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SurgSpace / Specialties / Hepatobiliary Surgery

Hepatobiliary Surgery

Liver, biliary tree and pancreas: the most anatomy-dense corner of general surgery, where the operation is planned segment by segment on imaging before the incision, and where variant ducts and vessels are the rule rather than the exception.

4 operations in depth5 interactive cases

Backdrop: Contrast CT of the upper abdomen with multiple low-density liver metastases replacing much of the right lobe · James Heilman, MD · CC BY-SA 3.0

Read the scan

Imaging

See the study, interpret it, then answer the surgical question.

The studies that shape surgical decision-making. Not a radiology curriculum: what the scan changes about the plan, then practice reading it.

Practice the image

Read the gallbladder

Fatty-food pain for months, now constant for 18 hours with fever. RUQ ultrasound. (Fictional educational case.)

Synthetic educational image · schematic RUQ ultrasound for practice

Find the stone and its acoustic shadow, read the thickened wall, and decide what the duct question adds: the whole biliary pathway on one probe view.

MRI
Magnetic resonance cholangiopancreatography showing the biliary tree with filling defects in the duct
MRCP · choledocholithiasis: stones outlined as dark filling defects in the bright bile duct

What each study decides

Investigations

  • Ultrasound of the right upper quadrant

    • First test for jaundice and biliary pain: stones, gallbladder wall, and the duct calibre that separates surgical jaundice from medical jaundice.
    • A dilated duct says obstruction; where it dilates says the level; and neither says the cause, which is the next test's job.

  • MRCP

    • The biliary tree photographed without touching it: stones, strictures and variant anatomy mapped before anyone passes a scope.
    • It splits the ERCP decision honestly: MRCP to look, ERCP to treat, and the days of purely diagnostic ERCP are gone.
    Want to interpret the full study? Open in RadSpace

  • Pancreatic-protocol CT

    • The staging instrument for the pancreas: arterial and venous phases read vessel by vessel to assign resectable, borderline or locally advanced.
    • In the liver, the same multiphase logic characterises lesions: arterial uptake and washout is HCC's signature in cirrhosis.
    Want to interpret the full study? Open in RadSpace

  • Liver tests, read as patterns

    • Obstructive (ALP and GGT leading, bilirubin conjugated) versus hepatocellular (transaminases leading): the ratio sketches the anatomy before any scan.
    • The synthetic numbers, albumin, INR, bilirubin over time, measure the liver's function rather than its irritation, and they gate every operative decision.

Hub shaped by the Surgical Specialties Lead with the Hepatobiliary surgery reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.