Description

Hepato-Pancreato-Biliary (HPB) surgery is a specialized field of surgery focusing on the treatment of diseases and conditions affecting the liver, pancreas, and biliary system (gallbladder and bile ducts). HPB surgeons perform complex procedures to address a variety of benign and malignant conditions. Common Conditions Treated by HPB Surgery Liver Diseases: Liver tumors (benign and malignant, including hepatocellular carcinoma) Liver cysts and abscesses Cirrhosis and its complications Bile duct injuries and strictures Pancreatic Diseases: Pancreatic cancer Chronic pancreatitis Pancreatic cysts and pseudocysts Neuroendocrine tumors of the pancreas Biliary System Diseases: Gallstones and cholecystitis (inflammation of the gallbladder) Cholangiocarcinoma (bile duct cancer) Bile duct strictures and injuries Choledochal cysts Types of HPB Surgeries Liver Surgery: Hepatectomy: Surgical removal of a portion of the liver. It can be a partial hepatectomy (removing part of the liver) or a total hepatectomy (removing the entire liver, often followed by liver transplantation). Liver Transplantation: Replacing a diseased liver with a healthy one from a donor. Radiofrequency Ablation (RFA) and Microwave Ablation (MWA): Minimally invasive procedures to destroy liver tumors using heat. Pancreatic Surgery: Pancreaticoduodenectomy (Whipple Procedure): Removal of the head of the pancreas, part of the small intestine, gallbladder, and bile duct, typically performed for pancreatic cancer. Distal Pancreatectomy: Removal of the body and tail of the pancreas, often including the spleen. Total Pancreatectomy: Removal of the entire pancreas, along with parts of the stomach, small intestine, bile duct, and gallbladder. Biliary Surgery: Cholecystectomy: Removal of the gallbladder, usually performed laparoscopically. Bile Duct Resection: Removal of part of the bile duct, often followed by reconstruction. Choledochal Cyst Excision: Removal of cysts from the bile ducts. Preoperative Evaluation and Preparation Medical Evaluation: Comprehensive assessment of the patient’s overall health, including blood tests, imaging studies (CT, MRI, ultrasound), and sometimes endoscopic procedures. Nutritional Assessment: Ensuring the patient is nutritionally optimized for surgery. Patient Education: Informing the patient about the procedure, risks, benefits, and postoperative care. Postoperative Care Intensive Monitoring: Close monitoring in the ICU or a specialized postoperative care unit. Pain Management: Using medications and techniques to manage postoperative pain. Early Mobilization: Encouraging movement as soon as possible to prevent complications like blood clots and pneumonia. Nutritional Support: Ensuring adequate nutrition through diet or supplements. Follow-Up Care: Regular check-ups to monitor recovery, manage complications, and ensure the effectiveness of the surgery. Potential Complications Infection: At the surgical site or internally. Bleeding: During or after surgery. Bile Leak: Leakage of bile from the bile ducts or liver. Pancreatic Fistula: Leakage of pancreatic fluids. Organ Dysfunction: Including liver or pancreatic insufficiency. Recurrence of Disease: Particularly in the case of cancer. Advances in HPB Surgery Minimally Invasive Techniques: Including laparoscopic and robotic surgeries, which reduce recovery time and complications. Enhanced Recovery Protocols: To improve postoperative outcomes and reduce hospital stay. Targeted Therapies: For cancers, including chemoembolization and radioembolization for liver tumors. HPB surgery is a highly specialized field requiring expertise and experience. Outcomes are generally better when performed by specialized HPB surgeons in high-volume centers. If you have more specific questions or need detailed information about a particular aspect of HPB surgery, feel free to ask!

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