西非的肝胆胰外科:及时的能力评估

IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Hpb Pub Date : 2024-09-01 DOI:10.1016/j.hpb.2024.05.009
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引用次数: 0

摘要

背景西非是世界上肝胰胆(HPB)恶性肿瘤发病率最高的地区之一。尽管手术对治疗至关重要,但非洲的 HPB 手术供应情况尚不清楚。这项横断面研究调查了西非医院目前的 HPB 手术能力。方法对海外外科医生人员、基础设施、程序、设备和用品(PIPES)调查进行了修改,以纳入 HPB 特定参数并量化能力。该调查由来自西非的外科医生顾问完成。结果来自冈比亚、加纳、象牙海岸和尼日利亚的 35 家机构完成了 HPB PIPES 调查。大多数机构(94.2%)都是三级转诊中心;其中五家机构有一名接受过 HPB 培训的外科医生。最常见的手术是开腹胆囊切除术(91.4%),其次是胃旁路术(88.6%)。肝脏大部切除术(14.3%)和Whipple手术(17.1%)很少见。88.6%的医疗机构具备重症监护室能力,25.7%的医疗机构具备介入放射学能力。这项研究表明,西非的 HPB 手术能力有限。这些结果可用于地区质量改进计划,并作为未来能力评估的基线。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepato-pancreato-biliary surgery in West Africa: a timely capacity assessment

Background

West Africa has among the highest rates of hepato-pancreato-biliary (HPB) malignancies in the world. Although surgery is critical for treatment, the availability of HPB surgery in Africa is unknown. This cross-sectional study investigated the current HPB surgical capacity of West African hospitals.

Method

The Surgeons OverSeas Personnel, Infrastructure, Procedure, Equipment, and Supplies (PIPES) survey was modified to include HPB-specific parameters and quantify capacity. The survey was completed by consultant surgeons from West Africa. A PIPES index was calculated, and a higher score corresponded to greater HPB surgical capacity.

Results

The HPB PIPES survey was completed by 35 institutions from The Gambia, Ghana, Ivory Coast, and Nigeria. Most institutions (94.2%) were tertiary referral centres; five had an HPB-trained surgeon. The most commonly available procedure was an open cholecystectomy (91.4%), followed by gastric bypass (88.6%). Major hepatic resections (14.3%) and the Whipple procedure (17.1%) were rare. ICU capabilities were present at 88.6% of facilities while interventional radiology was present in 25.7%.

Conclusions

This is the first HPB capacity assessment in Africa. This study showed the limited availability of HPB surgery in West Africa. These results can be used for regional quality improvement initiatives and as a baseline for future capacity assessments.

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来源期刊
Hpb
Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY
CiteScore
5.60
自引率
3.40%
发文量
244
审稿时长
57 days
期刊介绍: HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
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