HPB SurgeryComplex surgery for the liver, bile ducts and pancreas.
Hepato-pancreato-biliary (HPB) surgery treats conditions of the liver, gallbladder, bile ducts and pancreas – organs that sit close together and work as a system. These operations need specialised planning, and a team used to doing them.
What HPB surgery covers
The liver, bile ducts, gallbladder and pancreas share blood vessels and drainage channels. A problem in one often affects the others – which is why they are treated by one specialised team.
HPB surgery ranges from removing part of the liver for a tumour, to rebuilding a damaged bile duct so bile can drain again.
Conditions that may need HPB surgery
Some patients come after a scan finds a lump in the liver. Others arrive with jaundice, or with a bile duct injury after earlier gallbladder surgery.
Every case is reviewed with imaging specialists, oncologists and gastroenterologists, so the operation is part of a complete plan.
In HPB surgery, planning is half the operation.— How complex cases are approached
Planned in detail, done with precision
Before surgery, detailed scans map the tumour, the blood vessels and how much healthy liver will remain. For larger resections, techniques can be used to grow the remaining liver first.
Where suitable, operations are done laparoscopically or robotically through small incisions.
Getting back to normal
Most people are up and walking the day after surgery. Diet is restarted early, and follow-up scans confirm recovery.
For cancer surgery, the team will explain the results of the tissue analysis and any further treatment needed.
Conditions treated with HPB surgery
Every patient is assessed individually. These are the conditions most often treated.
Primary liver cancer (HCC) and benign tumours needing removal.
Selected patients whose bowel cancer has spread to the liver.
Radical cholecystectomy with lymph node removal.
Cholangiocarcinoma, including hilar tumours.
Reconstruction after injury or narrowing.
Removal and bile duct reconstruction.
From first visit to recovery
Timings vary with each patient. This is the usual order of steps.
Consultation
History, examination and review of existing scans.
Detailed imaging
CT, MRI or MRCP to map the problem and the anatomy.
Team review
Multidisciplinary discussion of the best treatment plan.
Surgery
Open, laparoscopic or robotic operation as appropriate.
Recovery & follow-up
Early walking, then regular review.
Dr. Vibha Varma
Consultant, Liver Transplant and Hepato-Biliary-Pancreatic Surgery, Lilavati Hospital & Research Centre, Mumbai – with 25 years of experience in liver transplantation and HPB surgery.
Quick answers
Can I live with part of my liver removed?
Yes. A healthy liver can regenerate, and people can live normally after a large part is removed, as long as enough healthy liver remains.
Is HPB surgery always open surgery?
No. Many operations can be done laparoscopically or robotically in suitable patients.
Will I need chemotherapy?
For some cancers, yes – before or after surgery. Your team will explain the plan for your situation.
How soon can I eat after surgery?
Usually within a day or two, starting with liquids and building up.