About Hepato Pancreato Biliary (HPB) Disease

• Dr. Paari Vijayaragavan
• 02 March

Liver is one of the most important of the organs in the body. In fact ,some of the cultures conside liver, not the heart, as the center /residence of the 'soul'. The liver has myriad functions, some of which include storing and using glucose and fat, producing the building blocks of the body namely the proteins, detoxifying the toxins and drugs, excretion of the waste products, maintain blood clotting mechanism and help in digestion of food and blood sugar control. Liver is the metabolic power-house of the body and serious diseases affecting the liver can cause the almost all of the body systems to come to a standstill. Though the liver has excellent regenerating capacity, it is a fact that it happens to bore the brunt of undesirable side effects of the life style changes of the present day. The excess calorie intake coupled with the lack of exercise is leading to the explosion of ‘fatty liver disease’ which when advanced can lead to ir-reversible damage to liver called ‘cirrhosis’. The growing alcohol consumption can lead to irreparable damage to the liver. Our country is a high prevalence area for Hepatitis B and C viruses . These viruses can affect the liver in a silent manner and can lead to a step wise progression of the liver damage through the stages namely, fibrosis, cirrhosis and ultimately can lead to formation of liver cancer.

The cancers of the liver are remarkable for being silent till the very advanced stage, when cure becomes improbable. In fact the symptom of ‘pain’ that most patients think of as the only symptom of serious disease is summarily absent till the very end stage. But the silver lining is that now these cancers can be cured when detected in a reasonably early stage, i.e. at a stage when they have not yet given troublesome symptoms or only when ‘warning signs’ are present.

Liver is one of the organs with most abundant blood supply and surrounded by major blood vessels going to and from the heart; in fact the liver has three different types of blood vessels crisscrossing it making it a maze of blood vessels. For the same reason, previously there had been a reluctance (may be rightly so) among the surgeons to boldly go after the cancers of these organs. With the improvement in understanding the anatomy of these organs, more surgical experience and availability of amazing surgical operating instruments, the chance for surgical cure for the cancers arising from the liver is brighter now than ever before. The addition of liver transplantation to list of successful operations now being available has been a boon for those patients with irreversible liver damage and with many in-operable liver cancers. Further there is exciting research going on in hepatocytes and islet cell transplantation and in stem cell liver regeneration.  The latest medical technological and research advances are being brought in from around the world for the benefit of our patient population under one roof and in their neighborhood. The awareness about the diseases affecting the liver and the fact that they have to be caught early for the treatment to be beneficial is almost negligible in our population and Dr Paari considers it an important task of his department to spread the awareness about the liver diseases and help the public catch the disease early through proactive medical surveillance in the persons at risk. Dr Paari and his team envision  to serve the patients with diseases affecting the liver, gall bladder, bile duct and pancreas with the utmost humane touch and best technological advancement so that ‘cure’ is not just a hope but a reality for our patients.