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Hepatopancreatobiliary Surgery Fellowships How Many Do We Need?

Rebecca M. Minter, MD1
[+] Author Affiliations
1University of Texas Southwestern Medical Center, Dallas
JAMA Surg. 2016;151(3):213-214. doi:10.1001/jamasurg.2015.4601.
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This Viewpoint discusses the growing number of hepatopancreatobilary surgery fellowships and emphasizes the need for standardization of training requirements.

As hepatobiliary and pancreatic surgery outcomes have improved, with patient mortality approaching 1% to 3% for these complex procedures when performed by high-volume surgeons in high-volume centers, the practice of hepatopancreatobiliary (HPB) surgery has grown. Data on the volume of pancreatic and hepatic resections performed between 2006 and 2010, extrapolated from the Nationwide Inpatient Sample,1 demonstrates an increase in the number of procedures performed by 33% and 69%, respectively. Concomitant with this growth has been the emergence of formal training in the field of HPB surgery, and consequently a dramatic increase in the number of HPB surgeons trained. Historically, general surgery or surgical oncology training provided the majority of surgeons performing these operations and providing care for patients with HPB surgical disease. Over the last 2 decades, however, there has been the emergence of dedicated formal training in HPB surgery, as well as focused tracks in HPB surgical training within surgical oncology and abdominal transplantation fellowships.

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Perceived Degree of Difficulty in Obtaining a Hepatopancreatobilary (HPB) Surgery Focused Position

Reprinted with permission from Wolters Kluwer. 1

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