Liver – Pancreas – Spleen – Bile

The pancreas is a 15 cm long gland located in the abdomen, behind the stomach and in front of the spine, and it produces digestive enzymes as well as hormones such as insulin. The gallbladder lies below the right side of the liver and collects part of the bile that the liver produces. The spleen sits in the left upper abdomen and is the most fragile of the organs inside the abdomen.

Dr. Konstantinidis and his surgical team treat the following conditions surgically:

• Liver cancer: either primary, when it starts in the liver itself, or, often, secondary, a metastasis from another organ, such as the large intestine.
• Pancreatic cancer: about 95% of pancreatic cancers derive from the exocrine part of the gland.
• Cholelithiasis (gallstones): the formation of cholesterol and bile stones in the gallbladder.
• Spleen disorders: enlarged spleen, splenic abscess, ruptured spleen, cancer and hematological diseases.

Liver cancer in its early stages and gallstones usually cause no symptoms. Later on, liver cancer may cause loss of weight and appetite, as well as swelling and pain in the abdomen. Pancreatic cancer may present with jaundice, pain in the upper and middle abdomen and in the back, and unexplained weight loss, symptoms that can also result from other conditions and should be checked by a doctor. Cholecystitis caused by gallstones leads to acute abdominal pain, vomiting and sometimes fever, while a ruptured spleen, usually the result of an abdominal injury, causes severe pain and is treated as a medical emergency.

Each condition has its own operation, which can be performed with open surgery, laparoscopically or robotically, depending on the case: hepatectomy for liver cancer, the Whipple procedure for tumors of the head of the pancreas, distal pancreatectomy for tumors of the body and tail, enucleation for certain neuroendocrine tumors, cholecystectomy for gallstones and splenectomy for spleen disorders.

Dr. Konstantinidis and his surgical team operate with the da Vinci Xi robotic system at Athens Medical Center, where they began robot-assisted pancreatic operations in 2006. Single-site robotic cholecystectomy is carried out through a single 1.5 cm incision in the navel.