Report on Outreach Project to Sri Lanka, December 2015

The Joint Clinical Sessions – IHPBA and SLHPBA

11th – 13th December 2015.

College of Surgeons Auditorium, Colombo, Sri Lanka

The joint clinical sessions of the IHPBA and Sri Lanka Hepato-pancreato-biliary Association (SLHPBA), under the global outreach program of the IHPBA was held from the 11th to 13th December 2015 in Colombo.

This was the first such program to be held in Sri Lanka, initiated by the IHPBA, under the auspices of Prof P Jagannath, President of IHPBA.

The resource persons included Prof P Jagannath, Prof Shailesh Shrikande and Prof Chetan Kantharia from India, Prof Ajith Siriwardena, Ms Anya Adair and Mr S Jegatheeswaran from the UK and Dr Rohan Jeyarajah from the USA, and Prof Mohan de Silva from Sri Lanka.

The 3 day program covered many topics of importance to surgeons with an interest in HPB from Sri Lanka (attached). Twenty consultants from all parts of the country and 54 surgical trainees registered and attended the sessions.

Laparoscopic Skills Training Center

The faculty was able to visit the laparoscopic skills lab of the College of Sri Lanka, which was located at the same venue as the sessions and some were able to observe the training program which is conducted regularly for surgical trainees in Sri Lanka. The overseas faculty pledged to support this activity by providing equipment which was needed to improve the facilities.

Sri Lankan Chapter

During the sessions, the SLHPBA was officially recognized as an affiliated national chapter of the IHPBA. The SLHPBA which was formed in 2011 consists of 50 members (surgeons, gastroenterologists, pathologists and radiologists). However the minimum number of members with IHPBA membership to become a National Chapter was only fulfilled recently. We sincerely believe that this affiliation would benefit the surgical fraternity with an interest in HPB to further their skills and knowledge. Prof Jagannath offered two complimentary registrations for the IHPBA 2016 to SLHPBA members.

Course evaluation

The clinical sessions was an intensive program with interactive lecture discussions. Many doubts were clarified and the participants expressed their gratitude and satisfaction in the “course evaluation” which was completed by all. The participation of so many internationally acclaimed speakers was highly appreciated by all. Many had requested this program to be a regular event in the future.

Visit to an HPB unit

Three international speakers (Prof Ajith Siriwardana, Ms Anya Adair and Mr Jegatheeswaran) were able to visit the Colombo South Teaching Hospital to get a firsthand experience of the facilities available in Sri Lanka.

Needs of the SLPHBA

The needs of the SLHPBA were highlighted to the international speakers. There are no dedicated HPB surgical units in the country. A few surgeons (mostly those attached to University Surgical Units) who have had some training in HPB surgery, practice complex HPB surgery. The audits of the recognized units were presented at the meeting. Although the variety of cases was adequate, the numbers of each unit are relatively small (50 to 75 complex cases per year) compared to centres of excellence overseas.

Training of HPB Surgeons

The Sri Lankan postgraduate training in Surgery is supervised and conducted by the Post graduate Institute of Medicine (PGIM), of the University of Colombo. The PGIM recently introduced “General Surgery with a special interest in HPB” as a specialty training programme. This program is for those after the MD in Surgery (the exit exam in Sri Lanka). The trainees complete one year of general surgery in the capacity of a senior registrar and train in a “recognized unit” for another year in Sri Lanka, before proceeding to a centre overseas for further training – for one year. With the limited number of cases (and hence exposure) in Sri Lankan units in one year, we depend a lot on the exposure gained in overseas centers. However, up to now the trainees who have completed the local training have not been able to secure a suitable training post overseas in a HPB surgical unit overseas. This has been the major setback for HPB surgical training and hence the growth of the specialty in the country. Many speakers offered to help by training Sri Lankan surgical trainees in their units. It would be necessary to work out the logistics for this endeavor. The Sri Lankan government offers a stipend/ scholarship for one year which is sufficient for living expenses in the west. Therefore it is not mandatory for the trainees to be offered a paid job, but only exposure and preferably hands-on training.

Capacity building and research

The surgeons who practice HPB surgery in Sri Lanka too would benefit by visits to centres of excellence for short periods. This too we hope could be worked out with the help of the IHPBA. Another area which we could benefit is by getting involved in research projects. Since the numbers are small in the centres in Sri Lanka we could join with projects conducted elsewhere.

Database of HPB cases

The SLHPBA had initiated an online database 3 years ago which did not catch on. Only one HPB unit maintains a comprehensive database. We intend to work on this and provide our membership with a proforma either online or as hard copies – in order to improve on the maintenance of data across all HPB units

Future of HPB Surgery

The future of HPB surgery in Sri Lanka seems bright, with GI surgeons too, planning to include HPB surgery in the training program. There is a great enthusiasm among the junior surgeons to take up HPB surgery. If proper supervised training could be provided to these interested and capable individuals, the care of patients with HPB diseases would definitely improve.

 

Aloka Pathirana

President, SLHPBA

17th December 2015

 

At the skills lab:

Launch of the IHPBA Sri Lanka Chapter:

 

     

 

 

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