Unlike general surgery books which describe standard or model procedures, this publication focuses on actual clinical settings where conventional surgeries cannot be performed, or where indications for surgery are uncertain. It reviews 20 of the thousands of hepato-pancreato-biliary surgeries performed at the University of Tokyo Hospital. The contributors provide detailed descriptions of surgical procedures as well as indications, diagnostic imaging findings, risk assessments, pathological findings, and prognoses. The procedures covered include laparotomy, laparoscopic surgery, and liver transplantation. The challenges and outcomes of each case are explained in detail. This publication will be useful to young surgeons with the goal of becoming highly skilled in hepato-pancreato-biliary surgery, already established hepato-pancreato-biliary surgeons, and surgeons specializing in other fields.