Surgical Oncology: HPB

About Stanford's Hepatopancreatobiliary (HPB) Section

The Division of Surgical Oncology offers a comprehensive approach involving specialized care and clinical research related to the treatment of both benign and malignant tumors. The program is centered at the Stanford Cancer Center  where surgeons in this section evaluate patients alongside medical oncologists, radiation oncologists, and microvascular surgeons to provide multidisciplinary treatment planning and disease specific clinical trials.  

The physicians meet regularly at weekly tumor boards for gastrointestinal cancers, liver and bile duct tumors, and sarcomas to create comprehensive care plans for patients.  In these meetings, specialists from surgery, medical oncology, radiation oncology, radiology, and pathology evaluate and discuss patients for whom they are considering a multispecialty approach. The tumor boards serve as a platform to discuss individual cases, evaluate management options among specialties, recommend care plans, and follow up on treatment progress. The group will collectively design the best course of action for each patient to ensure that every patient has an optimal treatment plan and receives the most appropriate therapy.

Liver, Pancreas, and Bile Duct Program

Problems of the liver, pancreas, gallbladder, and bile ducts are challenging disease that require multidisciplinary care plans. The primary focus of the Hepatopancreatobiliary (HPB) section of the Division of Surgical Oncology is to coordinate a team effort by several different physician specialties to offer expertise in complex surgical procedures, novel interventional radiology techniques, targeted drug therapies and minimally invasive treatment approaches.

The comprehensive liver tumor board is held every Tuesday mornings from 9 am to 12 pm in the Stanford Cancer Center.  Specialties in attendance to discuss complex liver and bile duct tumors (Hepatocellular carcinoma, Cholangiocarcinoma, Hepatic metastases, Hepatic adenomas, Focal Nodular Hyperplasia, Gallbladder cancer, Biliary cystadenomas) include surgical oncology, HPB surgeons, transplant surgeons, radiologists and interventional radiologists, medical oncology, radiation oncology, and pathology.  To refer a patient for Stanford Liver Tumor Board, please fax a referral form with supporting documentation to 650-320-9443.

HPB Patient-Care Team

Clinical Associate Professor, Surgery - General Surgery

Bio

Dr. Dua is a Clinical Assistant Professor of Surgery at Stanford. She received her undergraduate degree from the University of California, Los Angeles and her medical degree from Drexel University in Philadelphia. She completed her general surgery residency at Stanford University School of Medicine with a two year post-doctoral research fellowship in vascular biology. She then went on to do a one year fellowship in minimally invasive and robotic surgery at the Cleveland Clinic and a second two year fellowship in hepatobiliary and pancreatic surgery back at Stanford University prior to joining the division faculty. Her clinical focus is in gastrointestinal oncology with a focus on benign and malignant disease of the liver, pancreas, and bile duct. She also performs oncologic resections for tumors of the distal esophagus, stomach, and small intestine. Dr. Dua is the associate program director for the HPB fellowship, an active instructor in the Stanford University surgical clerkship curriculum for medical students, and also serves as the regional HPB Surgeon at the VA Palo Alto Health Care System. Dr. Dua participates in the Benign Pancreas Program at Stanford and her research includes both benign and malignant aspects of GI/HPB surgery with a focus on the management of severe pancreatitis as well as surgical strategies for the treatment of necrotizing pancreatitis. Other research interests include the application of minimally invasive approaches to the surgical management of HPB diseases including laparoscopic techniques in liver surgery and the use of laparoscopic and robotic platforms in pancreatic surgery. She currently has an ongoing clinical trial looking at the myoelectric activity of the stomach and intestine following pancreaticoduodenectomy as a function of predicting which patients are at higher risk of developing delayed gastric emptying or postoperative ileus. This study is being performed concurrently with the introduction of the division’s enhanced recovery after surgery perioperative care pathways to facilitate improved patient outcomes in those undergoing pancreatic resections.
The Robert L. and Mary Ellenburg Professor in Surgery

Bio

Jeffrey A. Norton, M.D. is the Robert L. and Mary Ellenburg Professor of Surgery and Chief of Surgical Oncology. Dr. Norton is an expert on endocrine and upper gastrointestinal cancer. He has published numerous papers on these diseases especially on the surgical management of gastric cancer and pancreatic endocrine tumors. His laboratory effort is focused on improving the anti-tumor immune response through cellular immunotherapy with interleukin-12. He has several on going multi-department human clinical protocols for the treatment of pancreatic cancer and hereditary diffuse gastric cancer. He is on the Editorial Board of Annals of Surgery, and Cancer Research.
Associate Professor of Surgery (General Surgery) at the Stanford University Medical Center

Bio

Dr. Poultsides is Chief of the Section of Surgical Oncology and Associate Professor of Surgery at Stanford University. He is an oncologic surgeon specializing in the removal of liver, pancreatic, and other abdominal tumors. He joined Stanford in 2009 after completing fellowship training in Surgical Oncology at Memorial Sloan Kettering and in Hepato-Pancreato-Biliary (HPB) Surgery at Johns Hopkins. Dr. Poultsides serves as Physician Lead of the GI Oncology Clinical Research Program at the Stanford Cancer Institute. His research program focuses on outcomes analysis following multidisciplinary treatment of hepatic, pancreatic and gastrointestinal malignancies. He has received a Masters Degree in Epidemiology from Stanford University and has led several nationwide, multi-institutional clinical research collaborations across several academic medical centers in the US. Within Stanford, Dr. Poultsides has developed a novel interdisciplinary research program assessing the completeness of surgical resection for pancreatic cancer. He has been the principal investigator in two, first in human, prospective clinical trials evaluating the role of mass spectrometric and intraoperative fluorescent imaging during surgery for pancreatic cancer. These research efforts were funded through the 2012 Stanford Hospital Cancer Innovation Fund award and the 2016 Stanford Cancer Institute translational research award. In addition, Dr. Poultsides sits on the guidelines panel of the National Comprehensive Cancer Network for gastric and esophageal cancer. For his contributions to the education of the next generation of surgeons, Dr. Poultsides received the John Austin Collins, MD annual teaching award from the Stanford Surgery residents in 2013 and the Best Rotation award from the Stanford Surgery chief residents in 2012, 2016, 2017, and 2018.
Associate Professor of Surgery (General Surgery) at the Stanford University Medical Center

Bio

Dr. Visser is a native of San Francisco, the youngest of eight children. He attended Deep Springs College in Eastern California and then went on to earn his BS at Cornell University in Ithaca NY. After receiving his MD degree at the University of California - San Francisco, he stayed at UCSF for his residency training in general surgery. He then completed specialized fellowship training in hepatobiliary and pancreatic surgery (also called HPB surgery) at the University of Edinburgh in Ediburgh, UK. Dr. Visser is board certified in general surgery by the American Board of Surgery. His principle practice is at Stanford Hospital and the Stanford Cancer Center, but he is also a staff surgeon at the Veterans Affairs Palo Alto Health Care System, serving our veteran patients. Dr. Visser is actively involved in the General Surgery training program and is the program director for the Stanford Hepatopancreatobiliary (HPB) Surgery fellowship program. Dr. Visser was honored in 2011 with the John Collins Memorial Teaching Award, an annual faculty recognition selected by the entire body of general surgery residents. He also received the Best Rotation Award in 2015, which is selected by Stanford chief residents in general surgery. He is the Medical Director of the GI Cancer Care Program at the Stanford Cancer Center.
Professor of Surgery (General Surgery) at the Palo Alto Veterans Affairs Health Care System

Bio

Dr. Wren is a board certified general surgeon who specializes in the surgical treatment of gastrointestinal cancer: including stomach, pancreas, intestinal, and colon and rectal cancers. She completed fellowship training in advanced hepatobiliary surgery and performs open, laparoscopic, and robotic approaches to these cancers. Dr. Wren is also very involved in humanitarian surgery and global surgery. She works and manages educational partnerships in Sub Saharan Africa. She is faculty fellow of the Stanford Center for Innovation and Global Health.

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