The most demanding surgery in oncology — planned honestly, done properly.
Liver and pancreas surgery leaves no room for improvisation. It demands exact anatomy knowledge, honest operability assessment, and the discipline to say no when an operation would harm more than help.
What is HPB cancer surgery?
This field covers the liver (primary cancers and metastases), gallbladder, bile duct (cholangiocarcinoma) and pancreas — organs packed tight with critical vessels, where surgical judgement matters as much as technique.
The liver's gift: it regenerates. Remove a portion and the remainder grows back — which makes careful two-stage strategies possible even for large tumours or small remnant livers.
The honest part: not every HPB tumour benefits from surgery. Part of our job is telling you when an operation is your best weapon — and when other treatments will serve you better.
Warning signs that deserve same-week attention
These symptoms need scans and blood tests promptly — not months of waiting. Most causes are treatable conditions like stones or hepatitis; the ones that aren't are exactly why we check now.
- ①Yellow eyes or skin (jaundice) — never normal, whatever the cause turns out to be.
- ②Persistent itching all over, worse at night, without any rash.
- ③Pale stools and dark urine — a classic signal of blocked bile flow.
- ④Pain in the upper-right abdomen, especially radiating to back or shoulder.
- ⑤Sudden diabetes with weight loss — new-onset sugar after fifty deserves a pancreas check.
- ⑥Unexplained fever together with jaundice — possible infection of blocked bile; needs urgent care.
- ⑦A feeling of fullness or lump in the upper abdomen — deserves imaging, not watchful guessing.
- ⑧Rapid unexplained weight loss alongside any symptom above — the combination raises priority further.
Cancers we treat in this region
◆Liver — Primary
Hepatocellular carcinoma assessed for resection within evidence-based criteria.
◆Liver — Metastatic
Bowel-cancer spread to the liver, where complete resection can still offer cure.
◆Gallbladder Cancer
Radical cholecystectomy including segment removal and nodal clearance.
◆Bile Duct Cancer
Cholangiocarcinoma — resection with hepaticojejunostomy reconstruction.
◆Pancreas — Head
The Whipple territory: pancreaticoduodenectomy with full nodal clearance.
◆Pancreas — Body & Tail
Distal pancreatectomy, with spleen preserved where safely possible.
Operations performed here
- ◆Segment-oriented liver resectionsAnatomy-respecting removal — preserving every millilitre of working liver.
- ◆Right & left hepatectomyMajor resections with ALPPS/PVE planning for small remnant livers.
- ◆Whipple procedurePancreaticoduodenectomy — the definitive operation for pancreatic head cancers.
- ◆Distal pancreatectomy + splenectomyFor body/tail tumours, performed to oncological standard.
- ◆Radical cholecystectomyGallbladder cancer surgery done completely the first time — it matters enormously here.
- ◆Bile duct resection & reconstructionHepaticojejunostomy restoring drainage with lasting patency.
From first visit to full recovery
Specialist imaging review
Triple-phase CT/MRI read personally — anatomy decides everything here.
Operability assessment
Liver volumes, function scores and fitness measured against honest criteria.
Tumour board plan
Medical and radiation oncology align on sequence — including chemo-first options.
Surgery
Resection with reconstruction, ICU support arranged in advance.
Regeneration & recovery
Liver function monitored as it regrows; nutrition actively managed.
Surveillance
Scheduled scans catch recurrence early, while options remain open.
Families usually ask…
It is major surgery, and honesty demands saying so. But outcomes have transformed with modern imaging, technique and intensive care. The biggest safety factor is patient selection — choosing operations for the right livers, which is exactly what the assessment phase exists for.
Yes — uniquely among organs, the liver regenerates. After up to 60-70% is removed, the remainder enlarges over weeks. This biology powers two-stage strategies: grow one side first, then operate on the other.
Because it rebuilds the plumbing between three organs in one operation, and outcomes vary hugely with surgeon volume and preparation. With proper case selection and experienced hands, it is performed routinely and safely — the reputation belongs to centres that attempt it casually.
No — most jaundice comes from stones, hepatitis or medicines. But it is always urgent: blocked bile needs diagnosis within days, because both benign and malignant causes worsen quickly when left. Get scanned first; assume nothing either way.
Absolutely — this is one surgery where the second opinion should come before the first cut. Bring your scans; we will tell you plainly whether the operation offers real benefit, what the alternatives are, and if another approach serves you better.