Understanding IPNB: Diagnosis and Management of Biliary Papillary Tumours
Intraductal Papillary Neoplasms of the Bile Duct (IPNB) are uncommon lesions that require a precise, methodical approach to both diagnosis and treatment. For patients, navigating this condition can be challenging due to its scarcity, while for clinicians, it represents an evolving area of biliary pathology. Recognized as a distinct entity in the World Health Organization […]
The Scholar-Surgeon: Does Your Surgeon Need to be an Academic?
When you or a loved one faces a complex diagnosis—particularly in the field of Hepato-Pancreato-Biliary (HPB) surgery—the first priority is usually finding someone with “good hands.” We want a technician who has performed the procedure hundreds of times. But increasingly, patients and colleagues are asking: Does it matter if my surgeon is also an academic? […]
Surgery Abroad: Is the Journey Worth the Risk? A New Zealand Perspective
When a patient is faced with a surgical diagnosis and a public healthcare system that is undeniably under pressure—leading to significant wait times—the idea of traveling overseas for “faster, cheaper” surgery can seem like a logical solution. However, the decision to seek major surgery outside of New Zealand is rarely a simple transaction. It is […]
Why Your Gallbladder Matters Even Without “Typical” Pain
As an HPB (Hepato-Pancreato-Biliary) surgeon, I often meet patients who are surprised when they are told that they need gallbladder surgery (laparoscopic cholecystectomy). They haven’t had the classic “gallbladder attack” or severe inflammation like cholecystitis. Yet, they have experienced a serious secondary complication like pancreatitis or stones found in the common bile duct (CBD). If you are in […]
Understanding HPB Surgery: Scope, Workload, and Training Path
Hepatopancreatobiliary (HPB) surgery is a subspecialty of general surgery that manages disorders of the liver, pancreas, gallbladder, and bile ducts. While often associated with cancer care, the field also encompasses benign conditions such as complex gallstone disease and chronic pancreatitis. The Role and Operative Workload An HPB surgeon’s workload is divided between complex operative procedures […]
Restoring Bile Flow – A Guide to Biliary Drainage Procedures
When the bile ducts—the tubes carrying bile from the liver to the small intestine—become blocked by stones, tumours, or scarring, a surgical “bypass” can be necessary. There are two common procedures used to restore this flow and allow your liver to drain adequately. Hepaticojejunostomy (The “Gold Standard”) This procedure involves connecting the hepatic duct (the main duct […]
Recovery at home after major pancreatic surgery
Recovery from major pancreatic surgery, such as a Whipple procedure, is a long-term process that continues for several months after you leave the hospital. While the first week at home is a significant milestone, you can expect your body to take 6 to 8 weeks to reach a baseline recovery, and up to 6 months for your digestive system […]
Navigating Your Gallbladder Surgery: The Vital Role of the Intraoperative Cholangiogram (IOC)
If you are scheduled for a laparoscopic cholecystectomy (the surgical removal of the gallbladder), you may see a procedure called an Intraoperative Cholangiogram (IOC) listed on your consent form. As an HPB specialist, I consider this “road map” one of the most important safety steps during your operation. What is an IOC? While you are under anaesthesia, I perform […]
Global Expertise, Local Innovation: Advancing HPB Surgery Through Robotics
When you are diagnosed with a complex condition of the liver, pancreas, or biliary system, your first priority is finding a surgeon who combines deep technical skill with the latest medical technology. In the modern surgical landscape, the “HPB” (Hepato-Pancreato-Biliary) designation represents the pinnacle of abdominal surgery—a sub-specialty that demands rigorous training and a commitment […]
Anatomical variation when performing Laparoscopic Cholecystectomy
Laparoscopic cholecystectomy (gallbladder removal) is one of the most common operations performed worldwide. Because it is routine, there is a tendency to view it as “simple.” However, as an HPB surgeon, I often remind my trainees and my patients of a crucial fact: while the procedure is standardized, the anatomy is not. Every human body […]