What is Hepatopancreatobiliary Surgery?
Hepatopancreatobiliary Surgery | Hepatopancreatobiliary (HPB) diseases are a field of Surgery that covers the diagnosis and treatment of diseases related to the Liver (hepatic), Pancreas (pancreatic), Gallbladder and Bile ducts (biliary). Whether HPB diseases are malignant diseases such as liver, pancreas and bile tumors or benign inflammatory diseases such as acute hepatitis, acute pancreatitis due to gallstones, acute cholangitis, diagnosis and treatment are both difficult and urgent. Delay in diagnosis and treatment can lead to long hospital stays, loss of the chance of surgical treatment and even deaths that could have been prevented with early intervention. For this reason, multidisciplinary teamwork is required for both rapid and accurate diagnosis of diseases and accurate and effective treatment planning.
Development of HPB Surgery
Liver, Pancreas and Bile (HPB) disease surgery has a special place among all surgical branches. Since the liver, pancreas and bile ducts are adjacent to the most important main vessels of our body, a surgery to be performed in this region (removal of the liver, pancreas and bile ducts due to tumor) must be performed without damaging the vessels, making it one of the most difficult surgeries technically. In addition, the fact that it takes 4-6 hours indicates another difficulty. The surgery with the highest risk of complications that can lead to death is HPB surgery. In the early 80s, these surgeries were resulting in a 20-40% mortality rate even in the USA, and for this reason, special HPB Surgery centers were established. HPB surgical units were established in our country in the same years.
Goals of HPB Surgery
Hepatopancreatobiliary surgery is a branch of surgery that aims to treat diseases that occur in important organs of the digestive system such as the liver, pancreas, gallbladder and bile ducts with surgical methods. The main purposes of these surgical procedures can be listed as follows:
Removal of Tumors: Surgical removal of benign or malignant tumors formed in the liver, pancreas or bile ducts is important to stop the progression of the disease and prolong the patient’s life.
Cleaning of Infection Foci: Cleaning of abscesses or inflamed areas caused by infections in these organs is necessary for the patient’s recovery.
Removal of Obstructions: Removal of obstructions in the bile ducts or pancreatic ducts is important to ensure the normal functioning of the digestive system and prevent liver damage.
Organ Transplantation: In cases such as liver or pancreatic insufficiency, organ transplantation may be required for the patient to survive.
Repair of Damaged Tissues: Repair or removal of liver or pancreas tissues damaged by trauma or other reasons is necessary for the patient to maintain their vital functions.
Some diseases in which hepatopancreatobiliary surgery is applied:
- Liver tumors
- Pancreatic tumors
- Gallbladder stones
- Bile duct tumors
- Pancreatitis
- Liver cysts
- Liver and pancreas injuries resulting from trauma
Advantages of hepatopancreatobiliary surgery:
- Stops the progression of the disease and prolongs life.
- Reduces pain and increases quality of life.
- It is the most effective treatment method for diseases at appropriate stages.
Today, the aim should be to perform surgical treatment of liver, pancreas and biliary cancers with a mortality rate below 2% and in accordance with oncological principles. Experience, skill, technically fine dissection, concentration and patience will prevent the biggest problem during surgery, which is involuntary fatal bleeding. Therefore, the best service specific to the patient in liver, pancreas and biliary disease surgeries should be provided by HPB surgeons who are specialized and experienced in their field.
Highlights of HPB Surgery
For a multidisciplinary approach in HPB surgery, the team should include an HPB surgeon, gastroenterohepatologist, diagnostic and interventional radiologist, medical oncologist, radiation oncology and nuclear medicine specialist. The HPB unit that makes up this team should be able to evaluate liver, pancreas and bile duct patients together immediately when necessary and should be able to immediately apply personalized treatment with the decision of the council. If there is a shock picture in patients with acute pancreatitis with jaundice due to gallstones or acute cholangitis due to bile duct stones, the HPB team should be able to provide ERCP service 24 hours a day, since hours are important in the treatment. Patients with stomach bleeding due to liver cirrhosis should also be taken to Endoscopy urgently and this bleeding should be stopped with the band method. Again, emergency percutaneous transhepatic cholangiography (PTC) and angiographic interventions should be able to be performed 24 hours a day when necessary. Again, emergency HPB surgeries should be performed 24 hours a day in a hospital with an HPB unit.
In HPB surgery, diagnostic methods such as ultrasound, computerized tomography, MR-MRCP, as well as minimally invasive methods such as EUS and ERCP are used.
The Role of Prof. Dr. Kemal DOLAY in HPB Surgery
Prof. Dr. Kemal DOLAY, one of the well-known surgeons in Turkey and the world, has undertaken important studies in the field of hepatopancreatobiliary surgery. He draws attention especially in this field with oncological radical operations performed with open, laparoscopic and robotic methods and a multidisciplinary approach. Prof. Dr. Kemal DOLAY has achieved positive and successful results in the lives of many people in the field of liver and pancreas surgery.
HPB surgery is important for increasing the quality of life as well as extending the life expectancy of patients. This diversity, both the experience of the surgeon and the multidisciplinary approach in treatment are of great importance for successful results.
Surgical Treatment Methods
Hepatobiliary surgery can be performed with minimally invasive methods such as laparoscopic surgery and robotic surgery, in addition to open surgery methods.
Open Surgery (Conventional Surgery)
Open surgery is a traditional surgical intervention method and usually involves operations performed with large incisions. In HPB surgery, open surgery is preferred especially in large tumors, locally advanced cancers and lesions located in difficult localizations of the liver.
Laparoscopic Surgery (Closed Method)
Laparoscopic surgery is a method performed with small incisions and applied by means of a thin camera and surgical instruments inserted inside. This method is considered a minimally invasive technique and provides faster recovery with a shorter recovery period.
Robotic Surgery (Closed Method)
Robotic surgery is a surgical method performed with a special robot system that imitates the movements of the surgeon. While the surgeon controls the robot via a console, the robot performs the surgery by entering the patient’s body through very small incisions. Advantages: Smaller incisions: Since it is performed with much smaller incisions compared to traditional open surgery, patients have shorter recovery times and feel less pain. Better image: Thanks to the robot’s high-resolution camera, the surgeon can see the operating area more clearly and perform more precise operations. More mobility: Thanks to the robot’s joints, the surgeon can move more easily in areas that the human hand cannot reach. Less bleeding: Thanks to the robot’s precise movements, the risk of bleeding is reduced. Less complications: Smaller incisions and less bleeding reduce the risk of complications such as infection.
Some Operation and Intervention Names in HPB Surgery
Pancreatic cancer and tumors
*Whipple surgery, with extended lymphadenectomy
*Distal subtotal pancreatectomy
*Total pancreatectomy
Liver tumor surgery: HCC, cholangiocarcinoma, metastasis
*Metastasectomy
*Segmental liver resection
*Hepatectomy, Hemihepatectomy
*Extended hepatectomy
Gallbladder stone and cancer surgery
*Laparoscopic cholecystectomy
*Radical cholecystectomy with liver resection
Bile duct cancer surgery
*Bile duct resection
*Hemihepatectomy with bile duct resection in Klatskin tumor
*Bile duct resection with pancreaticoduodenectomy
Benign diseases
*Gallstone, acute cholecystitis, cholangitis, ERCP
*Acute, chronic pancreatitis and its complications, ERCP, Endoscopic cystogastrostomy
*Pancreatic cysts and pseudocysts, ERCP, Surgery
*Bile duct injury and stenosis treatment, ERCP, Surgery
What Does HPB Mean?
HPB is a medical term used for the diagnosis and treatment of diseases related to the Hepatopancreatobiliary process and the liver (hepatic), pancreas and bile ducts (biliary).
Basic Scope of HPB
Hepatic (Liver): Includes events such as liver tumors, cysts, traumas and inflammations.
Pancreatic (Pancreas): Includes pancreatic cancer, cysts, inflammatory diseases such as pancreatitis.
Biliary (Bile Duct): Includes endoscopic and surgical treatment of gallstones, bile duct obstructions, inflammations and bile duct cancers, postoperative bile injuries.
Techniques Used in HPB Surgery
HPB surgery is usually performed with both open and minimally invasive methods:
Laparoscopic Methods: Less invasive, accelerates the healing process.
Robotic Surgery: Has more precise settings than laparoscopic surgery.
Open Surgery: Preferred for large tumors or complex situations.
Diseases Treated with Hepatopancreatobiliary (HPB) Surgery
Hepatopancreatobiliary (HPB) surgery includes many surgical treatments related to the liver, pancreas and bile ducts.
Liver Diseases
Liver Tumors (Hepatic Tumors)
Primary Liver Cancer (HCC): It is a type of cancer that multiplies spontaneously. Hepatitis B and C viruses increase the risk of disease in conditions such as cirrhosis. It includes HPB disease, a part of the disease or treatment methods aimed at cancerous tissue.
Intrahepatic cholangiocarcinoma: It is a primary liver tumor originating from the bile ducts within the liver.
Metastatic Liver Cancer: Cancers coming from other parts of the body affect the liver and the tumors are aimed to be removed in appropriate cases.
Liver Cysts and Abscesses: In addition to simple cysts consisting of fluid-filled sacs, there may also be precancerous lesions or infected collections are called liver abscesses. There may also be parasites and especially hydatid cysts, also called dog cysts in our country.
Bile Duct Diseases
Gallstones: Stones formed in the gallbladder or bile ducts can block the flow of bile and cause severe pain and nausea and vomiting. Complaining gallbladder stones can be easily operated laparoscopically.
Bile Duct Cancer (Extrahepatic Cholangiocarcinoma, Kaltskin Tumor): Cancer of the bile ducts is a rare but serious disease. Cancers in the bile ducts usually do not show symptoms in the early stages. Treatment may require surgical removal of the bile duct and, in some cases, the liver and pancreas, depending on the location of the tumor.
Bile Duct Obstructions and Strictures: Stenosis or obstructions in the bile ducts block the flow of bile and can cause jaundice. These obstructions can be relieved by surgical intervention or ERCP with the insertion of a stent.
Cholangitis: It is a disease that often develops due to obstruction in the bile ducts and causes abdominal pain, jaundice and high fever. Delay in diagnosis and treatment of cholangitis can result in death.
Pancreatic Diseases
Pancreatic Cancer: Pancreatic cancer is a type of cancer that is usually diagnosed late and progresses rapidly. Most cancers originate from the head of the pancreas and are surgically removed with the WHIPLLE operation.
Pancreatitis: Pancreatic inflammation can be acute or chronic. Chronic pancreatitis can lead to deterioration in the structural and functional functions of the pancreas. ERCP, EUS and, when necessary, surgical treatment methods are used in the treatment of pancreatitis.
Cystic Tumors of the Pancreas: Most cysts that develop outside of pancreatitis are precancerous cystic lesions. They consist of main and side branch IPMN, mucinous cystic neoplasia (MCN) and Pseudopapillary tumors.
Pancreatic Pseudocyst and WON: Collections occur around the pancreas as a complication of pancreatitis. Endoscopic or surgical drainages or resections are applied in necessary patients.
Pancreatic Fistulas: Pancreatic fluid coming into the abdomen or drain due to a complication of pancreatic surgery or pancreatitis treatment. In this case, ERCP or radiological treatment is usually sufficient, rarely surgical intervention is required.
Gallbladder Diseases
Gallbladder Inflammation (Cholecystitis): Acute cholecystitis, which occurs in the gallbladder, is usually caused by gallstones. Cholecystitis requires surgical removal of the gallbladder (Laparoscopic cholecystectomy).
Gallbladder Cancer: Gallbladder cancer, a rare but fatal disease, usually does not show symptoms in the early stages. Surgical removal of the gallbladder with the surrounding liver tissue and lymph nodes is necessary.
Prof. Dr. Kemal DOLAY and Hepatopancreatobiliary Surgery
Prof. Dr. Kemal DOLAY is an important medical person in the field of HPB surgery. He makes a great contribution to his patients with both rapid and accurate diagnosis, surgical experience and postoperative care experience, especially in liver, pancreas and bile duct diseases. Prof. Dr. DOLAY’s surgical treatments play an important role in ensuring that patients have a successful treatment process.
Whipple Surgery (Pancreaticoduodenectomy)
Whipple surgery is a routine procedure frequently performed for the treatment of diseases such as pancreatic cancer, bile duct cancer and duodenal cancer. In this procedure, the head of the pancreas, duodenum, gallbladder and bile duct and sometimes a part of the stomach are removed. In addition, nearby and regional lymph nodes to which tumors in this region can metastasize are also removed. After a radical removal procedure, the pancreatic duct, bile duct and stomach anastomoses are re-established.
Pancreatic Duct Reconstruction: When a part of the pancreas is removed, it is possible to reconstruct the duct so that flexibility can continue, it is the most important anastomosis of Whipple surgery, since the pancreatic tissue is fragile, the rate of pancreatic fluid leakage from this anastomosis is considerably higher than other anastomoses.
Bile Duct Reconstruction: Reconstruction of the bile ducts is the same as those other than Whipple surgery. It is a safe and low leakage anastomosis..
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is an endoscopic technique used for the examination and treatment of the bile ducts and pancreatic ducts. In this method, the endoscope and special catheters are entered through the mouth and the problem in the bile ducts is eliminated.
Opening of Bile Duct Obstructions: ERCP is used to remove bile duct stones or obstructions. In addition, in obstructive jaundice due to tumor or stone, bile flow is restored by placing a stent in the bile duct.
Bile Duct Stent Placement: In suitable patients with obstruction in the bile ducts, a plastic or metal stent can be placed with ERCP. This normalizes the bile flow.
Fistula and Abscess Treatment
In HPB surgery, surgical intervention may be required for the treatment of fistulas and abscesses in the pancreas (pancreatic fistula) or bile ducts (biliary fistula), but priority is given to ERCP and percutaneous radiological drainages.
Ablation Techniques
Ablation is a method used especially for the destruction of cancerous tumors. In HPB surgery, ablative treatments can be preferred in suitable patients, especially in liver and pancreatic cancers.
Radiofrequency Ablation (RFA): RFA is the destruction of cancerous-looking tissues by heating them with high-frequency electric current. This method can be applied to cancerous tissues located in a certain part of the disease.
Transarterial Fat Injection (TACE): In large tumors that are not suitable for direct surgery or multiple metastases, it is the process of entering the vein and injecting a chemoembolizing substance into the tumors in the liver as if performing angiography. It is expected to cause the tumor to shrink and become suitable for surgery.
Transarterial Radioembolization (TARE): This is a minimally invasive radiology method used in the treatment of liver tumors. In this method, radiation is applied directly to liver tumors via radioactive microspheres (small particles). A thin catheter (tube) is advanced from the groin or arm to the liver artery. The blood vessels of the tumor are determined with special imaging methods (angiography). Radioactive microspheres are injected directly into the vessels feeding the tumor via the catheter. These spheres accumulate in the tumor, deliver high doses of radiation to the tumor cells, and the tumor is intended to shrink.
HPB Surgery and Multidisciplinary Approach
Hepatopancreatobiliary (HPB) surgery is a complex surgical procedure that involves multiple resections and multiple anastomoses involving the liver, pancreas, bile ducts and duodenum. Today, especially in Whipple surgeries due to pancreatic cancer, there is a complication rate of over 50%, and if these complications are not managed correctly, the mortality rate, which is below 2%, can reach much higher figures. In order to reduce complications and reduce mortality to ZERO, multidisciplinary approaches are very important both in the pre-operative and early postoperative period and in terms of the quality of life after the patient is discharged. The multidisciplinary approach aims to reveal the best treatment method by working together with professionals from different departments, through council or individual consultations.
The Importance of a Multidisciplinary Approach
Holistic Perspective: The joint evaluation of each patient by healthcare professionals from different branches provides a holistic approach and ensures the formation of the most appropriate individual treatment plan.
Reducing Risks: In many HPB diseases, surgical interventions require endoscopic, ERCP, EUS and radiological interventions, which makes it possible to minimize surgical and postoperative risks with multidisciplinary teamwork.
Shortening of the Treatment Process: The treatment process can be accelerated with different methods together. In particular, simultaneous management of different treatment methods such as cancer treatment method, recovery and radiotherapy is essential.
Improving the Recovery Process: Patients benefit from not only surgical treatment but also support, psychological support, pain management and physical therapy. This accelerates the recovery process and increases the quality of life.
Multidisciplinary Team in HPB Surgery
A collaboration involving more than one structure is necessary for the successful application of HPB. The multidisciplinary team usually consists of the following specialists:
HPB Surgery Specialist (General Surgeon): The HPB surgeon is the team leader in the treatment of HPB diseases. The HPB surgeon is responsible for surgical interventions in the pancreas, bile ducts and related organs. Removal of tumors, organ transplantation and complex surgeries fall into this field.
Oncologists: They play a critical role in cancer treatment. Medical oncology applies medical treatments such as chemotherapy and immunotherapy for cancers in the pancreas, liver and bile ducts, and radiation oncology applies radiotherapy methods. They recommend and apply these treatment methods before surgery for necessary patients and after surgical intervention for suitable patients.
GastroenteroHepatologists: They are physicians who specialize in liver, bile duct and pancreas diseases. They should be experienced in both diagnosis and medical treatment of diseases.
Gastrointestinal Endoscopists: Endoscopic methods are used in pancreas, bile duct and gastrointestinal system diseases. Physicians who perform ERCP, endoscopic stenting and other endoscopic interventions in bile duct obstructions, pancreatitis complications, postoperative bile fistulas and pancreatic fistulas are GI endoscopists. In developed Western countries and Japan, these endoscopic procedures are performed by specialized internal medicine, surgery and radiology doctors.
Nuclear Medicine Specialists: This is a field of expertise that is involved in both diagnostics such as PET-CT and interventional treatments such as TARE.
Radiologists: During HPB surgery, diagnostic radiology is important for the correct diagnosis of the organs and tumor, and the staging of the disease. They use Ultrasound, Computerized Tomography (CT), Magnetic Resonance Imaging (MR-MRCP) imaging methods to provide definitive information about this condition. In addition, there must be a competent Interventional Radiology Specialist to take biopsies when necessary, to increase the remaining liver volume and to reduce the tumor, especially in patients who will undergo major liver resection before surgery, to perform procedures such as TACE, TARE and Portal vein embolization (PVE). In addition, there must be competence in the diagnosis of postoperative complications and in radiological treatment (percutaneous collection drainage, angioembolization, etc.).
Anesthesiologists: Since HPB Surgery is a complex and long process, some resections require special maneuvers and due to the risk of major bleeding, this team should include experienced and competent anesthesiologists, and should also recommend an approach that provides pain control after the intervention.
Nutritionists: HPB cancer patients usually need nutritional support. After surgery, special nutrition plans are created to meet the nutritional needs of patients, especially in pancreatic surgeries.
Psychologists/Psychiatrists: The difficult and long treatment processes of HPB cancer surgery patients can be psychologically challenging. Psychological support helps patients cope with stress during and after surgery.
Physiotherapists: In order to support patients’ respiratory adequacy and physical recovery processes after surgical interventions, physiotherapists apply treatments that increase patients’ mobilization and muscle strength.
Results of a Multidisciplinary Approach
A multidisciplinary approach in HPB surgery makes patients’ treatment processes more efficient. The joint work of various changes reduces the integrity of the treatment process, shortens the treatment period and accelerates the recovery process of patients. In addition, the quality of life of patients after this treatment is increased and the possibility of obtaining better long-term results is provided.
In conclusion, in a field such as HPB surgery, a multidisciplinary approach is an important strategy that increases success and makes the treatment process more effective.
Hepatopancreatobiliary Cancer Surgery
Prof. Dr. Kemal Dolay is an important HPB surgeon in the treatment of liver, bile duct and pancreas cancers, which are among the most difficult and life-threatening diseases of HPB surgery. The surgical intervention of the treatment of these types of cancer involves the removal of the tumorous Liver, Bile duct or part of the Pancreas together with the nearby and regional lymph nodes. Dolay states that he has successfully performed such RADICAL CANCER SURGERIES and is known as a surgeon who has contributed to extending the life span of his patients.
Prof. Dr. Kemal Dolay has guided many students and specialists in the field of hepatopancreatobiliary surgery in his academic career.
Hepatopancreatobiliary Surgery and Patient Processes
Hepatopancreatobiliary (HPB) surgery is a complex surgery that involves resection and anastomoses of organs such as the liver, pancreas, bile ducts and duodenum. HPB surgery is usually used to treat conditions such as cancer, benign tumors, cysts, bile duct obstructions and pancreatic diseases. Such surgeries require detailed patient process management in terms of interventions before, during and after surgery. Local surgeons such as Prof. Dr. Kemal Dolay achieve successful results by managing their patients’ process treatments in the best way. These cares are carried out more effectively with a multidisciplinary approach and continuous patient follow-up.
Patient Evaluation and Diagnostic Process
The first stage of HPB vaccination is a comprehensive evaluation. The following steps are followed to determine whether patients have a condition that requires surgical intervention:
Medical History and Medical History Examination: Prof. Dr. Kemal Dolay examines the patients’ medical history in detail and collects information such as current dates, past illnesses and family health problems. They open the patient’s new and old blood tests and radiological tests in professional programs, make their own comments and share this information instantly with the patient and relatives.
Laboratory Tests: Laboratory analyses such as specific tests related to the bile ducts, liver function tests, pancreatic enzymes and general biochemistry are performed. These tests provide detailed information about the necessity of surgery and the development status.
Imaging Methods: Advanced imaging techniques such as ultrasonography, computerized tomography (CT), magnetic resonance imaging (MR), and endoscopic ultrasonography are used to detect tumors, cysts or other pathological conditions. These images are of critical importance for the surgeon to be able to plan the operation before surgery.
Surgical Intervention and Surgical Plan
HPB surgery includes a wide range of options, therefore a customized surgical plan is prepared for the patient. Since everything can change individually, Prof. Dr. Kemal Dolay determines the most appropriate surgical method. Major surgical procedures:
Liver Resection: In cases of liver cancer or metastases, it is the procedure of removing a portion of the liver and 80% of it.
Pancreatoduodenectomy (Whipple surgery): In cases such as pancreatic cancer, surgery to remove the pancreas, duodenum, part of the bile ducts and the stomach. This procedure is usually performed when there are tumors in the head of the pancreas.
Biliary Tract Surgery: Due to bile duct diseases or bile duct cancer, bile duct resection, reconstruction or ERCP, endoscopic stenting procedures.
Minimally Invasive Surgery: Laparoscopic and robotic surgery, whether they are surgeries performed with smaller incisions, accelerate the recovery process and shorten the length of hospital stay of patients.
Postoperative Process and Recovery
The recovery process after HPB surgery should be closely monitored to reduce complications and deaths.
Pain Management: Patients’ pain should be managed after surgery. Prof. Dr. Kemal Dolay uses modern pain management methods and prioritizes patient comfort.
Monitoring and Controls: After surgery, most patients can be monitored in intensive care for the first night. During this period, vital signs are monitored, adverse conditions are prevented and body fluid characteristics are balanced.
Physical and Metabolic Recovery: When major organs such as the liver and pancreas are removed, it may take time for them to regain their normal functions. Support, physical therapy and metabolic support play an important role in this process.
Nutrition and Diet: Nutrition is very important after HPB surgery. Organs such as the liver or pancreas play a major role in digestion and metabolism. Therefore, under the guidance of Prof. Dr. Dolay, medications contribute to recovery with appropriate nutrition and diet plans.
Complications and Early Intervention
The mortality rate in HPB surgery has been reduced from 25% to 2%, but complications are still over 50%:
Infections: There is always a risk of infection in the surgical area, and especially after preoperative endoscopic, ERPC or radiological interventions and unnecessary bile drainage applications WITHOUT CONSULTING HPB SURGEONS, both the risk of infection and resistant microbes are encountered. This situation can lead to the use of long-term and expensive antibiotics, long hospital stays and impaired quality of life.
Bleeding: Since HPB surgery is performed on large blood vessels and extensive dissections are performed, the risk of bleeding is high. However, this risk can be greatly reduced in experienced and patient hands.
Bile Leakage: Situations such as leakage of bile fluids can be seen in the passage of the bile ducts. Such problems are usually detected and treated at an early stage.
Pancreatic Fistula: There is a risk of leakage of pancreatic fluids. This situation should be monitored from drains or if there is no drain, intra-abdominal collection should be investigated with blood tests and CT in patients whose healing is impaired and if present, the drain should be removed.
Patient Follow-up and Long-Term Monitoring
After surgery, patients are monitored with regular check-ups for long periods. This process becomes much more critical for related products used in cancer treatment. During check-ups, cancer recurrence risk and liver/pancreas capacity are monitored. Prof. Dr. Kemal Dolay offers long-term follow-up and healthy life guide to patients.
Early Diagnosis and Monitoring: Early diagnosis and treatment in HPB surgery can improve the long-term characteristics of patients. Therefore, they can be monitored with regular tests, and it is necessary to monitor the results of patients.
Hepatopancreatobiliary surgery is a complex and multidisciplinary field that has the potential to save patients and increase their limits. Prof. Dr. Kemal Dolay’s experience and expertise in this field ensures that patients successfully go through their surgical processes. A customized treatment plan is created for the patient and the stages before, during and after the surgical intervention are managed.