Complex liver & pancreas surgery — with an honest operability assessment before anything else.
HPB surgery is the deep end of surgical oncology: segment-oriented liver resections, the Whipple procedure, two-stage strategies for small remnant livers. The first service offered here is candour — a straight answer about whether operation is truly your best option.
What is HPB cancer surgery?
HPB covers the liver (primary tumours and metastases), gallbladder, bile ducts (cholangiocarcinoma) and pancreas — organs that sit together, drain together, and demand the same rare skill set when they turn malignant.
Two facts change how families should think here. First: the liver regenerates — modern resection planning works WITH that biology, sometimes growing the remaining liver first through two-stage strategies so a major resection becomes safe. Second: jaundice is not automatically cancer — stones and strictures cause it far more often, which is exactly why proper workup before fear takes over is worth everything.
The harder truth is also spoken plainly in this clinic: not every HPB tumour benefits from surgery. When operation would add suffering without adding months or years, you will hear that clearly, with the reasoning shown — because an honest no is itself treatment.
“My job includes telling you when the best operation is the one we do not do.”
તમે એકલા નથી — you are not alone in this. Bring every scan you have, even the ones from other hospitals.
Eight signs that belong in a specialist’s clinic
Jaundice with fever needs same-day attention at any hospital. The rest of these deserve a planned, unhurried workup within days — most causes will be benign, and knowing either way brings its own relief.
- ①Yellow eyes or skin (jaundice) — new jaundice always needs investigation, whatever the cause.
- ②Itching all over without a rash, often worse at night — bile salts can be behind it.
- ③Pale, clay-coloured stools.
- ④Dark urine out of keeping with how much you drink.
- ⑤Pain in the upper-right abdomen, steady or recurring.
- ⑥Sudden diabetes developing with weight loss — occasionally the pancreas signals this way.
- ⑦Fever occurring with jaundice — this combination needs a hospital today, not next week.
- ⑧Unintentional weight loss alongside any of the above.
Conditions we treat
◆Primary Liver Cancer
Hepatocellular and other primary liver tumours, resected by segment-oriented technique.
◆Liver Metastases
Cancer spreading to the liver — often still curatively treatable with properly planned resection.
◆Gallbladder Cancer
Radical cholecystectomy performed to standard, including cases found after routine stone surgery.
◆Bile Duct Tumours
Cholangiocarcinoma — duct resection with hepaticojejunostomy reconstruction.
◆Pancreatic Cancer
Whipple and distal pancreatectomy, selected on genuine benefit rather than bravado.
◆Remnant-Liver Planning
ALPPS and portal-vein-embolisation strategies that make major resections possible safely.
Operations performed here
- ◆Segment-oriented liver resectionsIncluding right and left hepatectomy — removing what the disease demands, sparing what regeneration can use.
- ◆Whipple procedurePancreaticoduodenectomy — the defining HPB operation, done by a team that does it regularly.
- ◆Distal pancreatectomy ± splenectomyFor body-and-tail pancreatic tumours, with vessel control done meticulously.
- ◆Radical cholecystectomyThe proper cancer operation for gallbladder cancer — more than a simple stone removal, always.
- ◆Bile duct resection + hepaticojejunostomyDucts removed and rebuilt where cholangiocarcinoma sits.
- ◆ALPPS / PVE two-stage planningGrowing the future liver remnant first, so the second stage proceeds safely.
From first visit to full recovery
Imaging reviewed personally
Your scans read again here — slice by slice, not from a summary line.
Liver volume assessment
Volumetry answers the central question: how much liver can safely stay?
Tumour board decision
Medical and radiation oncology weigh in; some livers do better with treatment first.
Surgery — possibly staged
One operation when safe; two-stage ALPPS/PVE strategy when it makes cure possible.
Regeneration watch
Liver function monitored closely while the remnant grows back to full strength.
Surveillance
Scheduled scans keep watch, so anything new is caught while small.
Families usually ask…
It is major surgery and deserves respect — blood loss control and remnant-liver planning are the difference between centres, which is why staging and volumetry happen before consent here. In properly selected patients at experienced hands, outcomes have improved dramatically over the past decade.
Yes — uniquely among human organs, the liver regenerates. A healthy remaining portion expands toward full working volume over weeks. This biology is the entire foundation of modern resection planning, and of two-stage strategies like ALPPS and PVE.
Because the pancreas sits wrapped around critical vessels and leaks matter when cut — outcomes depend heavily on surgeon and hospital volume. Honest counsel includes this: if your case needs a dedicated high-volume centre rather than general excellence, you will be told so and referred well.
No — gallstones and benign strictures cause most of it. But new jaundice must never be ignored either way, because the causes that ARE serious are best met early. An ultrasound plus blood tests usually sorts the question within a day or two.
When disease extent, liver reserve or overall condition means an operation would subtract quality of life without adding meaningful time. You will hear this plainly if it applies — with the scans on the table showing why, and with alternative treatment paths laid out.