Hepato-pancreato-biliary surgery
 | This article needs more citations. (July 2026) |
 Laparoscopic hepatectomy (liver resection) at Toronto General Hospital | |
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Occupation type | Specialty |
Activity sectors | Medicine, Surgery |
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Fields of employment | Hospitals, Clinics |
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.
Conditions
[edit]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
[edit]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
[edit]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
[edit]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
[edit]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
[edit]- 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]
See also
[edit]
References
[edit]- ↑ "Types of Pancreatic Tumors". Memorial Sloan Kettering Cancer Center. 2026. Retrieved 2026-07-04.
- ↑ Gore, Richard; Shelhamer, Ryan (1 October 2007). "Biliary tract neoplasms: diagnosis and staging". Cancer Imaging. 7 (Special Issue A): S15–S23. doi:10.1102/1470-7330.2007.9016. PMC 2727973. PMID 17921093.
- ↑ "Types of Gallbladder Cancer". Memorial Sloan Kettering Cancer Center. Retrieved 4 July 2026.
- ↑ Virgile, Jennifer; Marathi, Rachana (3 July 2023). Cholangitis. Treasure Island, Florida, United States: StatPearls Publishing. Retrieved 4 July 2026.
- ↑ "Liver Tumors". Johns Hopkins Medicine. Retrieved 4 July 2026.
- ↑ Rennie, Olivia; Sharma, Manaswi; Helwa, Nour (October 2024). "Hepatobiliary anastomotic leakage: a narrative review of definitions, grading systems, and consequences of leaks". Translational Gastroenterology and Hepatology. 9: 70. doi:10.21037/tgh-24-9. PMC 11535784. PMID 39503018.
- ↑ Panagakis, Andreas; Katsaros, Ioannis; Sotiropoulou, Maria; Mylonakis, Adam; Despotidis, Markos; Sourgiadakis, Aristeidis; Sakarellos, Panagiotis; Kapiris, Stylianos; Vergadis, Chrysovalantis; Schizas, Dimitrios; Felekouras, Evangelos; Vailas, Michail (8 December 2025). "Artificial Intelligence and 3D Reconstruction in Complex Hepato-Pancreato-Biliary (HPB) Surgery: A Comprehensive Review of the Literature". Journal of Personalized Medicine. 15 (12): 610. doi:10.3390/jpm15120610. PMC 12734307. PMID 41440973.
- ↑ Garden, O. James (2002). Hepatobiliary and pancreatic surgery (2., reprint ed.). London: W.B. Saunders. p. 248. ISBN 0-7020-2592-5.
- ↑ Abu Zahra, Saad; Nadeem, Arsalan; Kundu, Ashima; Gibson, Nick; Haggaz, Ali; Sato, Kent T.; Lewandowski, Robert J.; Gordon, Andrew C. (7 October 2025). "Recent Advances in Ablative Therapies for Hepatocellular Carcinoma". Cancers. 17 (19): 3251. doi:10.3390/cancers17193251. PMC 12523968. PMID 41097777.
- ↑ Garden, O. James (2002). Hepatobiliary and pancreatic surgery (2., reprint ed.). London: W.B. Saunders. p. 403. ISBN 0-7020-2592-5.
- ↑ Rosenzweig, Allison; Berlin, Jordan; Chari, Suresh; Kindler, Hedy; Matrisian, Lynn; Mayoral, Allison; Mills, Jeannine; Nissen, Nicholas; Picozzi, Vincent; Zelada-Arenas, Fatima; Fleming, Jason (5 July 2023). "Management of Patients With Pancreatic Cancer Using the "Right Track" Model". The Oncologist. 28 (7): 584–595. doi:10.1093/oncolo/oyad080. PMC 10322133. PMID 37043728. Retrieved 4 July 2026.
- ↑ "Pancreatic Cancer Surgery". Johns Hopkins Medicine. Retrieved 4 July 2026.
- ↑ D'Cruz, Jason R.; Misra, Subhasis; Menon, Gopal; Shamsudeen, Shafeek (2026). Pancreaticoduodenectomy (Whipple Procedure). Treasure Island, Florida, United States: StatPearls Publishing. Retrieved 4 July 2026.
- ↑ Agrawal, Himanshu; Gupta, Nikhil (March 2023). "Dr. Leslie H. Blumgart – A 'Living Legend' and 'The Professor'". International Journal of Surgery. 109 (3): 502–503. doi:10.1097/JS9.0000000000000105. PMC 10389176. PMID 37093078.
- ↑ Hall, Ashton D.; Kumar, Julia E.; Mazur, Jan P.; Bondoc, Alexander J.; Giffin, Bruce F.; Bryant, Whitney K. (February 2025). "Dr. Allen Oldfather Whipple (1881–1963): Namesake of the pancreaticoduodenectomy". Journal of Medical Biography. 33 (1): 66–76. doi:10.1177/09677720231197430. PMID 37941365.
