Innovative Treatment Options Tailored to the Patient

When it comes to bile duct injuries and other hepatobiliary conditions, expert evaluation is vital to accurately diagnose and then determine the best course of treatment for the individual patient.

At Hoag, our multidisciplinary team of gastrointestinal experts includes hepatobiliary surgeons, gastrointestinal specialists, hepatologists and interventional radiologists who work together to thoroughly review and determine the best treatment option suited to each individual patient.

The Hoag-USC team then carefully tailors a personalized treatment plan to effectively achieve the best possible outcome for the patient. This emphasis on a collaborative, comprehensive approach to patient-centered care is why Hoag patient outcomes rank are among the nation’s best.


When it comes to bile duct injuries, the most effective treatment option is surgical repair of the damaged bile duct. There are a variety of innovative surgical options available. Determining the best surgical treatment depends on where in the bile ducts the injury has occurred.

  • Balloon Dilatation is often used as a temporary method of treating bile duct strictures. If the stricture completely blocks the bile duct, a balloon on the tip of a catheter is passed through an endoscope and is inflated at the site of the stricture, enlarging the blocked duct. After dilation, a stent is passed through the endoscope and placed at the point of stricture to keep it open.
  • Stent Placement: A stent is a thin, plastic or metallic tube-like structure that is used to open and support a narrowed portion of the pancreatic duct or bile duct, and prevent the reformation of the stricture. Biliary system stent placement can be performed during endoscopic retrograde cholangiopancreatography (ERCP).
  • Bile Duct Excision: In patients that have experienced injuries to the lower portion of the bile duct, an area of normal (uninjured) bile duct located above the injury site is sutured to the intestine. This procedure is often referred to as a Bile Duct Excision and Roux-en-Y Hepaticojejonostomy.
  • Bile Duct Excision with Liver Resection: In patients whose injury has occurred in the upper portion of the bile duct, and/or the hepatic artery, close to the liver, the repair is much more complex since finding a segment of normal bile duct above the injury site may be difficult; the repair for this injury may include the need for partial liver resection, if the injury is close to the liver and reconstruction of the bile duct to the remaining liver pieces.
  • Treatment of Infection: In addition to surgical treatment, treatment of all infection and sepsis that may develop as a result of leakage of bile, or due to blockage of bile, is an important component of each patient’s treatment plan.

It’s important to note that patients with bile duct injury often require complex operations that may range from a simple repair for a low bile duct injury to a complex repair with possible need for removal of part of their liver tissue for injuries that occur high up in the bile duct close to the liver.

For best results these patients are best treated in a specialized center that has experience in treating bile duct injuries for optimal outcome. At Hoag, our expert team of hepatobiliary and pancreatic surgeons performs the highest volume of bile duct, pancreatic and liver cancer surgeries in California, including minimally invasive laparoscopic and robotic-assisted procedures. Being a high-volume hepatobiliary cancer surgical program enables the gastrointestinal experts at Hoag to achieve a technical skill level not all facilities can match.

The Most Advanced Treatment Options Are Now Available in Orange County!

When it comes to seeking out the most advanced, academic-level gastrointestinal care, there is no longer any need to travel long distances. The Hoag Digestive Disease Center, in alliance with USC Norris Comprehensive Cancer Center, offers the latest in state-of-the-art diagnosis and leading-edge treatment options that may not be readily available at other centers, including participation in clinical trials that helps to bring advanced gastrointestinal care to even more patients.

Perhaps the most distinguishing aspect of Hoag’s advanced treatment of gastrointestinal conditions is that in each and every case, treatment is always specifically tailored to the meet the unique needs of the individual patient.

Expert Care You Can Trust!

The Hoag Digestive Disease Center, in alliance with USC Norris Comprehensive Cancer Center, continues to lead the way in complex hepatobiliary care, providing access to a highly specialized surgical team that works collaboratively with Hoag-affiliated gastrointestinal specialists to provide academic-level care. Hoag’s committed to accurate diagnosis, combined with progressive therapeutic options enables Hoag patients to achieve some of the highest clinical outcomes in the nation.

To schedule a comprehensive diagnostic evaluation, or a second-opinion consultation with a Hoag hepatobiliary expert, visit Meet the Team, or call us at: 949-764-5350.