What is HPB surgery?

The Medical Discipline of Liver, Pancreas, and Bile Duct Surgery

HPB surgery is a specialized surgical field that covers the treatment of diseases occurring in the Hepatic (liver), Pancreatic (pancreas), and Biliary (bile ducts and gallbladder) systems.

Surgeons working in this field primarily take part in the diagnosis and treatment of complex cases such as liver tumors, pancreatic cancer, bile duct strictures, gallbladder stones, and cystic diseases.

HPB surgery is a field that requires high levels of experience and expertise, both due to the complexity of the surgical techniques and the vital importance of these organs.

ABD’de Society of Surgical Oncology (SSO) ve Europe’da European-African HPB Association (E-AHPBA) gibi kurumlar, HPB cerrahisini ayrı bir üst ihtisas alanı olarak kabul eder.

For this reason, this surgical branch requires advanced training and focused experience, distinguishing it from general surgery.

Which Conditions Does HPB Surgery Address?

HPB surgery deals with benign and malignant diseases that occur in the following three main organ groups:

 1. Liver Surgery

Hepatocellular carcinoma (liver cancer)

Liver metastases (the spread of other cancers to the liver)

Liver cysts (simple cysts, hydatid cysts, cystic adenomas)

Liver abscesses and hemangiomas

Segmental liver resections and lobectomies

2. Pancreas Surgery

Pancreatic cancer (adenocarcinoma)

Neuroendocrine tumors

Cystic lesions (IPMN, MCN)

Chronic Pancreatitis

Whipple procedure (pancreaticoduodenectomy)

Distal and total pancreatectomies

3. Gallbladder and Bile Duct Surgery

Gallstones and obstructions

Acute / chronic cholecystitis

Common bile duct stones and bile duct strictures

Bile duct tumors (cholangiocarcinoma)

Bile fistulas and bile leak repair

Cases requiring endoscopic or laparoscopic surgery

Due to the anatomical and functional connections between these organs, HPB surgery requires a multidisciplinary approach. The surgeon plans patient management in collaboration with gastroenterologists, oncologists, radiologists, and pathology specialists.

Who Can Perform HPB Surgery?

HPB surgery is a specialty that goes beyond general surgery.

For a surgeon to perform procedures in this field, they must have:

• Having completed a General Surgery residency,
• Having completed a General Surgery residency,
• Must have personally performed a sufficient number of complex HPB cases

In countries such as the United States, Germany, and the United Kingdom, HPB surgeons typically work in highly sub-specialized areas within liver, pancreas, and bile duct surgery.

This is highly important for ensuring that patients are directed to the correct treatment.

Why Should I Consult an HPB Surgeon?

Liver, pancreas, and bile duct diseases often present late symptoms, and by the time a diagnosis is made, the condition may already be advanced. Therefore:

• Timely diagnosis
• On-time diagnosis,
• Receiving treatment at a highly experienced surgical center,

hastanın yaşam süresini ve kalitesini doğrudan etkileyebilir.

Prof. Dr. Mert Erkan is a surgeon who completed advanced HPB training in Germany, has restored the health of hundreds of patients through surgery, and has contributed to international scientific literature with his publications in this field.