KNUCH

KNUCH Hepatic pancreatic surgery department is the first institute in the region specialized in diagnosis, treatment and research of liver cancer (hepatocellular carcinoma, intrahepatic cholangiocarcinoma, etc.), hepatobiliary cancer, periampullary cancer and duodenal cancer. We practice more than 100 cases of liver resection, 50 cases of pancreatic duodenal resection, 150 cases of radiofrequency thermal ablation annualy, and is among the highest in the country. Based on these performances and experiences, Gastroenterology, General Surgery, Radilology, Pathology doctors and experts are working together for patient-centered treatment through an multidisciplinary system.

• 1

  Surgical treatment

  Tumors that develop in the liver can be roughly classified into primary and metastatic tumors. Primary tumors include various benign and malignant tumors. Among the primary malignant tumors, hepatocellular carcinoma and intrahepatic bile duct cancer are more common, and metastatic tumors that have spread from malignant tumors of various organs are often found. Surgical treatment of liver tumors is performed for primary liver tumors and metastatic lesions, and hepatic resection can be performed with treatments such as radiofrequency ablation (RFA), Transcatheter arterial chemoembolization (TACI), and chemotherapy, considering the location (position, number and size of the lesion), residual liver function, and the patient's condition.
  
  Tumors around the ampulla are usually malignant, but in rare cases benign or non-tumor diseases are diagnosed.
  
  For diagnosis, cytoscopy and biopsy can be performed through the Endoscopic Retrograde Cholangiopancreatography (ERCP) and endoscopic ultrasound. Malignant tumors around the ampulla include the Pancreatic head adenocarcinoma, peripheral cholangiocarcinoma, and duodenal & ampullar cancer, which require radical resection to be cured. Although they are all different types, the Pancreaticoduodenectomy is performed to resect the extrahepatic bile duct, duodenum, and head of pancreas because of the locational characteristics of the lesion.
  
  Pancreatic masses can be distinguished into inflammatory masses and non-inflammatory masses, and non-inflammatory masses can be distinguished into benign, borderline, and malignant tumors. In the case of benign and borderline tumors, laparoscopic resection of the pancreas can be performed, but radical resection is required for malignant masses. Depending on the location of the lesion, a pancreaticoduodenectomy is performed, and also a distal pancreatectomy can be performed if the lesion is located in the body or tail of pancreas.

• 2

  Fatty liver and Fibroscan tests

  Introduced on July 24, 2013, the "Fat liver and Fibroscan" uses vibrators and ultrasound for evaluation and grading of fatty liver, and its accuracy is high in renewable way, allowing patients to be diagnosed with fatty liver or cirrhosis without discomfort and pain.
  
  The "fat liver and liver fibroscan" is a diagnostic method that objectively and quantitatively evaluates the degree of fatty liver and liver fibrosis by quickly measuring liver elasticity and fatty liver. Since this "fat liver and fibroscan" is an inspection using vibration and ultrasonic waves, the inspection time is short and there are many advantages of repetitive inspection. In particular, it does not affect other organs, so it is very useful for the diagnosis and treatment of fatty liver and cirrhosis, such as follow-up before and after treatment.

• 3

  Ultrasound endoscopy

  The pancreatic & biliary tract is located in the center of the abdominal cavity, making it difficult to perform a complete examination with an abdominal ultrasonography. Ultrasound endoscopy, equipped with an ultrasound detector at the tip of the endoscope, is a detailed examination of pancreatic biliary tract lesions and is a safe test method without radiation exposure. In addition, fine needle aspiration biopsy for histological diagnosis is a safe test with few complications, and the diagnostic accuracy for pancreatic biliary tract cancer is 95%, which is excellent. In addition, we are trying to develop various treatment procedures using fine needle with ultrasound endoscopy induction, and through this, we are trying to develop new treatment procedures for pancreatic biliary tract cancer that are limited to chemotherapy. Moreover, we are trying to improve patient’s life quality by performing nerve block for pain associated with pancreatic cancer.

• 4

  ERCP(Endoscopic Retrograde CholangioPancreatography)

  In most cases, surgical resection is not available at the time of diagnosis for patients with pancreas & biliary tract cancer, and may require biliary drainage due to obstructive jaundice. Endoscopic biliary drainage is a relatively convenient procedure as it can relieve the discomfort of exposing the biliary drainage tube to the outside of the body. We have a radiation fluoroscopy room in the Gastroenterology department, which is the first case in Daegu and Gyeongbuk region, and it makes various procedures can be performed smoothly.