Hepato Pancreato Biliary

Understanding

What is Hepato Pancreato Biliary?

The liver and biliary tract were thought to be mystical organs with a complex anatomy, a vast array of functions, and remarkable regeneration potential for centuries. The treatment of hepatobiliary disease has undergone an enormous transformation in the last few decades. These advancements have largely been attributed to improved understanding of anatomy and physiology as well as a variety of newly developed diagnostic and therapeutic techniques. Surgery has played a key role in these developments. Such advances have led to the emergence of the specialty of hepato-pancreato-biliary surgery.

Hepato-pancreato-biliary (HPB) surgery encompasses general surgical management of diseases (both benign and malignant) of the liver, pancreas, gallbladder, and bile ducts. These are some of the most complicated and challenging surgeries, requiring a high level of competence and skill with a multi-disciplinary approach.

The understanding regarding entirely novel diagnostic and therapeutic approaches for the treatment of hepatic-pancreatic-biliary (HPB) disease is expanding at a fast pace. With the use of the latest techniques, hepatic-pancreatic-biliary (HPB) disorders can be diagnosed more accurately and treated with resection, ablation, or other appropriate measures more prudently.

Purpose

Following are the diseases that can be treated with Hepato-Pancreato-Biliary (HPB) Surgery:

Diseases associated with liver:

  • Primary and metastatic liver cancer or tumors
  • Liver cysts
  • Liver abscess

 

Diseases associated with gallbladder:

  • Gallbladder cancer
  • Choledochal cysts
  • Gallbladder polyps

 

Diseases associated with bile duct:

  • Bile duct stones
  • Biliary tract cancer (Cholangiocarcinoma)
  • Choledochal cysts

 

Diseases associated with Pancreas:

  • Pancreatic cyst & cystic tumors
  • Acute or chronic pancreatitis
  • Pancreatic tumors

Pre-evaluation

  • The pre-evaluation procedure for Hepato-Pancreato-Biliary (HPB) surgery may involve thorough evaluation of symptoms, medical history recording, and physical examination. Findings from these examinations, may call for the following investigations for reaching to a final diagnosis and chart-out the right treatment plan:

    • Blood tests for alpha-fetoprotein (AFP)
    • Computed tomography (CT) scan for liver tumor size and location
    • Magnetic resonance imaging (MRI) for better image of tumor
    • Angiogram for the examination of your liver’s blood vessels
    • Biopsy to confirm a liver cancer diagnosis
    • Endoscopic retrograde cholangiopancreatography (ERCP) to examine your bile ducts
    • Percutaneous transhepatic cholangiography (PTC) for people who can’t have an ERCP

Types Of

(HPB) Surgery

Open procedures

Like complicated gallbladder resections or major hepatic resections, are more complex surgeries. It involves wider incisions and complex therapeutic interventions.

Laparoscopic surgery

Another minimally invasive procedure is laparoscopic surgery. This kind of surgery executes a variety of surgical procedures using small cuts and specialized instruments equipped with cameras. This method, which offers advantages like less postoperative pain and faster recovery, is widely utilized in HPB surgeries.

Robotic surgery

Is an advanced medical technique that employs robotic systems to precisely and specifically execute surgical procedures. This technique is widely utilized in HPB procedures and has benefits like improved dexterity and less invasive incisions.

Procedure of Hepato-Pancreato-Biliary (HPB) Surgery

Following are the Hepato-Pancreato-Biliary (HPB) surgical approaches:

For Liver

  • Liver Resection: For benign liver growths and liver cancer, open, laparoscopic, and robotic surgical approach can be followed depending upon the conditions. Major resections are carried out by HPB surgeons for complicated metastatic tumors.
  • Radiofrequency Ablation (RFA): RFA uses heat to destroy cancerous tissue, and it is a treatment option for small liver tumors.

For pancreas

  • Pancreatic Resection: HPB Surgeons can perform a total pancreatectomy, which involves removing the entire pancreas, gallbladder, spleen, and part of the stomach and small intestine, or a distal pancreatectomy, which involves removing the pancreatic tail and possibly some of the pancreatic body or spleen.
  • Vascular Resections: When pancreatic cancer invades large veins or arteries, surgeons may cut out or rebuild blood vessels. This extremely sophisticated method is not commonly performed.
  • Pancreatic Necrosectomy: For acute pancreatitis, surgeons may choose to remove pancreatic necrosis, or dead pancreatic tissue.
  • Whipple Procedure: This approach involves the removal of the pancreatic head, the first segment of the small intestine, a portion of the bile duct, and the gallbladder by skilled HPB surgeons. To maintain digestive function, surgeons join the small intestine to the pancreas and remaining bile duct.

For Bile Duct and Gallbladder

  • Bile Duct Repair: Surgery can be performed to treat bile duct injuries, leakages, and blockages, which may happen due to other surgeries.
  • Laparoscopic Cholecystectomy: It is minimally invasive gallbladder removal surgery for gallstones, pancreatitis, cancer, or cholecystitis.

Frequently Asked Questions

Get answers to your questions

Q1: How long does it take to recover from hepato-pancreato-biliary surgery?

A: Because nerves were cut during the procedure, the skin surrounding the incision may remain numb and may improve with time. To fully recover, it might take you four to eight weeks.

Q2: What are the complications associated with HPB surgery?

A: Postoperative complications from hepatobiliary surgery include urinary tract infection, subphrenic infection, venous catheter-related infection, incisional infection, pulmonary atelectasis or infection, intraperitoneal hemorrhage, and gastrointestinal tract bleeding. These complications are also common to general abdominal surgery.

Q3: What is hepatobiliary surgery speciality?

A: Surgical subspecialty hepato-pancreato-biliary (HPB) surgery, also called hepatobiliary surgery, focuses on treating diseases of the liver, pancreas, bile duct, and gallbladder, including cancer.

Q4: What is major HPB surgery?

A: Major hepatic resection and pancreatic surgery are two procedures that are included in hepato-pancreatico-biliary (HPB) surgery; both are intricate and carry a high risk of complications.

Q5: What is the duration of liver surgery?

A: Three to seven small incisions are made to remove the liver mass after the patient is put to sleep with general anesthesia. The process can take one to seven hours, depending on the lesions as well as the volume of liver that needs to be removed.