Hepato-pancreato-biliary surgery
Surgical specialty of the liver and pancreas
From Wikipedia, the free encyclopedia
Hepato-pancreato-biliary surgery (HPB surgery), also referred to as hepatobiliary surgery, is a surgical subspecialty of general surgery that is concerned with the surgical treatment of disorders affecting the liver, pancreas and biliary system.
- Doctor
- Surgeon
- Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)
- Doctor of Medicine (M.D.)
- Bachelor of Medicine, Bachelor of Surgery (MBChB)
- Doctor of Osteopathic medicine (D.O.)
- Master of Surgery (M.S.)
 Surgeons performing a laparoscopic hepatectomy (liver resection) | |
| Occupation | |
|---|---|
| Names |
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Occupation type | Specialty |
Activity sectors | Medicine, Surgery |
| Description | |
Education required |
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Fields of employment | Hospitals, Clinics |
Conditions
Conditions treated by HPB surgeons include, but are not limited to:
- Tumours of the pancreas (adenocarcinoma, pancreatic neuroendocrine tumours, Intraductal papillary mucinous neoplasm (IPMN), etc.)[1]
- Pancreatic cysts
- Acute and chronic pancreatitis
- Gallstones
- Tumours of the biliary tract (gallbladder cancer and cholangiocarcinoma)[2][3]
- Portal hypertension
- Cholangitis (inflammation of the bile ducts due to ascending bacterial infection of the biliary tree)[4]
- Tumours of the liver (colorectal liver metastasis, Hepatocellular adenoma, hemangioma, hepatocellular carcinoma)[5]
- Hepatobiliary and pancreatic trauma
Procedures
HPB procedures can be performed through open (traditional laparotomy), laparoscopic or robotic approaches. Regardless of the surgical modality, major HPB procedures carry a high perioperative morbidity and mortality risk.[citation needed] This is due largely to the technical complexity of these procedures and the complicated vasculo-biliary anatomy surgeons must navigate.[6][7] Common HPB interventions are categorised below according to their primary anatomical location:
Biliary tract
An endoscopy technique that may be performed by HPB surgeons is endoscopic retrograde cholangiopancreatography. During this procedure, fluoroscopy outlines the biliary tree, facilitating possible interventions such as sphincterotomy and stone extraction.[8]
Liver
HPB surgeons treat benign and malignant diseases of the liver using advanced surgical procedures. These include liver resections, transplants and ablation therapies — such as microwave ablation, radiofrequency ablation, cryoablation and histotripsy — to destroy tumours.[9]
Pancreas
Resectional surgery offers the only chance of cure in pancreatic and other periampullary cancers.[10] Pancreatic cancer has a 12% 5-year survival rate; however the American Society of Clinical Oncology estimates that only 20% of pancreatic cancer patients may be eligible for surgery.[11][12] The primary surgical treatment of pancreatic cancer within the head of the pancreas is a pancreatoduodenectomy, also known as the Whipple procedure.[13]
Notable hepato-pancreato-biliary surgeons
- Leslie H. Blumgart – one of the most influential figures in the field who sought to make hepato-pancreato-biliary surgery a recognised specialty and developed the Blumgart pancreaticojejunostomy technique.[14]
- Allen Whipple – namesake of the pancreaticoduodenectomy, described the primary features of insulinomas (Whipple's triad), and revived portocaval anastomosis as a treatment for portal hypertension.[15]
