carry out more extensive operations on the liver than is normally feasible.
• Endoscopic ultrasound (EUS) – This procedure allows us not only to diagnose problems around the pancreas and bile ducts but also to take tissue samples, drain cysts and give local analgesia.
• ERCP (Endoscopic retrograde cholangio-pancreatography) – This procedure is used to examine the bile ducts and pancreatic ducts particularly for people who are jaundiced. Stones in the bile ducts can be removed and small tubes (stents) placed to treat jaundice.
The Hepatobiliary & Pancreatic Service (Liver and Pancreas) is mainly delivered at the Royal Blackburn Teaching Hospital site, including all planned and emergency inpatient surgery.
Radiological investigations and procedures are performed at both the Royal Blackburn Teaching Hospital and Burnley General Teaching Hospital.
Our outpatient clinics are held at numerous sites including the Royal Blackburn Teaching Hospital, Burnley General Teaching Hospital and Clitheroe Community Hospital.
David Chang - Consultant Surgeon specialising in hepatobiliary and pancreatic diseases
Colin Harris - Consultant Surgeon specialising in hepatobiliary and pancreatic diseases
Ambareen Kausar - Consultant Surgeon specialising in hepatobiliary and pancreatic diseases
Darren Subar - Consultant Surgeon specialising in hepatobiliary and pancreatic diseases
Dr Snehal Lapsia - Consultant Radiologist
Dr Duncan Gavan - Consultant Interventional Radiologist
Dr Neil Wilde - Consultant Interventional Radiologist
Dr John Taylor - Consultant Interventional Radiologist
Dr Vishal Kaushik - Consultant Gastroenterologist/EUS Lead
Dr Yoggi Reddy - Consultant Hepatologist EUS/ERCP
Dr Mohammed Mansoor - Consultant Hepatologist
Dr Damien Lynch - Consultant Gastroenterologist/ ERCP
Dr Alex Green - Consultant Gastroenterologist/ ERCP
Dr Richard Prescott - Consultant Histopathologist
Dr Ajay Metha - Consultant Clinical Oncologist
Dr Wiebke Appel - Consultant Clinical Oncologist
Dr Sin Lau - Consultant Medical Oncologist
HPB Rapid Diagnostic Service (RDS) Nurse – Vicki Stevenson-Hornby
HPB Clinical Nurse Specialist - Jess Gronan and Cristina Veneziale
HPB Cancer Support Worker - Lauren Heyworth
C14 telephone number:
01254- 735400
01254 735212
Cancer peer review
Our service has been reviewed as part of the quality assurance programme for cancer services set up by the Department of Health. We have consistently scored highly and above the National benchmark.
In the report we were described as ‘an enthusiastic and cohesive team with strong clinical leadership. Team members are very supportive and there is excellent support from a network of CNSs and from imaging and oncology’.
Patient support group
We are committed to providing patient centered care and aim to offer support throughout your treatment. Our team of dedicated nurse specialists has also set up a patient support group PALMs (Pancreas and Liver Meeting to Support you) which meets every third Thursday in the month. This is an informal group for patients and their relatives and carers.
Information available for patients, relatives and carers
There is comprehensive information available covering all aspects of HPB disease from diagnosis to treatment and aftercare. This has been developed in-house and has been extensively praised by patients and their carers.
Facility for relatives to stay overnight when undergoing major surgery
We have accommodation available adjacent to the surgical ward where a relative or carer can stay to be near you immediately following your operation.
Excellent results from patient satisfaction surveys
The results have shown us that the patients that underwent a Pancreatic or Liver resection at The Royal Blackburn Hospital had a positive experience. These are some of the comments we have received :
‘I have nothing but praise and admiration for the whole team’
‘The care was the best I have received in any Hospital, I owe my life to the team concerned’
‘I was very impressed by the care and follow up I received from the Specialist Nurse’
Neuroendocrine specialist centre
We are now recognized as a Specialist Centre for the management of neuroendocrine tumours with a designated multi-disciplinary team that meets regularly to discuss and plan your treatment.