The most demanding address in surgery — met with regeneration science and honest judgement.
The liver can regrow; the pancreas forgives nothing. HPB surgery rewards teams who plan in stages, respect volumes, and say no when an operation would harm more than it helps.
What are HPB cancers?
This service covers cancers of the liver (primary and metastatic), gallbladder, bile duct (cholangiocarcinoma) and pancreas — the organs where surgical judgement matters as much as surgical skill.
The liver’s remarkable property is regeneration: remove the diseased portion and the remainder grows back. That biology powers modern strategy — portal vein embolisation (PVE) and ALPPS coax the future remnant to enlarge before major resections, turning some “inoperable” livers into operable ones.
Gallbladder cancer deserves particular vigilance in this region: an incidental finding after gallstone surgery must never be dismissed — correct staging and, when needed, a radical cholecystectomy change the whole story.
Honest operability assessment is the signature here: scans read personally, liver volumes measured, anaemia and nutrition corrected first — and when an operation would not truly help, you will be told so plainly and offered the next best path.
Eight signals that deserve examination
Jaundice is never normal. These signals call for scans and blood work, promptly.
- ①Yellow eyes or skin (jaundice) — always worth investigating, whatever the cause turns out to be.
- ②Persistent itching all over, worse at night — often accompanies hidden bile duct blockage.
- ③Pale stools and dark urine — the classic pair that says bile isn’t flowing.
- ④Pain in the upper-right abdomen, deep or nagging rather than cramping.
- ⑤Sudden diabetes with weight loss in later life — occasionally the pancreas signalling early.
- ⑥Unexplained fever with jaundice — needs urgent attention, not waiting.
- ⑦A lump or fullness in the upper abdomen noticed while bathing or lying down.
- ⑧Any combination lasting beyond two weeks — deserves imaging, not assumptions.
Organs and services covered
☀Liver — Primary & Metastatic
Hepatocellular carcinoma and bowel-cancer spread to the liver, assessed for curative resection.
☀Gallbladder Cancer
Incidental and advanced cases staged properly; radical cholecystectomy done to standard.
☀Bile Duct Tumours
Cholangiocarcinoma resected with biliary reconstruction (hepaticojejunostomy).
☀Pancreas
Whipple procedure and distal resections performed within high-support pathways.
☀Two-Stage Strategies
PVE and ALPPS planning for small future liver remnants — making major surgery possible.
☀Operability Assessment
Volumes measured, fitness optimised, and a straight answer about whether surgery truly helps.
Operations performed here
- ☀Segment-oriented liver resectionsAnatomy-respecting removal planned on volume, preserving maximum healthy liver.
- ☀Right & left hepatectomyMajor resections with inflow-outflow control and low transfusion goals.
- ☀Whipple procedurePancreaticoduodenectomy — the definitive operation for pancreatic-head tumours.
- ☀Distal pancreatectomy ± splenectomyFor body-tail tumours, with careful spleen-preserving decisions where safe.
- ☀Radical cholecystectomyThe correct operation for gallbladder cancer — including incidentally found cases.
- ☀Bile duct resection & hepaticojejunostomyRebuilding drainage when the duct itself must go.
From first visit to full recovery
Reports & imaging review
Scans read personally; jaundice worked up to its true cause.
Volume & function testing
Liver remnant measured; biopsy and markers clarify tumour type.
Tumour board plan
Medical and radiation oncology shape sequencing before theatre.
Prehabilitation
Jaudice drained if needed; nutrition and fitness built up before major surgery.
Surgery
Precise resection with reconstruction, in high-dependency support.
Recovery & surveillance
Liver-function monitoring, adjuvant therapy if advised, scheduled reviews.
Families usually ask…
It is among the most technically demanding operations in oncology — which is exactly why planning is obsessive here: volumes measured, anaemia corrected, technique matched to anatomy. In properly prepared patients, outcomes have transformed over the past decade.
Yes — uniquely among human organs, the liver regenerates. Remove a portion and the rest enlarges within weeks. This biology underpins PVE and ALPPS two-stage strategies that make big resections safer.
The Whipple procedure rebuilds three connections at once and demands both technical precision and intensive postoperative care. It should only be done within systems prepared for it — dedicated anaesthesia, HDU/ICU backup, dietitian and physiotherapy from day one.
No — stones and infections are commoner causes. But every jaundice deserves a proper scan-based answer, because when it is a tumour, catching it early changes what surgery can achieve.
You will hear it straight, with reasons — and then get the strongest alternative plan: therapies that can shrink the tumour into operability, symptom control, and second opinions welcomed at any point.