Practice No 4208293
Practice No 4208293
Practice No 4208293
Practice No 4208293
Meet Your Gallbladder & Liver-Lesion Surgeon
When gallstones keep flaring despite healthy eating or your first attack lands you in hospital, it is usually safer to remove the gallbladder than to wait for the next hit. Each new bout can push a stone into the bile duct, causing yellow skin, severe pain or even life-threatening pancreatitis. The same keyhole operation can also take out benign liver cysts that are steadily growing or pressing on nearby organs. Keyhole surgery stops these problems before they strike again, often with just an overnight stay.
See which option fits your scan results and symptoms.
What is a Gallbladder?
The gallbladder lies behind your right ribs at the front, below the liver and above the duodenum (gut). It is a pouch in which bile is stored until needed to help digest fat. It is connected to the tubing (bile ducts) that carries bile from the liver to the gut. Stones forming in the gallbladder often cause pain or inflammation in the gallbladder. If stones escape from the gallbladder they can block the bile ducts and cause pain, fever and yellow jaundice or block the duct of the pancreas, which shares a common outlet to the gut, causing pancreatic inflammation (pancreatitis).
What does the operation consist of?
Laparoscopic cholecystectomy is a surgical procedure that involves complete removal of the gallbladder through a 12mm cut near the navel. A laparoscope, which consists of a telescope with a miniature video camera, is placed through the navel to allow the surgeon and his assistants to view the gallbladder. In addition, three (or occasionally four) other smaller incisions are made in the upper part of the tummy through which various operating instruments are inserted. They are used to separate the gallbladder from its surrounding attachments. This procedure has advantages over the standard open operations in that there is usually less post‑operative pain (only one or two pain injections are usually necessary), a shorter hospital stay (an average of two days) and a quicker return to normal activities (on average, one week). Nevertheless the operation itself is the same and has the same risks.
Your surgeon may decide to stop the laparoscopic procedure and convert to the standard open operation. This decision is based on a number of different factors such as the inability to safely identify the blood vessels and bile ducts, the presence of extensive adhesions (scar tissue), unusual gallbladder anatomy, the presence of other intra abdominal disease, and bleeding.
What is a Gallbladder?
The gallbladder lies behind your right ribs at the front, below the liver and above the duodenum (gut). It is a pouch which is connected with the tubing (bile ducts) that carries bile from the liver to the gut. Stones forming in the gallbladder often cause pain. If stones escape from the gallbladder they can block the bile ducts and cause pain, fever and jaundice (a yellow skin) or block the duct of the pancreas and cause inflammation of that organ.
What does the operation consist of?
A cut is made in the skin below the right ribs at the front. It is usually made in a skin crease across your tummy so that it hardly shows afterwards. The gallbladder and its stones are removed. X‑rays may be taken to show whether there are any stones in the bile ducts. If there are, they are removed. The exact procedure depends very much on the detailed findings at the time of the operation. The cut in the skin is then closed up.
What is the problem?
Your symptoms point to your pancreas or gallbladder and bile ducts being the cause of your condition. The tests done so far have not been too helpful. The best way of finding out now is to do an ERCP. It has not been suggested before because it is a bit complicated and may need a stay in hospital.
What does an ERCP consist of?
This means passing a flexible telescope (duodenoscope) through the mouth into and through the stomach to the first part of the bowel called the duodenum. Looking through this scope the outlet of the ducts (pipes) from the liver and pancreas can be seen. A small tube is then passed into the ducts. Dye is injected and x‑ray films are taken.
The x‑rays may show gallstones in the ducts, narrowing of the ducts or may be normal. Stones can be removed and small plastic tubes placed through narrowed ducts at the time. This will avoid an operation.
Ends gallstone attacks — prevents serious flare-ups
Removing the gallbladder eliminates the stones that can block bile ducts, averting painful attacks, jaundice and even pancreatitis before they strike again
Noticeably less pain after keyhole removal
Laparoscopic cholecystectomy needs only tiny cuts, so most patients require just one or two pain injections post-op, not days of strong narcotics.
Home sooner
The average hospital stay after the keyhole procedure is about two days (open surgery, 2–5)
Rapid return to normal life — no special diet
Most people are back to everyday activities within a week and can eat a normal diet because the body copes well without a gallbladder
Dr. Mark grew up in Durban and matriculated in the top 30 in Natal. He completed his medical undergraduate training at UCT in 1998, where he was the elected class rep. for five years. He won the Family Medicine class medal, and Frank Foreman prize for the greatest contribution to student affairs. Internship at Edendale Hospital in Pietermaritzburg was followed by a year at various secondary hospitals in Cape Town for his community service, and then a year getting some GP experience in Manitoba, Canada. In 2002 Mark returned to Cape Town to specialise in general surgery at UCT. He completed this training in 2006, being awarded the ASSA prize for surgical research, and the Swann-Morton prize for the best surgical registrar.
Super-specialist training in HPB (Hepato-Pancreatico-Biliary) surgery started with the 2-year Certificate in Surgical Gastroenterology at Groote Schuur Hospital, with the CMSA exams completed at the end of 2008. In 2009 Mark further expanded his HPB experience and training with a Fellowship in HPB surgery at the HPB/Transplant unit in Newcastle-upon-Tyne, UK.
Super-specialist training in HPB (Hepato-Pancreatico-Biliary) surgery started with the 2-year Certificate in Surgical Gastroenterology at Groote Schuur Hospital, with the CMSA exams completed at the end of 2008. In 2009 Mark further expanded his HPB experience and training with a Fellowship in HPB surgery at the HPB/Transplant unit in Newcastle-upon-Tyne, UK.
Mark joined the Matley and Partners team in 2010. His primary interest is in HPB surgery, and he is accomplished in all aspects of this discipline, ranging from the management of gallstone disease, to complex liver and pancreatic resections. He is a keen endoscopist, including gastroscopy, colonoscopy and ERCP. Mark was the first surgeon in South Africa to perform the ALPPS liver resection procedure. In addition to the HPB surgery, Mark enjoys all aspects of general and laparoscopic surgery, including laparoscopic hernia repairs. He is a believer in team work, and tries to blend the best of modern techniques and technology with some old-fashioned “good bed-side manner”, in addition to careful decision-making and surgical technical expertise.
Mark is married to Tanya and they have two children. Mark’s hobbies include golf, fly-fishing, and scuba diving. Despite more than 25 years in the Cape, he remains a Sharks fan.
Ebrahim joined the Matley Partnership as a specialist colorectal surgeon with international training in laparoscopy from both Amsterdam and Nottingham. He is a Capetonian who matriculated from Livingstone High School, and completed his MBChB at UCT in 2002.
He completed his internship in Durban, where he met his wife Khatija, and completed his community service in Khayelitsha, including an additional year there with Medicin Sans Frontier, rolling out their antiretroviral program.
After two years of surgery in the UK, he completed his specialist training in Cape Town, obtaining his FCS in 2013. During this time he was awarded the MMed degree from UCT for his dissertation “Systems delays in Breast Cancer”. He gained a broad experience in general surgery before two years of sub-speciality training in the colorectal unit at Groote Schuur. In 2016 he was awarded the Specialist Certificate in Surgical Gastroenterology.
In 2017, he was awarded the SASES travelling fellowship to work with internationally renowned colorectal and laparoscopic surgeon, Professor Willem Bemelman, at the Amsterdam Medical Centre. Thereafter he completed his year abroad as a colorectal fellow, in Nottingham, UK. This is a busy unit with 10 colorectal surgeons providing the full range of colorectal specialist services. During this time he gained invaluable experience in advanced laparoscopy for inflammatory bowel disease and cancer surgery, which are his specific interests, and he is currently accruing UK robotic credentialing. Ebrahim is one of a handful of accredited specialist colorectal surgeons in the Western Cape, adding this expertise to the GIT team at Matley and Partners.
He is married to Khatija, a full time Obstetrician & Gynaecologist consultant at Groote Schuur Hospital, and they have two children. He is a golfer, family man and enjoys travelling at home and abroad.
Dr. Henri Pickard is a specialist Vascular Surgeon who proudly continues a rich family tradition of surgical practice, following in the footsteps of both his grandfather and father. He studied Medicine at the University of Cape Town (UCT), beginning a journey deeply rooted in heritage and excellence.
After completing his internship in Pietermaritzburg and community service in East London, Henri developed a strong interest in surgery. In 2012, he returned to Cape Town to work at the Trauma Centre at Groote Schuur Hospital, followed by a period at Victoria Hospital where he gained a wide range of surgical experience.
In 2014, Henri began his MMed degree and specialist training in General Surgery at Groote Schuur Hospital through UCT. In 2020, driven by a passion for the precision and complexity of the field, he pursued sub-specialist training in Vascular Surgery.
Henri is known for his collaborative work in multidisciplinary teams, his commitment to achieving the best outcomes for his patients, and his compassionate, patient-centred approach.
He grew up in Pietermaritzburg, George, and Cape Town, and matriculated from Rondebosch Boys’ High School. A proud South African, Henri is an enthusiastic Two Oceans runner, avid cricket follower, passionate Springbok supporter, and a devoted follower of Jesus. He is also a committed family man, deeply devoted to his wife Tricia and their three young children.
Neil grew up in Worcester and matriculated from Esselen Park High School in 1985. He completed his medical training at the University of Cape Town in 1991 and did his internship at Livingstone Hospital in Port Elizabeth. Following internship Neil worked at Red Cross Children’s Hospital as a medical officer in paediatrics before joining Mitchells Plain community health centre, where he gained extensive experience in general medical practice. His surgical experience started in 1996 at Worcester Regional Hospital where he worked as a medical officer in General Surgery for 3 years, prior to starting his specialist surgical training at Groote Schuur hospital in 1999.
On completion of his training in general surgery he was appointed as a consultant general surgeon at New Somerset hospital in 2005, where he was responsible for all clinical services until 2007 when he started his sub-specialist training in vascular surgery at St James’s hospital, the academic hospital of Trinity College Dublin in the Republic of Ireland. During his 3 year training period in vascular surgery, Neil received expert training in all aspects of open, endovascular and venous surgery at this prestigious high case volume unit. Neil returned to Cape Town in 2010 and was appointed as a consultant vascular surgeon at Groote Schuur hospital. In 2014 he was appointed as head of the vascular unit at University of South Africa (Medunsa) in Pretoria.
During the past 7 years, he was responsible for undergraduate, postgraduate and fellowship vascular teaching and training at the university as well as doing private practice at Netcare Unitas hospital in Centurion. Neil has served on the EXCO of the Vascular Society of South Africa since 2014.
Neil is an accomplished and experienced vascular surgeon, with special interests in endovascular surgery, dialysis access and venous surgery. He believes that good clinical practice is built on the foundation of empathetic bedside manner and teamwork.
Neil is married to Tracy, and they have 3 children. Neil enjoys an active outdoor lifestyle with hobbies including running, cycling, and golf. He also has a keen interest in history and philosophy.
Philip Matley has been a vascular surgeon in the practice that now bears his name since 1990. He is past-President of the Vascular Surgery Society of South Africa and a past moderator and chief examiner for the vascular surgery specialist examinations in South Africa. He has served on various national and international regulatory bodies and educational foundations.
During his training in Cape Town, he was the recipient of numerous awards including the Douglas Medal for the best candidate in the examination for the Fellowship of the College of Surgeons of South Africa as well as the Phyllis Knocker-Bradlow Award.
He has a special interest in the minimally invasive treatment of varicose veins, improving the circulation in the legs and brain through stents or surgery and the treatment of aneurysms.
In addition to his surgical practice, he is the chairman of Surgicom, the management body for private surgery practice in South Africa and serves on the board of South African Private Practitioners Forum (SAPPF).
Philip Matley grew up in KZN and is a keen golfer, mountain biker, walker and traveller
