What Is Hepatobiliary Surgery?
Hepatobiliary surgery, also called hepatopancreatobiliary surgery, is an advanced subspecialty of General Surgery concerned with the surgical treatment of diseases of the liver, gallbladder, bile ducts, and pancreas.
General Surgery encompasses a very broad range of diseases, and knowledge about each organ and body system is expanding rapidly. As the variety and complexity of surgical procedures increase, General Surgery has developed a number of subspecialties. These now include Surgical Oncology, Colorectal Surgery, Hepatobiliary Surgery, Breast and Endocrine Surgery, Vascular Surgery, and Organ Transplant Surgery.
Surgeons wishing to specialize in these fields develop their knowledge and skills by working in experienced centers after completing their General Surgery training. In Türkiye, clinics at university hospitals and teaching and research hospitals in particular have established specialist branches such as hepatobiliary surgery.
Conditions Treated by Hepatobiliary Surgery
Although gallbladder conditions are among the most common reasons for hepatobiliary operations, cancer cases constitute some of the most important treatment areas:
- Pancreatic cancer
- Cancer of the ampulla of Vater
- Gallbladder and bile duct cancer (cholangiocarcinoma)
- Liver cancer (hepatocellular carcinoma)
- Liver sarcomas
The liver is the most common site of metastases from tumors originating in the digestive system, especially colorectal cancer. Hepatobiliary surgery is therefore a major field of oncological surgery.
Common Non-Tumor Conditions
- Gallstones
- Bile duct stones
- Obstructive jaundice
- Bile leakage and duodenal perforation following surgery or ERCP
- Hydatid cysts of the liver and associated bile duct complications
- Pancreatic pseudocysts and benign or premalignant lesions
Why Hepatobiliary Surgery Matters
Cancers involving these organs often progress quickly and may have a fatal course. Hepatobiliary surgery therefore requires a multidisciplinary approach. Treatment is coordinated by teams including specialists in General Surgery, Gastroenterology, Radiology, Medical Oncology, and Pathology.
All or part of the affected organ may be surgically removed. Procedures may use the following techniques:
- Laparoscopic surgery (minimally invasive approach)
- Robotic surgery
- Open surgical techniques
Minimally invasive approaches may also be preferred in selected cases.
Non-Surgical Treatment Methods
In addition to surgery, supportive or alternative methods may be used to treat cancers of the hepatobiliary system:
- Systemic chemotherapy
- Radiotherapy
- Transarterial chemoembolization (TACE)
- Transarterial radioembolization (TARE)
- Radiofrequency ablation (RFA)
- Percutaneous ethanol injection
By combining surgery and interventional oncology, the team can develop the most appropriate treatment plan for each patient. This approach has made hepatobiliary surgery one of the most advanced and multidisciplinary fields of modern medicine.