What would you do? A survey of HPB surgeons practice patterns

Ahmer Irfan; Wendy Feng; Katherine McElroy; Vikas Dudeja; Sushanth Reddy; John Bart Rose

doi:10.1016/j.hpb.2023.12.003

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What would you do? A survey of HPB surgeons practice patterns

Journal article

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Peer reviewed

What would you do? A survey of HPB surgeons practice patterns

Ahmer Irfan, Wendy Feng, Katherine McElroy, Vikas Dudeja, Sushanth Reddy and John Bart Rose

HPB (Oxford, England), Vol.26(3), pp.436-443

03/01/2024

DOI: 10.1016/j.hpb.2023.12.003

PMID: 38143165

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Abstract

Background: The surgical decision making for pancreatic adenocarcinoma is complex. Although practice guidelines exist for many scenarios, these do not cover many common eventualities that may be encountered during these cases. We sought to identify the practice pattern variations amongst pancreatic surgeons in response to commonly experienced clinical scenarios. Methods: A multiple-choice questionnaire was distributed to all full members of the IHPBA. Participant demographics, training history, and clinical practice information were obtained. The survey provided various operative scenarios and participants were asked how they would likely proceed. Responses were collected and stored anonymously in a secure database. Statistical analysis was performed using Stata 16.0. Results: 164 responses were submitted. Most of the respondents were male and had been in practice for over 10 years. The median age range was 40-50 years old. When asked about staging laparoscopy, the majority performed it selectively. For most respondents a pathological aorto-caval nodes was a reason to abort the procedure but most would have continued in the setting of a positive hepatic artery node. When encountering a single Segment 2 liver metastasis, participants who practiced in Europe were significantly more likely to resect and proceed compared to those in Asia and North America. Participants who had undergone only a Surgical Oncology fellowship were most likely to abort. With respect to direct colonic invasion, most participants would resect the specimen en bloc. Respondents who participated in fewer that 20 PDAC operations/year were most likely to abort. Conclusions: Surgical decision making in PDAC surgery is complex and there is significant disagreement on the correct management. While formal guidelines cannot exist for all situations, this survey highlights the need for consensus on commonly encountered operative scenarios.

Gastroenterology & Hepatology

Life Sciences & Biomedicine

Science & Technology

Surgery

Details

Title: Subtitle: What would you do? A survey of HPB surgeons practice patterns
Creators: Ahmer Irfan - University of Alabama at Birmingham
Wendy Feng - University of Alabama at Birmingham
Katherine McElroy - University of Alabama at Birmingham
Vikas Dudeja - University of Alabama at Birmingham
Sushanth Reddy - University of Alabama at Birmingham
John Bart Rose - University of Alabama at Birmingham
Resource Type: Journal article
Publication Details: HPB (Oxford, England), Vol.26(3), pp.436-443
DOI: 10.1016/j.hpb.2023.12.003
PMID: 38143165
NLM abbreviation: HPB (Oxford)
ISSN: 1365-182X
eISSN: 1477-2574
Publisher: Elsevier
Number of pages: 8
Language: English
Date published: 03/01/2024
Academic Unit: Anatomy and Cell Biology; Surgery
Record Identifier: 9985244574202771

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