dr prashant kadam
Cancer involving the liver or pancreas often requires specialised diagnosis and treatment because these organs sit close to major blood vessels, bile ducts and the digestive system. An HPB Surgeon plays an important role in evaluating whether surgery can safely remove cancer and how surgery should fit into the patient’s overall treatment plan.
An HPB Surgeon specialises in diseases of the liver, pancreas, gallbladder and bile ducts. The specialist works with oncologists, hepatologists, gastroenterologists, radiologists, pathologists and transplant teams to develop an appropriate treatment strategy. This multidisciplinary approach is particularly valuable when cancer involves complex anatomy or requires more than one type of treatment.
Evaluating Liver and Pancreatic Cancer
The treatment journey usually starts with a detailed assessment. An HPB team reviews symptoms, medical history, blood tests and imaging studies such as ultrasound, CT or MRI scans. These investigations help establish the tumour’s location, size, relationship with blood vessels and possible spread to other organs.
For liver cancer, the assessment also considers the condition of the remaining liver. Cirrhosis, portal hypertension and reduced liver function can significantly influence whether surgical removal is appropriate. According to clinical guidance from the American Association for the Study of Liver Diseases, treatment selection for hepatocellular carcinoma depends on tumour characteristics, liver function and the patient’s overall condition.
For pancreatic cancer, staging helps determine whether the tumour is resectable, borderline resectable, locally advanced or metastatic. This classification can influence whether surgery should occur first or after systemic treatment.
Role of an HPB Surgeon in Liver Cancer Surgery
Liver cancer surgery can provide a potentially curative option for selected patients when the tumour can be completely removed while preserving enough functioning liver tissue.
The hepatopancreatobiliary surgeon evaluates the tumour’s location and its relationship with blood vessels and bile ducts. Depending on these findings, surgery may involve removing a portion of the liver, known as a liver resection.
However, not every liver cancer patient is suitable for resection. Some patients may benefit from liver transplantation, particularly when specific tumour and liver disease criteria are met. Other patients may require liver-directed therapies or systemic treatment.
The decision should therefore come from a specialist assessment rather than from tumour size alone. Liver function, underlying liver disease and the possibility of achieving complete cancer control all matter.
Role in Pancreatic Cancer Treatment
Pancreatic cancer can be challenging to treat because the pancreas lies near major blood vessels and the bile duct. An Hepato Pancreato Biliary Surgeon assesses whether surgical removal is technically possible and whether it is likely to provide meaningful cancer control.
Pancreatic Surgery for Resectable Tumours
Pancreatic Surgery varies according to the tumour’s location. A tumour in the head of the pancreas may require a pancreaticoduodenectomy, commonly called the Whipple procedure. This operation removes the pancreatic head along with nearby structures and reconstructs the digestive pathway.
Tumours affecting the pancreatic body or tail may require a distal pancreatectomy. In selected situations, more extensive surgery may be considered.
The National Cancer Institute recognises surgery, chemotherapy, radiation therapy and other treatments as potential components of pancreatic cancer care depending on disease stage and individual circumstances.
When Chemotherapy Comes Before Surgery
An HPB surgeon does not always recommend immediate surgery. Some pancreatic cancers may benefit from chemotherapy before an operation. This approach can help treat microscopic disease early and may allow specialists to reassess the tumour before undertaking major surgery.
For borderline resectable or locally advanced disease, treatment planning often involves close collaboration between the hpb doctor, medical oncologist and radiologist. Repeat imaging can help determine whether surgery has become appropriate.
Managing Complex Biliary and Liver Conditions
Liver and pancreatic cancers can affect bile ducts and cause jaundice. In such situations, an HPB specialist may coordinate procedures to relieve bile duct obstruction while cancer treatment continues.
Complex cases can also involve blood vessel reconstruction, combined liver and bile duct surgery or other technically demanding procedures. The exact approach depends on tumour anatomy and the patient’s overall health.
Importance of Multidisciplinary Cancer Care
Cancer treatment rarely depends on surgery alone. The HPB team may work with medical and radiation oncologists, interventional radiologists, gastroenterologists and transplant specialists.
A multidisciplinary review can help determine whether surgery should take place immediately, after chemotherapy, alongside another treatment, or not at all. This approach reduces the risk of choosing an operation without considering potentially more appropriate alternatives.
Choosing the Right HPB Specialist
Patients diagnosed with liver or pancreatic cancer may benefit from consultation with an experienced specialist who regularly manages complex HPB conditions. Important considerations include surgical training, experience with complex liver and pancreatic procedures, access to multidisciplinary care and the availability of appropriate postoperative support.
Dr Prashant Kadam is a liver transplant and HPB surgeon in India with a clinical focus on complex liver and hepatopancreatobiliary conditions. Any treatment recommendation should be based on the patient’s diagnosis, imaging, liver function, cancer stage and overall health.
The role of an HPB Surgeon extends beyond performing an operation. From diagnosis and staging to surgical planning and postoperative care, the specialist helps determine whether surgery is appropriate and how it should integrate with other cancer treatments. For patients with liver or pancreatic cancer, timely specialist evaluation can help establish a clear, evidence-based treatment pathway.