Before you delve into HPB Surgery, you need to know HPB. HPB stands for Hepato-Pancreatic-Biliary systems or the pancreas, liver, bile duct, and gallbladder diseases. HPB surgery treats Hepato-Pancreato-Biliary conditions with similar symptoms such as jaundice, lighter stool color, and darker urine color. These diseases are managed and treated by a team of transplant specialists, Hepatologists, and Hepato-Pancreato Biliary Oncologists.
Definition of Hepato-Pancreato Biliary (HPB) Surgery:
The pancreas, liver, bile duct, and gallbladder surgery would be called HPB Surgery. The surgery is amongst the most complex surgeries, and only a specialized and highly skilled surgeon can operate. General surgeons who are HPB surgeons can diagnose and treat the malignant and benign diseases of the liver, pancreas, bile duct, and gallbladder. The surgeon needs to be trained in invasive surgeries like laparoscopic surgery, endoscopic surgery, and robotic surgery while performing Hepato-Pancreato-Biliary Surgery.
List of Types and Conditions that HPB Surgery Treats
While some common conditions like pancreatic tumors, there are also some unique diseases like bile duct and gallbladder cancer.
The common conditions that HPB Surgery treats are:
- Neuroendocrine tumors are formed when specific cells transform into tumors in the bile duct, gallbladder, liver, and pancreas.
- The pancreas, bile duct, gallbladder, and liver have noncancerous tumors.
- Hepato-Pancreato-Biliary surgery also treats liver cancer, pancreatic cancer, and cancers in the bile duct and gallbladder.
Various Types of Hepato-Pancreato-Biliary Surgery:
Different types of HPB surgery vary depending on the patient’s type of condition.
They have been listed and described below:
| Type of Surgery | Description |
| Distal and Total Pancreatectomy | A distal pancreatectomy is a process of removing the tail and body of the pancreas. The head of the pancreas remains whole while the procedure happens. The total Pancreatectomy is the removal of the whole pancreas. |
| The Whipple Procedure | Pancreaticoduodenectomy or also known as the Whipple Procedure is a surgery that removes tumors from various places, such as the ampulla of the water (which is a small opening to the first part of the small intestine, even known as the duodenum), the lower part of the bile duct, and the top portion of the pancreas.
The operation can be done laparoscopically or robotically to remove the total head of the gallbladder, bile duct, and pancreas along with the surrounding lymph nodes. The whole stomach is left intact in a different version of the Whipple Procedure, which is a pylorus-preserving version. In the regular version, a one-third portion of the stomach is removed. Through the bile duct, stomach and pancreas, the intestinal tract is connected again. |
| Minimally Invasive Liver Surgery | Minimally invasive liver surgery has two options such as complete robotic liver resection and whole laparoscopic liver resection.
Various factors decide whether you would have this surgery or not. The factors include size, biology, and the place of the lesions in the liver. The surgeon will discuss each option with you and help you decide the best choice for you. |
| Auto Islet Transplant Surgery | The surgery treats chronic pancreatitis that needs a complete pancreatectomy. In numerous cases, when patients are due for auto islet transplant surgery, they become candidates for a minimally intrusive approach. Your surgeon will decide whether you are an ideal candidate for islet transplant surgery. |
Rare Conditions That Can be Cured Only by Hepato-Pancreato-Biliary Surgery
Along with tumors, Hepato-Pancreato-Biliary surgery also treats different cancers. For instance,
- Liver Tumour:
There are only two options to cure primary liver cancer: liver transplantation or resection. The disease would have to be removed surgically to be cured entirely of metastatic colorectal cancer in the liver. When a tumor is not operable by traditional general surgery, ablative therapy is used where radio waves and heat kill tumor cells. The surgeon also utilizes minimally invasive techniques to help the patient heal fast with more minor scars. It also decreases the chance of wound infection.
- Bile Duct and Gallbladder Tumours:
Furthermore, the patients often need their bile duct and gallbladder reconstructed and liver cancer surgery. It depends on how the tumour has blocked the bile duct.
- Tumors in Pancreas:
There is only one cure for the malignant tumors in the pancreas, which is the complete removal by surgery.
The Alternatives to HPB Surgery
There are patients with pancreatic cancer at an advanced stage, and no surgery can cure it. Radiotherapy and chemotherapy can soothe the pain but cannot cure the disease.
RFA or radiofrequency ablation, chemotherapy, TACE, or transarterial chemo-embolization are liver cancer treatment. A liver transplant is the only option when the cancer is restricted to the liver, and the patient has cirrhosis.
Many patients have one question. Is HPB surgery the only cure for pancreatic and liver cancers? So, the answer is yes. Most liver and pancreas cancers can be cured only by Hepato-Pancreato-Biliary surgery. However, it is also important to take care of yourself and your health.