Liver, pancreas & biliary
Hepato-bilio-pancreatic surgery — one of the most complex areas of digestive surgery — approached minimally invasively where possible, with a focus on colorectal liver metastases, treated in a strategy integrated with the tumour of origin.
Three organs, one team
The liver, pancreas and biliary tract work together in digestion and are closely linked anatomically. Their surgery requires a centre with dedicated experience and multidisciplinary decision-making.
Liver resections
Most commonly for colorectal cancer metastases — but also for primary liver tumours. The liver has a remarkable capacity to regenerate, allowing significant portions to be removed safely.
Pancreatic surgery
Resections for tumours and cystic lesions of the pancreas (including IPMN), performed laparoscopically where location allows — a technically demanding area where experience is decisive.
Biliary pathology
From complicated gallstone disease to bile duct tumours, restoring bile flow and, where needed, resections involving the liver or pancreas.
When to see a doctor
Conditions of this region often give subtle signs at first. A few symptoms, however, call for prompt assessment.
Yellowing of the skin
Jaundice — the skin and whites of the eyes turn yellow, a sign requiring urgent assessment.
Dark urine, pale stools
Dark-coloured urine and pale stools, associated with jaundice.
Itching of the skin
Persistent itching, sometimes before jaundice appears.
Upper abdominal pain
Pain in the upper abdomen or radiating to the back, especially in pancreatic conditions.
New-onset diabetes
The sudden appearance of diabetes in an adult, sometimes a sign of a pancreatic problem.
Weight loss
Weight loss and loss of appetite, with no obvious cause.
Painless jaundice — yellowing of the skin without pain, with dark urine — must always be investigated promptly. Most often the cause is treatable, but rapid assessment with ultrasound and CT/MRI is essential to establish exactly what is happening.
Precision imaging
The hepato-bilio-pancreatic region is assessed with fine imaging that guides the surgical plan exactly.
CT & MRI with MRCP
CT and magnetic resonance with MRCP cholangiography outline in detail the tumours, vessels and bile ducts — the basis for planning a safe resection.
Endoscopic ultrasound (EUS)
Allows the pancreas to be examined “from the inside” and biopsy of hard-to-reach lesions with high accuracy.
CA 19-9 & CEA
Tumour markers complete the picture and are useful in monitoring after treatment.
Multidisciplinary team
HPB surgeon, oncologist, radiologist and gastroenterologist together determine resectability and the sequence of treatment steps.
Complex resections, as minimally invasive as possible
Each operation is planned individually, according to location, relationship to the major vessels and the functional reserve of the organ.
Colorectal liver metastases
Removal of metastases from the liver, in a strategy integrated with treatment of the colorectal tumour of origin — synchronous or staged. For many patients, this offers a real chance of cure.
Liver resections
From limited resections to major hepatectomies, with modern techniques for bleeding control and, where possible, a laparoscopic approach.
Laparoscopic pancreatic surgery
Resections of the body and tail of the pancreas (including for IPMN lesions) via a minimally invasive approach, with better recovery than open surgery.
Complex biliary pathology
Resolving obstructions and tumours of the bile ducts, restoring bile flow and associated resections when needed.
Where you are operated matters as much as whether you are operated
Surgery of the liver and pancreas is among the most demanding in all of surgery. Outcomes depend directly on the team's experience and on a centre familiar with these operations.
A “not operable” received in one place does not always mean the same in a centre with HPB experience and multidisciplinary decision-making. A specialist second opinion is always worthwhile.
Request a specialist assessmentTrained at the reference centres
Hepato-bilio-pancreatic surgery requires dedicated training, acquired at the institutions that define the field in Romania.
Institute
certification · Fundeni
experience
decision
The first step is a conversation.
International patients welcome. Begin with a remote second opinion — share your records and receive an honest assessment of your options.
Request a second opinion international@drvalentincalu.ro International office · Bucharest