Hepatobiliary and Pancreatic Surgery

These complex surgeries are performed for conditions affecting the liver, bile ducts, gallbladder, and pancreas, including liver tumors (both benign and malignant), pancreatic cancer, bile duct cancers (cholangiocarcinoma), gallbladder cancer, chronic pancreatitis, bile duct strictures, complex gallstone disease, and traumatic injuries. Our experienced surgical team uses advanced techniques including minimally invasive approaches when appropriate to achieve the best possible outcomes for these challenging procedures.

Recovery from major hepatobiliary and pancreatic surgery varies depending on the specific procedure but typically involves a hospital stay of 7-21 days. Initial recovery focuses on pain management, monitoring for complications like bile leaks or bleeding, and gradually resuming normal activities. Full recovery may take 2-4 months depending on the extent of surgery. Our team provides comprehensive post-operative care including nutritional support, physical therapy, and regular follow-up appointments to ensure optimal healing and function.

The Whipple procedure (pancreaticoduodenectomy) is one of the most complex abdominal surgeries, removing the head of the pancreas, part of the small intestine (duodenum), gallbladder, common bile duct, and sometimes part of the stomach. It's most commonly performed for pancreatic cancer in the head of the pancreas, but also for bile duct cancer, ampullary cancer, and severe chronic pancreatitis. The remaining organs are reconnected to restore digestive function. It offers the best chance for cure in appropriate candidates.

These are among the most complex surgical procedures with potential complications including bleeding requiring transfusion, bile leaks, pancreatic leaks (after pancreatic surgery), delayed gastric emptying, infection, blood clots, and rarely, liver or pancreatic failure. Serious complications occur in 20-30% of cases but are usually manageable with experienced care. Mortality risk is low (1-3%) at high-volume centers. Long-term effects may include diabetes, need for enzyme supplements, and digestive changes requiring dietary modifications.

Preparation involves comprehensive medical evaluation including detailed blood work, cardiac and pulmonary assessment, nutritional evaluation, and imaging studies. Pre-operative optimization may include treating diabetes, improving nutritional status, stopping smoking at least 4 weeks before surgery, managing other medical conditions, and sometimes 'prehabilitation' programs involving exercise and nutrition. Detailed discussions with the surgical team, anesthesia providers, and other specialists ensure you're fully prepared and understand realistic expectations.

Liver resection involves surgically removing part of the liver affected by tumors, cysts, or other conditions. The liver's unique ability to regenerate allows removal of up to 70-80% while maintaining adequate function. It's performed for primary liver cancer (hepatocellular carcinoma), metastatic cancer (especially from colorectal sources), benign tumors like hemangiomas, and traumatic injuries. Success depends on adequate remaining liver function, tumor characteristics, patient health, and absence of cirrhosis. Modern techniques allow precise removal while preserving maximum healthy liver tissue.

Bile duct surgery treats conditions affecting the tubes that carry bile from the liver to the intestine. Procedures include bile duct reconstruction for strictures or injuries, tumor removal for cholangiocarcinoma (bile duct cancer), complex stone removal requiring surgical access, and repair of bile duct injuries from previous surgery. Surgery may involve removing affected sections and reconnecting healthy ducts, or creating new connections (hepaticojejunostomy) to restore bile flow. These procedures require specialized expertise and are typically performed at experienced hepatobiliary centers.

Success rates vary significantly by procedure and underlying condition. For liver resection, 5-year survival rates exceed 70% for early-stage liver cancer and 40-60% for appropriately selected colorectal metastases. Pancreatic surgery for cancer has 5-year survival rates of 20-25% for resectable disease. For benign conditions, outcomes are generally excellent with low mortality and good long-term function. Success depends on disease stage, patient health, surgeon experience, hospital volume, and post-operative care quality.

Follow-up care includes regular monitoring for complications, cancer recurrence (if applicable), liver function assessment, and nutritional status evaluation. This involves periodic blood tests (liver enzymes, tumor markers if cancer), imaging studies (CT, MRI), and clinical evaluations. Nutritional support may be needed, including enzyme supplements for pancreatic surgery patients and vitamin monitoring. Diabetes management is important for those who develop it post-surgery. Long-term surveillance helps detect issues early and ensures optimal quality of life.

Good candidates have adequate liver and cardiac function, good nutritional status, ability to tolerate major surgery, and disease that's technically resectable without excessive risk. Age alone isn't a contraindication if overall health is good. For cancer patients, disease should be localized without distant spread, and patient should have realistic expectations about outcomes. Borderline cases may benefit from neoadjuvant therapy to improve surgical candidacy. Multidisciplinary evaluation helps determine the best individualized approach and timing for each patient.