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Surgery of the Liver, Pancreas and Biliary System

December 20th, 2016

HPB stands for Hepato-Pancreato-Biliary surgery, or in other words, surgery of the liver, pancreas and biliary system. The biliary system, which includes the liver, gallbladder, and bile ducts, forms part of the body’s digestive system. This system is responsible for nutrient absorption and waste disposal, and can be affected by a range of short term or chronic diseases or conditions. Sometimes these conditions can be more than embarrassing – they can also be life threatening. 

Jacob Dowden, M.D., Hepato-Pancreato-Biliary surgeon at University Surgical Associates, is specially trained to perform surgeries on the liver, pancreas and biliary system. He’s the only surgeon in the Chattanooga region who has completed an HPB surgery fellowship.

“The shorthand term for hepato-pancreato-biliary surgery is HPB. Hepato relates to the liver, pancreato refers to the pancreas and biliary is the system that helps drain bile from the body,” Dr. Dowden says . “The specialty is often focused on treating patients with cancer of the liver or pancreas, colorectal cancer that spreads to the liver, and other benign liver diseases.” 

New diagnostic and surgical capabilities for HPB conditions mean better treatment options are available for end-stage liver disease, malignant liver tumors, benign tumors and cysts of the liver and pancreas, pancreatic cancer, and tumors of the gallbladder. Other conditions include bile duct injuries and strictures, benign tumors and cysts and inflammation of the bile ducts.

The Team Approach 

HPB surgery is very complex, and so are the preparations and coordination required between the surgeon and other members of the overall medical team. The gastroenterologist is usually the first physician to discover pancreatic or liver cancers – whether that’s through different types of investigations or advanced GI procedures. The HPB surgeon and medical and radiation oncologists work together to determine the right combination of surgery and chemotherapy a person needs to have the most effective treatment. Radiologists also play a vital role because they evaluate and/or make initial diagnoses based on the results of screenings.  

“I attend several multidisciplinary tumor conferences, where physicians come together to form a treatment plan for each person. Together we work to determine the sequence of treatments that would be most effective,”  Dr. Dowden says. “The type of cancer, a person’s physical condition and other factors are part of the discussion about whether we perform surgery before or after chemotherapy. Each person and their individual condition is evaluated because there’s never a one-size-fits-all approach.”  

When Dr. Dowden considered what specialty to pursue, he liked the challenge and thoughtful planning that goes into every HPB surgery he performs. He also wanted to feel confident to perform any abdominal surgery his patients may need. Many of Dr. Dowden’s patients have been diagnosed with pancreatic cancer, and he emphasizes that the diagnosis isn’t an automatic death sentence. 

“There’s a common misconception that pancreatic cancer is universally fatal, but that’s not the case. It is a difficult cancer to treat, but we have a lot of new options to approach it in an aggressive and safe way,” Dr. Dowden says.  “There are no HPB or pancreatic cancer procedures that require a drive to Nashville or Atlanta. It’s important to me for people to know that the most advanced cancer-fighting surgeries and treatments are available right here in Chattanooga. This is what I was trained to do, and love giving people an opportunity to live longer and healthier lives.” 

To see Dr. Dowden’s profile, click here. To schedule an appointment with Dr. Dowden, call (423) 267-0466. 


Posted by University Surgical  | Category: hpb surgery

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