Savannah native brings his specialty in liver, pancreas and bile duct surgery to the Savannah region
Dr. Russell Kirks
Specialty: Hepatobiliary and pancreatic surgery
5354 Reynolds Street (Professional Office Building, Candler Hospital)
Savannah, Ga. 31405
High School: Savannah Christian
Undergraduate: University of Georgia
Medical School: Medical College of Georgia
General Surgery Fellowship: Carolinas Medical Center in Charlotte
Hepatobiliary Surgery Fellowship: Virginia Macon Medical Center in Seattle
SJ/C: Why did you decide to become a doctor?
I couldn’t decide on what to do towards the end of high school and ended up spending some time with some emergency room providers. I thought the pace of what they did was interesting, as well as the breadth of what they saw and treated, but then, from shadowing some surgeons, I thought surgery was super interesting and decided that’s what I wanted to pursue.
SJ/C: How would you describe hepatobiliary and what are some conditions you treat?
Hepatobiliary surgery and pancreatic surgery is treating benign and malignant problems of the liver, pancreas and bile duct. Those can be things people are born with; things that happen from injuries or other surgeries; cancers; or the long-term effect of other diseases. What makes hepatobiliary surgery different from something like surgical oncology is that we also include problems like chronic pancreatitis, bad gallstone disease, those two things specifically, but we also treat the malignant conditions of the liver, pancreas and bile duct. Instead of just being focused on the surgical procedures themselves, what the extra training provides is knowing when it’s appropriate to do surgery, how to optimize people for an operation, and how to collaborate with other specialties such as gastroenterology, interventional radiology and medical oncology to come up with the best treatment plans for patients with these specific problems.
SJ/C: How did you pick this specific specialty?
Reading through all the different surgery text books as a student, I thought that some of these problems were the most interesting in terms of the interplay between anatomy and physiology and results, and what could not only structurally but medically and functionally be done to correct them. When I was a medical student I was lucky enough to see some of the major hepatobiliary operations like a bile duct exploration to remove stones from the bile duct and a Whipple operation. I was fascinated with the idea of liver molding, or the strategies we have to modify the liver in order to change its shape so that we can remove advanced tumors. As an example, we can induce part of the liver to grow so that another portion can be removed along with the tumor. The liver is a pretty remarkable organ in that it regenerates pound for pound whatever is cut out. That allows us to really tailor our operation to the exact problem of the patient. It was this interesting anatomy and physiology and its interplay that attracted me to the field.
SJ/C: Why do you think it’s important to offer this specialty to patients in the Savannah region?
I’ve known Dr. (T. Ellis) Barnes and Dr. (John) Odom for a long time, and when I would speak to Dr. Odom about some of these things, I learned that many patients with hepatobiliary problems were being referred to Atlanta, Charleston, Jacksonville or sometimes even farther away to be seen by a surgeon and potentially have surgery. That can create headaches if you need to see a surgeon for a problem, and when you’re away from family when you have the procedure. It’s comforting just knowing that there is a system and someone close to home who can help whatever occurs in or around the time of surgery should a complication occur. Especially for people who don’t have the means to travel for four hours one way or be without family on a regular basis, I saw the opportunity to extend these services to people in my home town.
SJ/C: Are there some common procedures that you perform?
I certainly do gallbladder surgery and bile duct surgery for bad gallstone disease. I also do liver resections for things like either liver tumors that started in the liver or metastasize to the liver. I also do operations like the Whipple Operation, which is the removal of the head of the pancreas, the bile duct, the gallbladder and typically the bottom third of the stomach and then creating connections to drain those organs back into the intestinal tract. It’s typically a cancer operation. I also perform the distal pancreatectomy where the left-sided half of the pancreas is removed. These are typically more involved and complex operations to resect these organs.
We are doing other things here such as liver resections and liver ablations using microwave energy to cook liver tumors inside without having to do a liver resection. Depending on which operation, it’s either going to be an open operation, a laparoscopic operation or sometimes robotic operations, depending on the patient, the tumor location and other technical requirements to perform a safe operation.
SJ/C: How has technology impacted your specialty?
For the field, especially for liver surgery but for HPB surgery in general, this is probably one of the most technologically involved fields of general surgery. Tools that we use for most HPB operations in HPB surgery include intraoperative ultrasound where I’m using an ultrasound probe during your surgery. This allows me to find tumors and target them for ablation, see what their relationship is to your surrounding vascular structures, or to see if tumors are resectable and to look at other parts of the organ to assess disease extent as well. Other things that I use are energy devices to aid in dissection and sometimes a microwave ablation device to perform an in situ ablation of liver tumors.
SJ/C: These are some pretty involved surgeries. How are these technologies beneficial to patients?
Technology allows us to extend certain cancer-related options to people who would not be resection candidates, specifically liver resection. For people who have liver dysfunction, a liver resection is not always the right option for them. Now we can treat some tumors just as adequately with thermal ablation as we can with resection. That allows us to extend treatment to those patients who would otherwise not be a candidate for resection.
SJ/C: When it comes to our liver, our pancreas, what’s some general advice you would give to people to keep those organs healthy?
Part of it, especially for liver disease, certainly moderation alcohol intake and a healthy diet. If you have some type of evaluation showing you have a problem with one of those organs, even something relatively common, such as fatty liver disease, those are things that should not be brushed under the table and should be discussed with your primary care doctor as well as a nutritionist to see if there are aspects of your lifestyle that can be altered to improve the health of those organs. Alternatively, if you are having concerning symptoms, such as yellowing of the skin (jaundice) or changes in your bowel habits or abdominal pain that is not getting better, it’s not really something to ignore. No one will ever penalize a patient for coming forward to evaluate complaints like these. Patients feeling free and safe to talk to their providers is the best case scenario and can allow problems to be detected earlier.
Family: Parents, grandmother, aunts, uncles and cousins in the area
Hobbies/Interests: Going to the beach, yard working and cooking