Liver & Pancreatic (HPB) Surgery

Overview

Hepatopancreatobiliary surgery — often shortened to HPB — covers operations on the liver, pancreas, gallbladder and bile ducts. These organs are closely connected: the liver produces bile, the bile ducts carry it, and the pancreas drains its digestive juices into the same system. Disease in one often affects the others, so treating them requires a detailed understanding of the whole region.

HPB operations range from removing part of the liver or pancreas that contains a tumour, to clearing stones or relieving a blockage of the bile ducts. Because these organs have a rich blood supply and lie close to major vessels, the surgery is intricate and is carried out with meticulous care and, where appropriate, a minimally invasive approach.

Conditions it treats

• Liver tumours (both primary liver cancer and cancer that has spread to the liver)
• Benign liver cysts and lesions that cause problems
• Pancreatic tumours and cysts
• Complications of severe or chronic pancreatitis
• Bile-duct stones, strictures and tumours
• Gallbladder cancer and complex gallstone disease

Key benefits

• Removes tumours and diseased tissue, offering a chance of cure or long-term control
• Relieves blockage of the bile ducts and associated jaundice
• Treats complications of pancreatitis that do not settle with other measures
• Minimally invasive options for selected cases mean less pain and quicker recovery
• Allows precise diagnosis and staging from the removed tissue
• Delivered as part of a coordinated, multidisciplinary cancer and GI service

How the procedure is performed

HPB operations are carried out under general anaesthesia and vary widely depending on the organ and disease. A liver resection removes the segment of liver containing a tumour, taking advantage of the liver's remarkable ability to regenerate. Pancreatic operations range from removing the tail of the pancreas to a major procedure such as the Whipple operation, which removes the head of the pancreas along with nearby structures and reconstructs the digestive connections.

Bile-duct problems may be treated by removing a blockage, clearing stones, or creating a new drainage pathway. Some procedures are suitable for a laparoscopic (keyhole) approach, while more complex cases are performed by open surgery. The choice is made carefully after detailed imaging and assessment.

Preparing for surgery

Thorough preparation is essential for HPB surgery. You will have detailed blood tests and imaging such as CT, MRI/MRCP and sometimes endoscopic studies to map the disease precisely. Your general fitness, liver and nutritional status are assessed, and any jaundice may need to be relieved beforehand. The team will explain the plan, discuss the risks and benefits, and optimise conditions such as diabetes and blood thinning before the operation.

Recovery & aftercare

Because these are major operations, recovery is more involved than for routine surgery. Many patients spend the first day or two in a high-dependency setting for close monitoring, followed by several days on the ward as eating and mobility are gradually restored. Full recovery usually takes several weeks. The team provides close follow-up, nutritional support, and coordinates any further treatment such as chemotherapy when needed.

Risks & considerations

• Bleeding, which can be significant given the rich blood supply
• Bile leak from the liver or bile ducts
• Pancreatic leak or fistula after pancreatic surgery
• Infection or collections of fluid needing drainage
• Temporary liver dysfunction or new diabetes after pancreatic surgery
• Blood clots and other general risks of major abdominal surgery