Hepato-pancreato-biliary surgery

Hepato-pancreato-biliary surgeon
Surgeons performing a laparoscopic hepatectomy (liver resection)
Occupation
Names
  • Doctor
  • Surgeon
Occupation type
Specialty
Activity sectors
Medicine, Surgery
Description
Education required
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

Conditions treated by HPB surgeons include, but are not limited to:

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. 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]

See also

References

  1. ↑ "Types of Pancreatic Tumors". Memorial Sloan Kettering Cancer Center. 2026. Retrieved 2026-07-04.
  2. ↑ 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.
  3. ↑ "Types of Gallbladder Cancer". Memorial Sloan Kettering Cancer Center. Retrieved 4 July 2026.
  4. ↑ Virgile, Jennifer; Marathi, Rachana (3 July 2023). Cholangitis. Treasure Island, Florida, United States: StatPearls Publishing. Retrieved 4 July 2026.
  5. ↑ "Liver Tumors". Johns Hopkins Medicine. Retrieved 4 July 2026.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ Garden, O. James (2002). Hepatobiliary and pancreatic surgery (2., reprint ed.). London: W.B. Saunders. p. 248. ISBN 0-7020-2592-5.
  9. ↑ 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.
  10. ↑ Garden, O. James (2002). Hepatobiliary and pancreatic surgery (2., reprint ed.). London: W.B. Saunders. p. 403. ISBN 0-7020-2592-5.
  11. ↑ 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.
  12. ↑ "Pancreatic Cancer Surgery". Johns Hopkins Medicine. Retrieved 4 July 2026.
  13. ↑ 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.
  14. ↑ 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.
  15. ↑ 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.
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