The most demanding operations in oncology — offered only where they truly help.
Liver, pancreas and biliary surgery demands deep planning and complete honesty: about what can be removed safely, what the liver can regenerate, and when the wisest treatment is not an operation at all.
What is HPB cancer surgery?
Hepato-pancreato-biliary (HPB) oncology covers the liver, gallbladder, bile ducts and pancreas — organs buried deep, fed by major vessels, and unforgiving of imprecise surgery. These are operations where the surgeon’s planning counts as much as the day of surgery itself.
The modern science here is remarkable: the liver regenerates. Two-stage strategies can grow a healthy remnant large enough to remove extensive disease. But every strategy starts with an honest operability assessment — scans read properly, function measured, risks stated plainly.
The truth families deserve: for some pancreatic and advanced biliary cancers, surgery offers less than excellent systemic therapy alone would. You will hear that straight here, with the reasoning shown.
“My first duty in HPB surgery is to tell you clearly whether surgery helps you.”
Warning signs that deserve a specialist’s eyes
These symptoms overlap with benign conditions — but they share one rule: they need proper imaging, not waiting.
- ①Yellow eyes or skin (jaundice) — painless jaundice deserves same-week attention.
- ②Persistent itching across the whole body without rash.
- ③Pale, clay-coloured stools.
- ④Dark urine, especially alongside the above.
- ⑤Pain in the upper-right abdomen, constant or recurring.
- ⑥Sudden-onset diabetes with weight loss — a classic early pancreatic clue.
- ⑦Fever with jaundice — infection in a blocked bile duct is an emergency.
- ⑧Several of these together — combinations are always worth urgent checks.
Cancers we treat in this region
◆Primary Liver Cancer
Hepatocellular carcinoma and cholangiocarcinoma arising within the liver — resected by segment-aware planning.
◆Liver Metastases
Bowel-cancer spread to the liver — resection here offers real long-term survival, often staged with chemotherapy.
◆Gallbladder Cancer
Radical cholecystectomy including port-site and nodal clearance — discovered early or found after routine surgery.
◆Bile Duct Cancer
Hilar and distal cholangiocarcinoma with resection and hepaticojejunostomy reconstruction.
◆Pancreas Head
The Whipple procedure — pancreaticoduodenectomy done at proper volume with structured recovery.
◆Pancreas Body & Tail
Distal pancreatectomy with splenectomy; small-remnant strategies (PVE/ALPPS) planned where needed.
Operations performed here
- ◆Segment-oriented liver resectionsVessel-by-vessel parenchymal sparing — maximum cancer removed, maximum liver kept.
- ◆Right & left hepatectomyMajor resections with low-central-volume technique and cell-salvage support.
- ◆Whipple procedurePancreaticoduodenectomy with standardised pathways for the notorious recovery.
- ◆Distal pancreatectomy + splenectomyWith vaccination protocols to protect immunity afterwards.
- ◆Radical cholecystectomyThe proper second operation when gallbladder cancer is found unexpectedly.
- ◆Bile duct resection & hepaticojejunostomyWith PVE/ALPPS coordination for small future remnant livers.
From first visit to full recovery
Triphasic imaging review
CT/MRI read personally; liver volumes and vessel anatomy mapped.
Operability assessment
Liver function, fitness and nutrition scored honestly — before any promise.
Preparation when needed
Jaundice drained, chemo given, or remnant liver grown — sequencing wins battles.
Surgery
Precise resection with vascular control and reconstruction as planned.
Structured recovery
ICU protocols, drain management, glucose control, early mobilisation.
Regeneration watch
Liver function monitored as it regrows; surveillance schedule fixed in writing.
Families usually ask…
It is among the most technically demanding surgeries in medicine — but in planned, properly worked-up patients at experienced hands, major liver resection today has mortality under a few percent. Preparation (imaging, function tests, sometimes growing the remnant) is what makes it safe.
Yes — uniquely among human organs. After up to 70% is removed, a healthy liver regenerates substantially within weeks. This biology powers modern strategies like portal vein embolisation and ALPPS for otherwise unresectable disease.
The pancreas sits behind everything important and leaks dangerously when cut. Outcomes depend heavily on volume, protocol and patient selection — which is why honest centres publish their numbers and structure recovery tightly rather than improvising.
No — most jaundice comes from stones, hepatitis or medicines. But painless progressive jaundice in adults always needs urgent imaging to exclude bile duct, pancreatic or gallbladder cancer. Early scans find curable disease.
Not at all. Modern systemic therapy for pancreatic and advanced biliary cancer is stronger than ever — and choosing it over a futile operation IS the correct surgery decision. We coordinate those treatments actively and stay involved throughout.