Emerging technology is driving advances in the surgical field at a rapid rate and hepatobiliary pancreatic (HPB) surgery is a prime example. In the last 20 years there has been a huge increase in HPB procedures and every major city in India now boasts of centers of excellence devoted to this subspecialty.
This issue of the Indian Journal of Surgery with the special theme of GI Surgery is devoted to hepatobiliary pancreatic surgery. Topics have been chosen to reflect on technical advances and controversies. The issue contains matters of interest to all levels of surgeons. Every practicing surgeon must read the extremely balanced review article by A Behari and VK Kapoor, which dissects the controversy surrounding the need for surgery for asymptomatic gallstones. The article on pancreaticoduodenal injury by Atul Sharma provides a practical approach to tackling this challenging problem, that many general surgeons will encounter.
Recent advances in surgical procedures for choledochal cyst, acute and chronic pancreatitis, portal hypertension, hilar cholangiocarcinoma and pancreatic cancer have all been dealt with in detail. Anil Sharma has written an excellent article on single incision HPB surgery.
Liver transplantation have been exponentially increasing in India. This issue has two excellent reviews about the controversies surrounding transplanting for hepatocellular cancer which has been deftly dealt with by R Kakaodkar, and the all important issue of donor safety in living donor liver transplantation discussed by SK Mathur et al.
Technological advances have led to complex radiological procedures for hepatocellular cancers. Kulkarni et al provide a comprehensive review on ablative and embolization treatment for hepatocellular cancer.
It was ultrasonography that initially enabled accurate diagnosis of HPB morbid anatomy . Now, technology has advanced to be able to send an ultrasound probe into the gastrointestinal tract. The place of endoscopic ultrasound in GI surgery has been reviewed by Gouda and Gupta.
Chandralekha Tampi provides an insight into the modern interpretation of HPB pathology and a balanced approach to the analysis of liver and pancreatic tumors; an article which must be read by all HPB surgeons.
This volume starts with a thoughtful editorial by Professor Samiran Nundy, whose unstinting efforts established G I surgery as a separate speciality in North India, and deals with the direction for the future of GI surgery in our country. He makes an impassioned plea for a pragmatic approach in treating the middle class Indian and the need to publish Indian data in Indian journals rather than aping the protocols published in western literature. Now that the Indian Journal of Surgery is indexed in Pub Med Central, articles are visible worldwide through a PubMed search and we hope the readership of this journal will heed his advice. We hope to attract the best of our country’s surgical research in future.