HPB Surgery Curriculum

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.

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.

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.

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.

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.

Anatomy and (patho)physiology of the portal system, anatomical variations.
Portal hypertension: etiology, pathophysiology, complications, diagnosis, and portosystemic decompression treatments(surgical and non surgical options, pro’s and con’s of the different methods) and outcome.

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.

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.

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.

Assessment and counselling of patients with HPB-diseases and their families.
Ability to adequately council 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.