HEPATO-PANCREATICO-BILIARY SURGERY (HPB SURGERY)

Deals with problems related to the liver, pancreas and bile ducts. 


LIVER SURGERY 
Resections of benign conditions such as liver adenoma, liver hemangioma and other as needed.
Managing liver cysts such hydatid cysts and liver abscesses.
Managing liver tumors such a hepatocellular cancer. The HPB surgeon is often the best person to liaise with the liver transplant teams by deciding who needs resection or liver transplant surgery. 
Liver metastasis that arise from colorectal cancers can managed by a combination of surgical resections and other treatments at the same time such as microwave ablation or RFA.


PANCREAS SURGERY 
These are most often resections of pancreatic cancer but can also be for conditions such chronic pancreatitis or cysts of the pancreas.
These are complex surgeries such as a Whipple procedures and advanced laparoscopic pancreatic surgeries. A lymph node dissection should accompany these resections.

https://www.youtube.com/watch?v=OI_mslxzJUw


BILE DUCT SURGERY  
This entails a variety of surgeries such as laparoscopic cholecystectomy with or without a cholangiogram. Bile duct explorations can be performed either through open surgery or key hole (laparoscopy).  A choledochoscope is passed down the bile duct and this enables viewing calculi (stones) in the common bile duct which enables management of these problems using a large variety of madalities such as ERCP, Spyglass and laser.

Cancer of the bile duct and the gallbladder demands complex surgery to deal with it effectively. It frequently involves a liver resection and extensive lymph node dissection for some of these cancers by a surgeon trained in these procedures. The HPB surgeon along with a trusted team of radiologists and oncologists can offer a treatment plan. 


GALLBLADDER

The most commonly performed surgery performed by an HPB surgeon is a laparoscopic cholecystectomy (gallbladder removal) done through key hole surgery. This is accompanied often accompanied by a intra-operative cholangiogram. An immediate ERCP can be perfromed if common duct stones are detected. 

Gallbladder cancers are uncommon but as mentioned requires management by a team of experts for the best treatment options and outcomes. 

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