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HBP Surgery

Overview

What Is Hepato-Pancreato-Biliary Surgery?

Hepato-Pancreato-Biliary (HPB) Surgery focuses specifically on surgical problems involving three vital digestive system components. First one being the liver (hepato-), the pancreas (pancreato-), and the network of bile ducts and gallbladder (biliary). More specific than abdominal surgery, HPB surgery is a distinct, highly focused discipline dealing with organs that present unique surgical challenges due to their delicate anatomy, critical functions, and complex blood supply.

A hepatopancreatobiliary surgeon is a specialist who has completed years of additional training beyond general surgery, where they’re specifically taught how to handle intricate procedures in these areas. Managing common issues like troublesome gallstones to performing life-saving operations for pancreatic cancer or liver tumours is part of their daily work as is putting together comprehensive treatment plans for each patient.

Types of HPB Condition

Categorised by the organ system they involve, conditions within the HPB spectrum are diverse. Liver-related conditions can include both malignant tumours, such as hepatocellular carcinoma (primary liver cancer), and metastases from other cancers. Benign issues like symptomatic haemangiomas or complex cysts are also covered.

Pancreatic disorders, on the other hand, range from inflammatory diseases like chronic pancreatitis to various tumours. This includes adenocarcinoma and cystic neoplasms. The biliary system comes with its own set of challenges, presenting as symptomatic gallstones or cancer in the gallbladder. In the bile ducts, obstructions, strictures, and cholangiocarcinoma are how issues manifest. Each category presents unique diagnostic and therapeutic challenges. They all require a tailored approach considering their specific pathology, its stage and the patient's overall health.

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Some signals are clearer than others. Persistent pain in the upper abdomen or back, especially if it's deep and nagging, shouldn't be ignored. The appearance of jaundice, which is the yellowing of the skin and eyes, is a direct sign that the liver or bile ducts aren't functioning properly. Unexpected, significant weight loss without trying to lose weight is another serious indicator.

Often, the path to a hepatopancreatobiliary surgeon begins with an observation on a scan. A tumour, a cyst or a complex mass in the liver, pancreas or bile ducts is usually discovered by a GP or another doctor on an ultrasound, CT, or MRI, who will then arrange a specialist referral. If patients find themselves dealing with repeated episodes of pancreatitis or facing complications from long-standing pancreatic disease, the next logical step would be to seek specialist evaluation. The more treatment options that are likely to be available the earlier these conditions are evaluated by a specialist.

Getting an accurate diagnosis is a detailed process. It always starts with a thorough conversation. Our specialists need to understand a patient’s complete history, their symptoms and how they're affecting everyday life. From there, we move to advanced imaging. Modern HPB surgery relies heavily on high-resolution CT scans and MRI scans with special protocols, like MRCP. This provides us with a detailed map of a patient’s anatomy, showing us the exact size and position of any problem areas and their relationship to crucial blood vessels.

Blood tests give us additional clues, looking at liver function and specific markers that might suggest certain types of tumours. For a definitive answer, we often need a tissue sample. A procedure called endoscopic ultrasound (EUS), where a thin, flexible scope with an ultrasound probe gets us close to the pancreas or bile ducts to take a precise biopsy, helps us obtain these tissue samples. Scans, bloodwork and biopsy results are then reviewed not by one doctor, but by our entire multidisciplinary team to agree on the clearest diagnosis and the most coherent plan forward.

  • Malignant Liver Tumours
  • Benign Liver Disease
  • Pancreatic Cancer and Cysts
  • Pancreatitis
  • Biliary and Gallbladder Disorders

At NMC Hospital and Clinics across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain, hepatobiliary and pancreatic surgery moves beyond just operating and surgery. Crafting a personalised strategy that is individual to our patients is the approach we take. Wherever it's safe and clinically appropriate, we champion minimally invasive techniques. This means using laparoscopic (keyhole) or robotic-assisted surgery to perform procedures like liver resections or distal pancreatectomies. The benefits are real. Less post-operative pain, smaller scars, and a faster return home are guaranteed for many patients.

We maintain equal expertise in major open surgery for the most complex cases. This includes the Whipple procedure for pancreatic head tumours. Our commitment to a true multidisciplinary team model at NMC is non-negotiable. All cases will be discussed across functions, by surgeons, medical and radiation oncologists, radiologists, and pathologists together. Whether it involves surgery first, chemotherapy, or a combination, this collaborative approach ensures the treatment plan is built on consensus and the latest evidence.

At NMC Hospital and Clinic across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain, our team consists of consultant surgeons specifically trained and experienced in the field of hepatopancreatobiliary surgery. Supported by a dedicated network of hepatologists, interventional radiologists, specialist nurses and oncologists, all team members understand the complexities of the HPB patient journey.

Our consultants are recognised not only as experts in performing complex resections and reconstructions but also have a human-centred approach, with unparalleled bedside manners. They explain diagnostic findings, discuss all viable treatment options, covering both surgical and non-surgical options, to guide patients and their families through every step of the decision-making process. Those looking for a trusted hepatopancreatobiliary surgeon within the NMC network can expect to find both exceptional skill and supportive guidance.

FAQs

Find the Answer to Your Medical Questions

Frequently Asked Questions

An HPB surgeon is a general surgeon who has further training. They've completed a dedicated fellowship, spending years exclusively training in the complex, high-stakes surgery of the liver, pancreas and bile ducts. This gives them specific expertise for cancers and complex benign diseases in these organs that general surgeons typically do not handle.
Absolutely not. The field has transformed with many surgeries being minimally invasive. Gallbladders can be routinely removed laparoscopically. Keyhole and robotic techniques are being used increasingly to remove parts of the liver or pancreas. The approach, minimally invasive or traditional open, is carefully chosen based on your specific condition, the tumour's location and what is safest and most effective for you.
Recovery is a process. You can expect to be in the hospital for around a week to ten days, where you’re closely monitored as you start to drink and eat again. Your first few weeks at home require rest and focusing on good pain management and nutrition. Most people start feeling significantly better within 2-3 months. A full return to all your normal energy levels and activities often takes 6 months or more.
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