Syllabus UEMS-HPB Surgery
OBJECTIVE
- Ability to understand and diagnose diseases of the liver, the biliary tract, the pancreas, the spleen and the portal venous system
- Ability to develop a treatment strategy according to professional standards for these diseases and to execute it
- Ability to deal with postoperative complications in this field of surgery
LIVER
- Anatomy and its anatomical variations
- (Patho)physiology of the liver (including knowledge of fysiology and pathophysiology of coagulation)
- Pathophysiology of liver failure (including hepatorenal and hepatopulmonary syndrome)
- Basic knowledge of functional liver diseases, parenchymal diseases like hepatitis, metabolic diseases and vascular abnormalities (Budd-Chiarri)
- Benign liver tumors and cysts : etiology, pathophysiology and complications, diagnosis, treatment
- Primary malignant liver tumors: etiology, pathophysiology and complications, diagnosis, treatment and prognosis with and without treatment.
- Secondary malignant liver tumors: etiology, pathophysiology and complications, diagnosis, treatment and prognosis with and without treatment.
- Basic principles of non surgical treatments ( chemotherapy i.e. Serafonib and Radiotherapy, bleeding tumors)
- Basic principles of palliative treatment.
- Infectious diseases of the liver (including parasytic diseases) : etiology, pathophysiology and complications, diagnosis, treatment and prognosis
- Trauma of the liver : etiology, pathophysiology and complications, diagnosis, treatment
- Pathophysiological aspects of surgery in the cirrhotic liver
- Basic knowledge on indications, contraindications and outcome of liver transplantation
GALLBLADDER and BILE DUCTS
- Anatomy and (patho)physiology of the biliary system, bile secretion and anatomical variations
- Congenital diseases of the biliary system : etiology, pathophysiology and complications, diagnosis, treatment and prognosis with or without treatment
- Gallbladder and bile duct stones : etiology, pathophysiology and complications, diagnosis, treatment
- Cholecystitis and cholangitis : etiology, pathophysiology and complications, diagnosis, treatment
- Benign and malignant tumors of the biliary system : etiology, pathophysiology and complications, diagnosis, treatment and prognosis with or without treatment.
- Basic principles of non surgical treatments (Stenting, chemo and Radiotherapy)
- Basic principles of palliative treatment
- Basic knowledge about diagnostic and intervention procedures like endoscopy (ERCP) and PTCD regarding indications, outcome and complications.
- Trauma of the biliary system : etiology, pathophysiology and complications, diagnosis, treatment
PANCREAS
- Anatomy and (patho)physiology of the pancreas, anatomical variations
- Congenital diseases of the pancreas: etiology, pathophysiology and complications, diagnosis, treatment and prognosis.
- Benign and malignant tumors of the pancreas : etiology, pathophysiology and complications, diagnosis, treatment and prognosis with or without treatment
- Peripappillary tumors: etiology, pathophysiology and complications, diagnosis, treatment and prognosis with or without treatment.
- Basic principles of non surgical treatments (Stenting, chemo and Radiotherapy)
- Basic principles of palliative treatment.
- Acute and chronic pancreatitis : etiology, pathophysiology and complications, diagnosis, treatment
- Trauma of the pancreas and the duodenum : etiology, pathophysiology and complications, diagnosis, treatment
SPLEEN
- Anatomy and (path)physiology of the spleen, anatomical variations
- Indications for and pathophysiology of elective splenectomy, complications
- Splenic trauma : etiology, pathophysiology and complications, diagnosis, treatment
PORTAL SYSTEM
- Anatomy and (patho)physiology of the portal system, anatomical variations
- Portal hypertension : etiology, pathophysiology, complications, diagnosis, and portosystemic decompressiontreatments(surgical and non surgical options, pro’s and con’s of the different methods) and outcome
CLINICAL SKILLS
LIVER
- Work up of patients for a liver resection, selection, diagnostic modalities and conditioning.
- Evaluation and decision making about surgical resectability.
- Strategies to improve resectability.
- Intraoperative ultrasound evaluation of the liver
- Techniques of vascular control of the liver
- Techniques of major and minor hepatectomies
- Basic techniques of laparoscopic liver surgery
- Treatment of complications, abcesses, bleeding, liver insufficiency, infections.
- Perioperative care
BILE DUCTS
- Laparoscopic and open cholecystecomy
- Techniques of diagnostic and interventional bile duct exploration
- Surgical techniques for biliary drainage
- Evaluation and decision making about surgical resectability of bile duct tumors
- Surgical techniques for bile duct resection
- Surgical treatment of bileduct strictures
- Surgical treatment of congenital malformations of the bileducts
- Treatment of complications of biliary surgery like anastomotic leaks
- Perioperative care
PANCREAS
- Duodenopancreatectomy, resection of the body and/or tail of the pancreas
- Duodenum preserving pancreatectomy and drainage procedures
- Drainage operations of the pancreas, Puestow technique, Beger Technique, E-S pancreaticostomy.
- Ampullectomy
- Surgical procedures for acute necrotising pancreatitis
- Treatment of complications (anastomotic leaks), surgical pancreatitis
- Perioperative care
SPLEEN
- (Partial)Splenectomy open/laparoscopic
- Treatment of complications
- Perioperative care
PORTAL SYSTEM
- Conservative(pharmacological) management of portal hypertension and ascites
- Portosystemic shunt operations
- Blocking procedures
PROFESSIONAL SKILLS
- Assessment and councelling of patients with HPB-diseases and their families
- Ability to adequately councill the colleague general surgeon with an HPB problem
- Taking care of patients needing palliative care.
- Communication and teamwork skills
- Practice evidence-based medecine : experience with audit, clinical trials, journal review
- Ability to act in a multidisciplinary environment
- Understand medico-legal and ethical issues
- Record and retrieve information from databases
- Recognition of the changing nature of knowledge and ability to acquire new knowledge for currency of HPB surgical practice
