Dr. Concepción Gómez-Gavara specializes primarily in liver and pancreas surgery, employing advanced and minimally invasive techniques such as laparoscopy and robotic surgery. These approaches ensure effective treatments that are less invasive and promote better postoperative recovery.
Her research focuses on improving patient outcomes in fatty liver disease, elderly patients, and new technologies utilizing fluorescence and indocyanine green. She has secured multiple competitive grants in these fields, including those from Mutua Madrileña (2020), ISCIII PI20, CaixaImpulse (2021), and DTS (2022).
Aware of the importance of patient satisfaction, she strives to provide comprehensive care and outstanding results. To further enhance her expertise, she trained in minimally invasive liver and pancreatic surgery in Japan (2019) and later moved to Paris, France, where she worked at Hôpital Henri Mondor, performing laparoscopic and robotic hepatobiliopancreatic surgery and transplantation.
Dr. Gómez-Gavara has published over 75 scientific articles, and in 2018, she successfully defended her doctoral thesis on Liver Transplantation Surgery, earning the CUM LAUDE International Mention distinction.
In 2022, she was selected for the Vanguard Committee of the European Union of Medical Specialists (UEMS), responsible for training and examining transplant surgeons across Europe.
With medical license number 54320, Dr. Gómez-Gavara exemplifies excellence and dedication in the field of HPB (Hepato-Pancreato-Biliary) surgery and transplantation, providing exceptional care and results for her patients.
Selected publications from PubMed
Chronic liver disease is associated with earlier-stage cholangiocarcinoma diagnosis and improved prognosis: Findings from the GLOBAL-BTC registry.
Izquierdo-Sanchez L, Narbaiza J, Martin-Robles J, Lamarca A, Klümpen HJ, La Casta A, Valsan A, Roessler S, Braconi C, da Fonseca LG, Dopazo C, Juliebø AT, Mauro E, Buettner S, Balderramo D, Ponz-Sarvise M, Ferrer JD, Zieniewicz K, Utpatel K, Sparchez Z, Brustia R, Peck-Radosavljevic M, De Sario G, Gómez-Gavara C, Carrilho FJ, Tesini G, Nair P, Gutierrez E, Zonderhuis BM, Koerkamp BG, Forner A, Folseraas T, Goeppert B, Pavithran K, Bujanda L, Erdmann JI, Valle JW, Banales JM, Global Biliary Tract Cancer Registry Study Group
J Hepatol. 2026 Aug 24 pii: S0168-8278(26)02863-1. doi: 10.1016/j.jhep.2026.08.020.
Indocyanine green fluorescence for intraoperative detection of liver tumours in minimally invasive surgery: protocol for the LIVERGREEN phase IV multicentre clinical trial.
Huerta M, Lopez-Ben S, Lladó L, Sánchez-Cabús S, Mils K, Molina V, Dopazo C, Vidal L, Dalmau M, Caralt M, Rosón N, Merino X, Armario D, Salcedo MT, Pellino G, Sapisochin G, Gómez-Gavara C, LIVERGREEN Collaborative Group
BMJ Open. 2026 Apr 16;16(4):e118275 doi: 10.1136/bmjopen-2026-118275.
Brightening the path to safe liver transplants: the role of ICG fluorescence in biliary anastomosis.
Huerta M, Dalmau M, Fernandes N, Dopazo C, Caralt M, Vidal L, Charco R, Bilbao I, Gómez-Gavara C
BMJ Surg Interv Health Technol. 2025;7(1):e000322 doi: 10.1136/bmjsit-2024-000322.
Heparinase I treatment to overcome RNA quantification interference in heparinized liver donor samples: One size fits all?
Dalmau M, Charco R, Bilbao I, Dopazo C, Caralt M, Molino JA, Gómez-Gavara C
PLoS One. 2025;20(5):e0322899 doi: 10.1371/journal.pone.0322899.
Global Outcomes Benchmarks in Laparoscopic Liver Surgery for Segments 7 and 8: International Multicenter Analysis.
Lopez-Lopez V, Morise Z, Gomez Gavara C, Gero D, Abu Hilal M, Goh BK, Herman P, Clavien PA, Robles-Campos R, Wakabayashi G, Laparoscopic Liver Surgery Multicenter Study Group
J Am Coll Surg. 2024 Oct 1;239(4):375-386 doi: 10.1097/XCS.0000000000001100.
This case presents a 75-year-old male with compensated cirrhosis, hypertension, type 2 diabetes, and nephropathy, undergoing laparoscopic resection of segment IVA and B for hepatocellular carcinoma (HCC). Preoperative imaging revealed a 49mm lesion in segment IVA, consistent with HCC, and chronic liver disease. Intraoperative indocyanine green (ICG) fluorescence was employed to guide resection and delineate anatomical landmarks in this cirrhotic patient. The procedure involved a five-port technique, with the Pringle maneuver used to control intraoperative bleeding. Key steps included meticulous mobilization of the liver, identification of segment IV pedicles, and parenchymal transection with ICG guidance, ensuring clear resection margins. The use of ultrasound and ICG allowed precise localization of biliary and vascular structures, critical in cirrhotic patients where anatomical variations may be present. The surgery was successfully completed with a total Pringle maneuver time of 100 minutes. The postoperative pathology confirmed a 50mm HCC without vascular invasion. The patient was discharged on the third postoperative day without complications, and no recurrence was noted after 20 months of follow-up.
Published
Jan 2025
Gallbladder cancer (GBC) is the most common malignant tumour of the biliary tract. It’s also the most aggressive gastrointestinal malignancy with five-year survival rate between 5-15% in relation to advanced stage at diagnosis. GBC can be suspected preoperatively or most commonly as an incidental finding on surgery or pathologic review. Current available systemic therapy is not effective in the majority of patients with distant metastases and surgical R0 resection is the only potential curative treatment. SEPIDEMIOLOGY and PATHOLOGY Worldwide incidence of GBC is less than 2/100,000 individuals but has a prominent geographic variability that correlates with the prevalence of cholelithiasis (> 10/100,000 cases in Chile, Northern India and Japan). The average age at diagnosis is 65 years old with female predisposition (3:1 ratio). Cholelithiasis is considered a primary etiological factor in GBC resulting in chronic mucosal inflammation over several years that may lead to dysplasia and malignant transformation. Progression from adenoma to carcinoma may also have a role in pathogenesis given the increased incidence of adenocarcinoma in gallbladder polyps larger than 1cm (indication for cholecystectomy). PRESENTATION AND WORKUP 1·GALLBLADDER MASS OR DISEASE SUSPICIOUS FOR GBC: The initial workup includes a cross-sectional study with CT and/or MRI. Liver function tests, assessment of hepatic reserve and CEA and CA19.9 testing. Laparoscopic staging is recommended priori laparotomy for all instances of suspected or proven gallbladder cancer. Routine biopsy is not required. – In early staged T1a tumors a simple cholecystectomy is an adequate treatment. – For T1b and T2 tumors an optimal resection requires an extended cholecystectomy + and hepatoduodenal lymphadenectomy of at least 6 lymph nodes – For locally advanced disease (T3-T4), selected patients with good performance status and without distant disease could benefit for radical surgery with en bloc resection of involved with strong consideration for neoadjuvant therapy involved in clinical trials. 2· INCIDENTAL GBC AT SURGERY Intraoperative discovery of a GBC should prompt closure and subsequent referral to a hepatobiliary center. Other opinions support that if there is persuasive clinical evidence and an experienced surgeon is available, a definitive resection should be performed. 3· INCIDENTAL GBC AT PATHOLOGIC REVIEW Consider pathologic re-review by an hepatobiliary pathologist expert. Staging evaluation with cross-sectional imaging should be completed. Laparoscopic staging prior to laparotomy is recommended in incidental GBC as it could identify about 20% of patients with distant disease. – Re-resection between 4 and 8 weeks is indicated for T1b, T2 and T3 incidentally discovered GBC, unless contraindicated by advanced disease or poor performance status. – T1a lesions may be observed since these tumors don’t penetrate the muscle layer and long-term survival approaches 100% with simple cholecystectomy. Role of neoadjuvant and adjuvant therapy. Scarce high-quality data currently exists for the optimal systemic strategy for gallbladder adenocarcinoma. – Patients with preoperatively staged T3-T4 and lymph node disease should be considered for clinical trials studying the efficacy of neoadjuvant chemotherapy – Adjuvant therapy with chemotherapy and/or chemoradiotherapy should be offered following R0 resection of ≥ T2 and positive node GBC and if microscopically positive surgical margins. Palliative therapy for unresectable metastatic disease. The affection of liver or peritoneal metastases, malignant ascites, metastases to lymph nodes beyond locoregional nodes (in the celiac axis or aortocaval groove), extensive involvement of the hepatoduodenal ligament, or encasement or occlusion of major vessels are considered unresectable. The mainstay of palliative treatment in GBC is maintenance of adequate biliary drainage, nutrition and local compressive symptoms. Chemotherapy can provide effective palliation treatment.
Published
Jan 2021
Introduction Indocyanine green (ICG) is a fluorescent traceable dye that has been clinically used in a wide range of medical procedures. ICG has different routes of administration but when it is injected intravenously, it binds to plasma proteins and remains there until it is selectively taken up by the liver, it does not metabolize, and it is excreted through the bile. The main drawback is that the fluorescence signals emitted by protein-bound ICG can only be visualized through tissue of 5 to 10 mm thick, as light at 840nm is absorbed by water and hemoglobin. ICG has multiple applications in the field of medicine. In the field of liver pathology, ICG has historically been used to assess hepatic function. Two tests have been described to assess liver function: plasma disappearance rate (PDR) and Indocyanine Green fifteen (ICG15). Currently, the ICG technique is validated for three possible applications in hepatobiliary surgery. They can be categorized into: Lesion detection Hepatic perfusion assessment and liver mapping Bile duct visualization Lesion detection Hepatocellular carcinoma (HCC) and colorectal metastases are the most common primary and secondary malignant tumors of the liver respectively, and their resection remains the therapy of choice. By using intravenous ICG, liver tumors can be accurately identified due to the fact that malignant lesions can exhibit intense fluorescence. The two main applications for lesion identification are to detect superficial lesions not seen in previous radiologic tests and to exclude malignancy from lesions with low fluorescence signal. The bases of ICG imaging on malignant tumor entail different mechanisms and a different fluorescence pattern for each tumor type. Total fluorescence pattern. In well-differentiated HCC, the ICG is retained in the cells due to an impaired biliary excretion as a result of morphological and functional abnormalities of malignant cells. The fluorescent pattern is homogeneous. Rim fluorescence pattern. In poorly-differentiated HCC or colorectal cancer metastases, the ICG is retained by surrounding normal tissue resulting in a ring of fluorescence. The main drawback of this technique is the limited tissue penetration. Hence, only superficial lesions can be imaged with this modality. However, lesions can be exposed during parenchymal transection. ICG must be administered before surgery. There is some controversy on this aspect, as there is no consensual time of administration, but what is accepted is that ICG has to be administered at least one day before surgery. Hepatic perfusion assessment and liver mapping The major challenge in malignant hepatic surgery is performing a R0 resection with the maximal preservation of liver parenchyma. Accuracy in the resection of the corresponding anatomical segment is extremely important. Real-time delineation of liver segments after ICG intravenous administration can help surgeons to perform hepatic resections based on the precise segment irrigation by using systematic extrahepatic Glissonean pedicle isolation based on Laennecs’s capsule, as described by Sugioka. The aim of this technique is to identify anatomic segments before resection. Positive staining technique. Boundaries of the hepatic segment to be resected can be precisely identified by injecting ICG into the corresponding portal branch. The fluorescent segment will be identified as the region to be removed. Negative staining technique. The segment to be removed appears as an ischemic region following the administration of ICG intravenously after clamping the corresponding portal pedicle. The ischemic region is seen as a non-fluorescence parenchyma. Bile duct visualization ICG needs to be administered intravenously 30-40 minutes before surgery to perform an extra-hepatic cholangiography, as it allows a perfect identification of biliary structures thanks to its exclusive biliary excretion. The dissection of Calot’s triangle is not required. It can be useful in cholecystectomies, especially in patients with acute cholecystitis where structures are usually difficult to identify or in patients with anatomical variants. Bile excretion of the ICG can be compromised in patients with obstructive jaundice or liver dysfunction, so this technique may be useless for these patients. Obesity or chronic cholecystitis are two of the main drawbacks of this procedure as the fat surrounding the bile duct and the thickness of the bile duct, respectively, can hide the fluorescence. Hepatic lesionsHepatic perfusion assessmentBile ductObjectiveTo guide the resection of hepatic lesionsTo delineate ischemic boundaries and to identify anatomical segmentsIdentification of the bile duct during surgery and bile leakages after hepatectomyDoseIV: 0,25- 0,5mg/kgIV:5- 25 mg IP: 2,5-5mg/mlIV: 2,5mg IB: 0,025-0,5mg/ml Administration timeBefore surgery (1 day at least)After clampingExtra-hepatic visualization: 40 minutes before surgery Intra-hepatic visualization: At the beginning of transection IV: endovenous; IP: intraportal; IB; intrabiliary Other potential ICG-imaging applications ICG imaging can be used as an intra-hepatic cholangiography to detect bile leakage following an hepatectomy. Real-time visualization of the liver irrigation allows determining if an ischemic region is left after a segmentectomy or hepatectomy. This technique might prevent potential post-operative complications such as intra-abdominal collections, biliary leakage or even tumor recurrence. Take-home messages ICG imaging during hepatobiliary surgery is a safe, simple and feasible method that improves intraoperative liver anatomy visualization, improves liver tumor visualization and resection margins and reduces post-operative complications.
Published
Sep 2020
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