Hepato-Pancreato-Biliary Surgery

HPB Surgeons in Nashville

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Dr. Mariana Chavez
Hepato-Pancreato-Biliary Surgery
Downtown Nashville

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Dr. William Polk
Surgical Oncology
Dowtown Nashville

dr patrick wolf general surgeon surgical oncology at st thomas west in nashville

Dr. Patrick Wolf
Surgical Oncology
St. Thomas West Clinic

Advanced Laparoscopy
Bile Duct Surgery
Bile Duct Injury Repair
Complex Bile Duct Resection
Duodenal Surgery
Duodenal Tumors
Duodenal Ulcers
Gallbladder Tumors
Gallbladder Stones
Gallbladder Surgery
Gastrointestinal Cancer

Laparoscopic Surgery
Liver Cancer
Liver Tumors and Cysts
Liver Surgery
Neuroendocrine Tumors
Pancreas Cancer
Pancreas Tumors and Cysts
Pancreas Surgery
Retroperitoneal Sarcoma
Robotic Surgery
Whipple Procedure






What is Hepato-Pancreato-Biliary Surgery (HPB)?

Hepato-Pancreato-Biliary Surgery (HPB) is the surgical treatment of diseases in the liver (hepato), pancreas (pancreato), and biliary system (gallbladder and bile ducts). HPB surgery is one of the most complex general surgeries and requires a highly skilled general surgeon who specializes in liver/pancreatic/biliary diseases, like Dr. Mariana Chavez, located in Nasvhille, Tennessee.

As a hepatopancreatobiliary surgical specialist, general surgeons like Dr. Chavez not only diagnose but also treat benign and malignant dieases of the liver, pancreas, gallbladder and bile ducts. Dr. Chavez has advanced training on HPB surgery with minimally invasive techniques including endoscopic surgery, laparoscopic surgery and robotic surgery.

Which conditions does HPB surgery treat?

While some conditions are more common, like pancreatic tumors, others are relatively rare (gallbladder and bile duct cancers). At The Surgical Clinic, we treat all conditions with specialized expertise within our network of surgeons who are able to devise a plan of attack with the best options available for each patient. Whether that be open surgery, laparoscopic surgery, or robotic surgery techniques.

Some of the common conditions we treat for HPB Surgery:

  • Benign tumors in the liver, pancreas, gallbladder or bile duct – these are noncancerous
  • Neuroendocrine tumors in the liver, pancreas, gallbladder or bile duct – these form when specific cells turn into tumors
  • Cancers of the liver, pancreas, gallbladder or bile duct

What are liver tumors?

Cancerous and Benign Liver Tumors

While noncancerous (benign) liver tumors are fairly common, they don’t typicallly spread into other areas of the body (metastasize). Unlike benign liver tumors, primary liver cancers can exists as well as tumors that metasasize from other sites of the body. These tumors form most commonly from colorectal cancer, or potentially from the gastrointential trac, known as a neuroendocrine tumor.



Common pancreatic tumors

Common Pancreas Tumors

Malignant (cancerous) tumors of the pancreas commonly develop as primary pancreatic cancer, meaning it began in the pancreatic duct. Tumors of the pancreas, also know as tissue growth or masses, can also develop from nearby organs like the gastrointestinal tract or even from cystic tumors. It’s important to diagnose these tumors as benign or malignant to treat accordinly. 

Metatastic pancreatic cancer can lead to the spread of cancer into other ograns. Treating pancreatic cancer has become far more advanced in helping prevent this type of spread or recurrance of pancreatic tumors. 


What are biliary tumors?

Gallbladder and Bile Duct Tumors

The biliary system consists of your gallbladder and bile ducts. These bile ducts connect your liver to your small intestine as well as your gallbladder. Tumors that form in your biliary sytem are rarely cancerous, but can be highly complex to treat if diasgnosed as malignant. 

Types of HPB surgery

The first step in treating patients who present with hepatopancreatobiliary tumors is to meticulously discuss treatment options with a board of experts – general surgeon, surgical oncologist, interventional radiologist, radiation oncologist as well as the dagnostic radiology and nursing teams.

For treatment of cancerous tumors in the liver, pancreas or gallbladder and bile ducts, surgical treatment will vary depending on the nature of the cancer. While some may present as primary cancers, others can be metastatic.

Liver tumors

Treatment of liver tumors

Primary liver cancer – this type of cancer has two treatment options, resection or liver transplantation.

Metastatic colorectal cancer of the liver – the only way to cure this type of cancer is to surgically remove all of the disease.

In some cases, ablative therapy may be used during the surgical removal/resection. This type of therapy may also be used when a patient is unable to undergo traditional general surgery due to health related issues. Ablative surgery uses heat and radio waves to destory masses/tissue growth/tumors.

Dr. Mariana Chavez specializes in minimally invasive techniques when applicable to help reduce the size of incisions, recovery time and wound infection.

Pancreas tumors

Treatment of pancreas tumors

Pancreatic cancers must be surgically removed. Depending on the location of the tumor, there are a few advanced techniques to resect/remove the malignant pancreatic tumors. 

Tumors in the head of the pancreas – a Whipple resection (pancreaticoduodenectomy) may be performed with reattachment of remaining organs to digest food with vessel reconstruction if needed.

Tumors in the body and tail of the pancreas – a distal pancreatectomy can be performed using minimally invasive technique to fully remove the body and tail or the pancreas, and potentially the spleen if needed.

Biliary tumors

Treatment of gallbladder and bile duct tumors

The most common surgical approach in treating cancerous tumors of the gallbladder and bile duct is to comepletely remove the gallbladder, alongwith a liver resection. In this case, your general surgeon will need to reconstruct your bile duct to attach to your small intestine. More extensive techniques may be performed if the bile duct is blocked or presents more tumor involvement. 

hepato pancreato biliary surgery

Hepato Pancreato Biliary

Hepato-Pancreato-Biliary (HPB) surgery refers to malignances of the liver, pancreas and biliary tract. Once a patient is diagnosed with GI cancer, an HPB surgical specialist, like Dr. Marina Chavez, will explain the different procedure options and what is best. Some of these HPB surgery options include: the whipple rocedure, distal & total pancreatectomy or minimally invasive liver surgery.