At-a-Glance

I help patients with HPB conditions to make informed and individualised treatment decisions. These diseases are often complex, not only because HPB surgery is among the most technically demanding areas of abdominal surgery, but also due to significant anatomical variation that can affect both operative planning and outcomes.

Seeing my patients recover well especially those who benefited from minimally invasive surgery, has motivated me strongly to continue to provide safe, evidence- based care.

1. When a new liver lesion or tumour is found on imaging, such as during routine health screening scans.
2. When a pancreatic tumour is detected, or a pancreatic cyst is discovered on a scan.
3. When colorectal (colon) cancer has spread to the liver and may be completely treated with surgical removal.
4. When the cancer marker CA19-9 is elevated, especially if accompanied by symptoms or abnormal scan findings.
5. When gallstones are causing problems, such as:

• abdominal pain (biliary colic)
• gallbladder inflammation (cholecystitis)
• jaundice (yellowing of the skin/eyes)
• pancreatitis (inflammation of the pancreas)

I attend and actively participate in the International and local HPB related conferences, and engage in ongoing Continuous Medical Education (CME) to maintain up-to-date clinical knowledge.

My patient care philosophy is to deliver genuine, patient-focused surgical care and to ensure continuity of care from pre-operative through to post-operative management.

I have multiple patients with similar scenarios. These patients’ successful outcome encourages me to continue to do well for the rest of my patients.

Patient story 1:

This patient (middle-aged man) came to see me after a raised CA19-9 result. Further test with scans biopsy confirmed pancreatic cancer that had spread to the liver. Although surgery was not an option, after discussion, he acted quickly and chose to proceed with treatment without delay. With prompt investigation and coordinated care, systemic therapy was started early, giving him the best chance of respond.

Patient story 2:

This patient was diagnosed with a large but localised pancreatic tumour. Despite the anxiety that she faced after the major diagnosis, she stayed focus on the treatment and recovery. The tumour was removed successfully using minimally invasive surgery, Healing was smooth with no wound complications, and she manged to begin chemotherapy as planned.

Patient story 3:

This patient had recurring abdominal pain that did not improve despite multiple rounds of gastric medications. Instead of accepting the ongoing symptoms, he continued seeking the cause of his pain. Once gallstones were identified as the cause, he underwent laparoscopic cholecystectomy and made a complete recovery, with symptoms resolved.

Patient story 4:

This patient (a young gentleman) was diagnosed with a large liver cancer on the right side of the liver (about 15cm). Removing the tumour would leave a borderline amount of remaining liver, so the decision required carefully planning and preparation. Despite the uncertainty, the patient stayed determined for the treatment. He proceeded with detail investigations, including liver volumetry to measure the future liver remnant and an ICG test to assess liver function. He also followed the full pre-operative preparation plan closely. With thorough 3D pre-operative planning of the liver anatomy, he successfully underwent surgery to remove the tumour. He recovered well,  achieved clear surgical margins, and remains on regular follow up.

1. Many patients confused gallbladder as urinary bladder. The gallbladder is a small organ located under the liver and stores bile juice, which helps with digestion. It is not related to the urinary bladder. Since the gallbladder stores and concentrates the bile juice, stones can form there. Bile juice is produced by the liver (not the gallbladder), and therefore after gallbladder removal surgery the digestive tract is intact and most people can live normally after gallbladder removal.
2. Patients sometimes assume gallstones can be “ flushed out” like kidney stones by drinking more water. Gallbladder is part of the digestive system, not related to the urinary system in our body. Drinking more water will not help the gallstones in the gallbladder to pass through the urine. On the other hand, small gallstones can be more risky of dropping into the bile duct and cause blockage, infection, inflammation, jaundice or pancreatitis which can be serious.

Clear communication is the key.

I maintain work-life balance through good time management, and set clear boundaries. Outside work, I make time to be with my family, play badminton, listen to music on Spotify, and catch up with friends and colleagues. These help me stay refreshed and present for my patients.

There are a few exciting developments in HPB Surgery:

1. Robotic surgery: Minimally invasive techniques continue to advance. The use of robotic platforms has further improved precision and outcomes in complex procedures for treatment of pancreas, liver and bile duct tumours, allowing selected patients to benefit from smaller incisions and faster recovery.
2. Use of indocyanine green (ICG) fluorescence imanging in liver surgery has help surgeons to better visualise the liver anatomy, bile ducts and tumour boundaries during surgery. This supports safer anatomical liver resection, improves the ability to achieve clear margins, and help reduce blood loss.
3. 3D anatomical reconstruction for pre-opearative planning. This allows the surgeons to visualise liver structures more accurately. It also helps to estimate future liver remnant, i.e. the amount of liver that will remain after surgery, so the procedure can be planned more safely.

Do not ignore persistent abdominal symptoms. If discomfort, pain, bloating or indigestion does not improve, seek medical attention early.

Unfortunately, most HPB cancers have no symptoms in early stage, therefore it is important to keep up with regular health screening and check-ups. Do not ignore abnormal cancer markers blood test.