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.

KNOWLEDGE 

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.