Hepato-pancreato-biliary surgical capacity in East and South African countries: a regional assessment survey

Abstract

BACKGROUNDS: Hepato-pancreato-biliary (HPB) services are not widely recognized in African countries. This survey seeks to assess the current status of HPB surgery in East and Southern Africa. METHODS: The Surgeons Overseas Personnel, Infrastructure, Procedure, Equipment, and Supplies (PIPES) survey assessed HPB capacity in East and South African countries. The PIPES score was calculated for hospitals; a higher score indicates greater capacity. RESULTS: Twenty-five responses from 10 countries completed the survey, yielding a median score of 41 (range 18-57). 80% of hospitals are government-operated. Functioning X-ray machines and pre-tested blood banks are the most commonly available resources in 23 (92%) and 20 (80%) hospitals. The most common procedure is open cholecystectomy, performed in 24 (96%) hospitals, while laparoscopic cholecystectomy, distal pancreatectomy, and non-anatomic hepatic resections were conducted in 22 (92%) hospitals. The Whipple operation and liver resection were carried out in 20 (80%) hospitals. Interventional radiology is available in 5 (20%) centers, and liver transplantation was noted in 3 (12%) hospitals. Electrosurgery is available in 25 hospitals, and energy devices are accessible in 19. CONCLUSION: This study highlights the HPB surgery services in East and Southern African countries. Despite limited resources, certain HPB services are accessible.