What Is HPB Surgery and When Do You Need It
When Do You Need HPB Surgery?
The biliary system is a vital part of the digestive system responsible for storing and transporting bile, which is a digestive fluid produced by the liver. Bile is composed of bile salts, cholesterol, and waste products.
Bile’s primary function is emulsifying fat in the food we eat, enabling absorption of fatty acids and fat-soluble vitamins in the small intestine. Without bile, the body experiences complications from impaired fat absorption and malabsorption of important nutrients.
The liver, gallbladder, bile ducts, and pancreas constitute the organs in the biliary system, with each playing a vital role in maintaining digestive health.
As with any part of the body, organs and ducts in the biliary system can malfunction due to diseases and trauma. For instance, one of the most common disorders in the biliary system is gallstone disease (GSD).
Fortunately, most GSD cases won’t require intensive treatments or surgery. However, complicated biliary system conditions such as liver cancer, pancreatic cancer, and severe GSD may require hepato-pancreato-biliary (HPB) surgery.
What Is HPB Surgery?
Hepato-pancreato-biliary (HPB) surgery is a specialized field dedicated to treating diseases affecting the liver, pancreas, and biliary system. It encompasses a range of surgical procedures aimed at addressing conditions such as liver cancer, pancreatic disorders, gallstones, and bile duct obstructions.
HPB surgeons are highly skilled medical professionals who employ advanced surgical techniques to restore health and function to these vital organs.
When Do You Need HPB Surgery?
Whether or not a patient needs HPB surgery depends on a lot of factors, which a surgeon should discuss prior to recommending treatment. A primary consideration is the severity and type of condition.
Below are some disorders in the biliary system that would necessitate an HPB surgery:
Liver Conditions
Liver ailments can range from benign cysts to malignant tumors. These conditions may necessitate surgical intervention. In some cases, HPB liver surgery is recommended to remove tumors and prevent further spread.
According to the World Cancer Research Fund (WCRF) International, liver cancer is the world’s sixth most common cancer. In 2020, more than 900,000 new cases of liver cancer were recorded globally, with Mongolia having the highest overall rate of liver cancer for that year. Meanwhile, according to data from the Singapore Cancer Society, liver cancer is the fourth most common cancer in males. Thus, more men in Singapore may eventually need HPB liver surgery than women.
Aside from liver cancer, liver cysts or abscesses may also require HPB liver surgery for drainage or resectioning to alleviate symptoms and prevent complications. Lastly, traumatic injuries to the liver may also necessitate surgical repair to restore normal function. These kinds of injuries rarely occur in the liver, but have to be treated promptly to avoid complications.
Pancreatic Conditions
Various disorders can afflict the pancreas, a vital organ responsible for producing digestive enzymes and regulating blood sugar levels.
Pancreatic cancer, for one, is notorious for its aggressiveness, often warranting surgical removal of tumors to improve survival rates.
The disease is fortunately not as prevalent in Singapore, accounting for only 2 percent of the total cancer cases. Moreover, there have been vast improvements when it comes to early detection: from 16.5 percent in 2003-2007 to 30.7 percent in 2013-2017.
Another condition of the pancreas that may require HPB surgery is severe chronic pancreatitis. It is characterized by inflammation of the pancreas and can be caused by temporary symptoms that resolve on their own.
However, chronic and severe pancreatitis may require surgical intervention if complications such as pseudocysts or necrosis develop. Similarly, pancreatic cysts or chronic pancreatitis with complications may necessitate surgery to alleviate symptoms and prevent further damage.
Biliary System Conditions
Gallstones, a common biliary condition, affect an estimated 10 to 20 percent of the global population. While 80 percent of patients will experience no symptoms, approximately 500,000 will have to undergo cholecystectomy to treat their chronic cholecystitis. This is a condition where the gallbladder becomes inflamed.
Another complication of severe gallstones is bile duct obstruction. In some cases, the surgeon can use more non-invasive endoscopic retrograde cholangiopancreatography to remove the gallstone.
However, for recurring gallstones, the surgeon may recommend gallbladder removal surgery. Bile duct strictures, injuries, or infections may also require surgical intervention to restore normal bile flow and prevent complications such as jaundice or cholangitis.
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Hepato-pancreato-biliary surgery plays a crucial role in treating diseases of the liver, pancreas, and biliary system. It offers patients hope for improved outcomes and enhanced quality of life after a successful operation.
If you or a loved one are facing such conditions, don’t hesitate to consult with a qualified HPB surgeon who can provide personalized care and guidance tailored to your specific needs.
Remember, early intervention and expert surgical management can make all the difference in your journey towards health and well-being.
Have you looked into HPB liver surgery?
— Dr. Drayman
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I am a retired GP that is passionate about health, parenting, and helping others. I am a grandparent to 3 amazing little boys and mama to 2 incredible women.
