Liver and pancreas surgery, honestly assessed — including when not to operate.
Liver, gallbladder, bile duct, pancreas. The highest-stakes abdominal surgery there is — where liver-volume maths, remnant function and honest operability calls decide the plan before any blade moves.
Why this surgery is measured before it is done
These cancers sit deep and speak late — jaundice, itching, pale stools, pain under the right ribs, diabetes arriving suddenly with weight loss. The liver also carries a unique trick: it regrows, which is precisely what makes major resections possible when they are planned around volume.
Every HPB case here is calculated before it is operated: liver volumes measured on CT, the future remaining liver estimated, and — when that remnant runs small — portal vein embolisation or two-stage strategies such as ALPPS used to make surgery safe rather than heroic.
And the honesty clause: when a Whipple or a hepatectomy would harm more than help, we say so plainly and route you to the alternatives. Operability is assessed here, not assumed.
● Jaundice is a symptom, not a verdict — many causes are treatable, and none improve by waiting in silence.
Eight signs from the deep abdomen
These symptoms share one rule: they deserve imaging, not watching. Most turn out benign — the ones that don’t are exactly why we check early.
- ①Yellowing of eyes or skin (jaundice).
- ②Itching that spreads without any rash.
- ③Pale, clay-coloured stools.
- ④Urine gone dark tea-coloured.
- ⑤Pain in the upper-right abdomen.
- ⑥Sudden diabetes accompanied by weight loss — a pancreatic signal worth investigating.
- ⑦Fever appearing together with jaundice.
- ⑧Several of these together — this cluster gets seen promptly, not watched.
Organs this department operates on
◆Liver — Primary & Metastatic
Segment-oriented resections, from wedge to extended hepatectomy.
◆Gallbladder Cancer
Radical cholecystectomy — including tumours found incidentally after routine surgery.
◆Bile Duct (Cholangiocarcinoma)
Resection with hepaticojejunostomy reconstruction.
◆Pancreas Head
The Whipple procedure — pancreaticoduodenectomy, done at proper volume.
◆Pancreas Body & Tail
Distal pancreatectomy, with splenectomy when indicated.
◆Small-Remnant Planning
ALPPS and portal vein embolisation to make major resections survivable.
Operations performed here
- ◆Segment-oriented liver resectionAnatomy respected; regeneration supported rather than presumed.
- ◆Right & left hepatectomyVolume mathematics completed before commitment.
- ◆Whipple procedurePancreaticoduodenectomy — the most demanding standard operation in abdominal surgery.
- ◆Distal pancreatectomy ± splenectomyFor body and tail tumours, planned to the vessel.
- ◆Radical cholecystectomyTurning incidental findings into properly curative operations.
- ◆Bile duct resection & hepaticojejunostomyDrainage rebuilt when the duct must go.
From first visit to full recovery
- 10:00
First consultation
Reports read personally; jaundice, nutrition and fitness assessed together.
- 08:12
Staging & volumetry
CT liver volumes calculated; the multidisciplinary board weighs in.
- 13:26
The operability verdict
An honest yes, no, or grow-the-liver-first plan — family included in the room.
- 09:15
Surgery
Resection to plan, monitoring intensive, handover briefed in writing.
- 06:04
Day-one rounds
Liver labs tracked daily — regeneration is measured on graphs, not assumed.
- 17:40
Home & surveillance
Recovery milestones, nutrition support, scan schedule issued.
Families usually ask…
It is major surgery and deserves respect — but risk falls sharply when volumes are calculated, technique is anatomical and patient selection is honest. That triad is the entire method of this department.
Yes — uniquely among human organs. The remaining segments regenerate substantially within weeks, and two-stage strategies exist precisely to exploit that biology safely.
The pancreas sits behind everything important and heals badly when it leaks. Surgeon volume, disciplined technique and post-operative care tame most of that risk — which is why it belongs with dedicated HPB practice.
No — stones and strictures cause plenty of it. But persistent jaundice always needs proper imaging urgently, because the causes that are serious are also the ones that reward speed.
Often yes, depending on final pathology — pancreatic and bile-duct cancers usually benefit; some liver cancers follow different rules. The board decides with you before discharge.