Mr Michael Silva is a consultant surgeon in the department of Hepatobiliary and Pancreatic Surgery at the Oxford University Hospitals NHS Foundation Trust. The unit provides a specialist service for the management of conditions of the gall bladder, bile duct, pancreas and liver in the Thames Valley region and has a high reputation nationally and internationally. The units outcomes are monitored and audited to ensure maintenance of excellence, adhering to strict levels of clinical governance. This standard of care is maintained both in the NHS and in the private sector at the Nuffield Health the Manor Hospital in Headington, Oxford.

The concept of a multi disciplinary team

Effective care of your condition usually involves several specialists. A radiologist will perform and interpret any scans that are needed, a gastroenterologist may need to perform an endoscopic procedure, for example to remove stones from your bile duct, whilst the surgeon carries out operative procedures and a pathologist reports on the tissue that is removed as a biopsy or at surgery and an oncologist may provide radiotherapy and chemotherapy. These specialists meet weekly to discuss and coordinate your care. Such meetings are called multidisciplinary team (MDT) meetings, and MDT’s have been shown to improve quality of care, maintain universal standards and help eliminate mistakes.

HPB MDT’s in Oxford

  • Liver Cancer MDT:This MDT meets every Friday to discuss patients with liver tumours and metastatic cancer to the liver.
  • Pancreaticobiliary Cancer MDT:This MDT meets every Monday to discuss patients with primary cancers of the pancreas, gall bladder or bile ducts.
  • Neuroendocrine MDT:This MDT meets every Tuesday to discuss patients with neuroendocrine tumours of the pancreas and carcinoid tumours of the gastrointestinal tract.

Benign MDT: Meets every Tuesday to discuss patients with gallstone disorders, bile duct stones, pancreatitis and other benign HPB disorders. For example, patients who have stones in their bile duct are carefully discussed to decide whether they should have these stones removed by endoscopy, and then undergo surgery to remove their gall bladder, or whether it is best for both the gall bladder and bile duct stones to be dealt with at one operation.