HPB Perak - Mr BK

HPB Perak - Mr BK Mr BK (Balakumaran Balaravi Pillai) is an HPB surgeon based in Perak, managing liver, pancreas and biliary conditions.

Manages highly complex cases with steady hands.

What is ERCP?Most people have heard of a gastroscopy (OGDS) or colonoscopy, where a flexible camera is used to look insi...
20/07/2026

What is ERCP?

Most people have heard of a gastroscopy (OGDS) or colonoscopy, where a flexible camera is used to look inside the stomach or large intestine.

ERCP (Endoscopic Retrograde Cholangiopancreatography) is different.

Although it also uses a flexible endoscope, ERCP is not primarily a diagnostic procedure. Instead, it is a highly specialized therapeutic procedure designed to treat diseases of the bile ducts and pancreatic ducts.

Think of it this way:

🔹 OGDS looks inside the oesophagus, stomach and first part of the small intestine.
🔹 Colonoscopy looks inside the large intestine.

🔹 ERCP goes one step further. After reaching the first part of the small intestine (the duodenum), the endoscopist locates a tiny opening called the major papilla, where the bile duct and pancreatic duct drain. Special instruments are then passed through this opening into the ducts themselves to diagnose and, more importantly, treat problems.

Malay version:

Apakah itu ERCP?

Kebanyakan orang pernah mendengar tentang gastroskopi (OGDS) atau kolonoskopi, iaitu prosedur menggunakan kamera fleksibel untuk melihat bahagian dalam perut atau usus besar.

ERCP (Endoscopic Retrograde Cholangiopancreatography) p**a berbeza.

Walaupun ia juga menggunakan endoskop fleksibel, ERCP bukan sekadar prosedur untuk membuat diagnosis. Sebaliknya, ia merupakan prosedur terapeutik yang sangat khusus untuk merawat penyakit saluran hempedu dan saluran pankreas.

Bayangkan seperti ini:

🔹 OGDS (Gastroskopi):
Melihat bahagian dalam esofagus, perut dan bahagian pertama usus kecil (duodenum).
🔹 Kolonoskopi:
Melihat bahagian dalam usus besar (kolon dan rektum).

🔹 ERCP:
Melangkah satu langkah lebih jauh.
Selepas endoskop sampai ke duodenum, doktor akan mengenal pasti satu bukaan kecil yang dipanggil papila major (major papilla), iaitu tempat saluran hempedu dan saluran pankreas mengalir masuk ke dalam usus.
Melalui bukaan kecil ini, alat-alat khas dimasukkan ke dalam saluran tersebut untuk mengenal pasti masalah dan, yang lebih penting, merawatnya, seperti membuang batu, memasang stent atau membuka saluran yang sempit.

Chinese version:

什麼是 ERCP?

很多人都聽過胃鏡(OGDS)或大腸鏡(Colonoscopy),這兩種檢查都是利用一條柔軟的內視鏡,觀察胃部或大腸的內部情況。

**ERCP(內視鏡逆行性膽胰管攝影術)**則有所不同。

雖然 ERCP 同樣使用內視鏡,但它不只是用來檢查,更重要的是用來治療。 它是一種高度專業的微創治療技術,主要用於處理膽管和胰管的疾病。

可以這樣理解:
🔹 胃鏡(OGDS)
檢查食道、胃,以及小腸的第一段——十二指腸。

🔹 大腸鏡(Colonoscopy)
檢查整個大腸(結腸及直腸)。

🔹 ERCP
ERCP 比一般胃鏡更進一步。

當內視鏡到達十二指腸後,醫生會找到一個非常細小的開口,稱為十二指腸乳頭(Major Papilla)。這個開口就是膽管和胰管將膽汁及胰液排入腸道的出口。

醫生會透過這個小開口,把專用的醫療器械送入膽管或胰管內,不但可以找出問題,更重要的是立即進行治療。

例如:

✔️ 取出膽管結石
✔️ 放置支架,疏通阻塞的膽管
✔️ 擴張狹窄的膽管
✔️ 治療膽汁滲漏
✔️ 處理部分胰管疾病
簡單來說:

胃鏡和大腸鏡主要是「檢查」;而 ERCP 不只是「檢查」,更重要的是「治療」。

它結合了內視鏡、X 光影像及專業治療技術,能夠在不需要開刀的情況下,治療許多膽管及胰臟疾病,幫助患者更快康復。

Did you know that primary liver cancer often remains silent until it reaches an advanced stage? 💚Unlike many other cance...
15/06/2026

Did you know that primary liver cancer often remains silent until it reaches an advanced stage? 💚

Unlike many other cancers, hepatocellular carcinoma (HCC) typically develops against a backdrop of chronic liver disease, which inherently complicates early detection. Both the underlying liver condition, such as cirrhosis, and early-stage HCC tumors are usually completely asymptomatic. Because the liver can compensate for significant chronic damage, symptoms typically only emerge when the organ finally decompensates, or when the tumor grows large enough to stretch the liver capsule, affect biliary drainage, or invade nearby structures.

Furthermore, HCC can arise in a non-cirrhotic liver. As is sometimes seen with Hepatitis B or fatty liver, the tumor can grow silently deep within the abdominal cavity, often remaining undetected until it reaches an advanced stage or is discovered incidentally during imaging.

This is why screening & early detection in at-risk individuals are so important, as treatment options and outcomes are significantly better when HCC is identified at an earlier stage.

At the MMA Congress 2026, Mr. BK had the opportunity to discuss 'The Changing Landscape of Hepatocellular Carcinoma (HCC).' It was a great platform to explore how current approaches are reshaping patient care.

The session explored the evolving management of HCC, including advances in screening, diagnosis, multidisciplinary care, surgical techniques, locoregional therapies, and systemic treatment options. As liver cancer management continues to evolve rapidly, such discussions play an important role in keeping healthcare professionals updated and ultimately improving patient outcomes.

The presentation provided attendees with valuable updates on the rapidly evolving landscape of HCC management, from the importance of early detection and surveillance strategies to the expanding range of treatment modalities available today. Delegates gained insights into contemporary approaches to liver cancer care, including advances in surgical management, minimally invasive interventions, and multidisciplinary treatment pathways that are helping to improve outcomes for patients.

Thank you to the Malaysian Medical Association (MMA) for the invitation and to all attendees for their participation and engagement.

A meaningful weekend in Kuching, Sarawak for the recent HPB Journal Club gathering, themed “Controversies in HPB Surgery...
13/05/2026

A meaningful weekend in Kuching, Sarawak for the recent HPB Journal Club gathering, themed “Controversies in HPB Surgery.”

Instead of the usual journal presentation format, this session was carried out as a debate-style discussion. This created a lively and engaging atmosphere with excellent participation from the audience. Different treatment approaches, surgical strategies, and real-life experiences were openly discussed, making the sessions both educational and thought-provoking.

Held 2–3 times a year, the HPB Journal Club brings together HPB surgeons and fellowship trainees from across the country to stay updated with the latest medical advancements and continuously improve patient care. Beyond textbooks and journals, these gatherings allow doctors to learn from one another, share experiences managing complex cases, and discuss how best to care for patients facing liver, pancreas, and bile duct diseases.

The event was made even more memorable with the Meet & Greet session with world-renowned Prof Goro Honda from Tokyo Women’s Medical University and his doctoral fellow, Dr Hirohito Kakinuma from Kyoto University, who were in Kuching as facilitators and observers for the 4th Borneo Laparoscopic Liver Resection Masterclass.

We were also privileged to welcome Prof Glenn Bonney from Singapore. Beyond his insightful lunch talk, he served as a guest moderator and provided invaluable mentorship during the Thesis Updates session.

More importantly, the Journal Club continues to serve as a valuable platform that strengthens the bond within the HPB fraternity. It is a reminder that progress in healthcare is built through teamwork, shared knowledge, mentorship, and continuous learning.

Always good to see the HPB family coming together with one common goal: better care and better 𝗅̶𝗂̶𝗏̶𝖾̶𝗋̶ life for patients nationwide.

Photo credit: myhpbs

Perak now has dedicated expertise in hepatopancreatobiliary (HPB) surgery.Meet Mr. (Dr.) Balakumaran Balaravi Pillai als...
29/04/2026

Perak now has dedicated expertise in hepatopancreatobiliary (HPB) surgery.

Meet Mr. (Dr.) Balakumaran Balaravi Pillai also known as Mr. BK.
The first and only resident HPB Surgeon in the state of Perak.
He is a surgeon focused on complex liver, pancreas and biliary conditions.

With fellowship training locally spanning from all corners of Malaysia:
- Hospital Selayang,
- Hospital Sultanah Aminah (JB),
- Hospital Umum Sarawak, and
- Hospital Sultanah Bahiyah (Alor Star)

and internationally:
Tata Memorial Centre (Mumbai, India),
Ayravat Hospital (Uttar Pradesh, India),
Rajavithi Hospital (Bangkok, Thailand) and
Khon Kaen University (Khon Kaen, Thailand),

his work centers on managing challenging abdominal diseases with precision and care.

From gallbladder disease to liver and pancreatic tumours, his practice is built on one principle:
doing complex surgery, safely and well.

He is currently posted to Hospital Raja Permaisuri Bainun in Ipoh, Perak as he manages referrals from all over Perak.

Stay tuned to know more about HPB services and the man behind it!

📍 Managing patients across Perak
🤝 Referrals & collaborations welcome

Address

Ipoh
30000

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