普通外科住院医师培训中的肝胆胰外科培训：对现实世界来说足够吗？
Hepato-pancreato-biliary training in general surgery residency: is it enough for the real world?
作者信息
Chang Yeon-Jeen, Mittal Vijay K
机构信息
Department of Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, USA.
出版信息
Am J Surg. 2009 Mar;197(3):291-5. doi: 10.1016/j.amjsurg.2008.10.005.
BACKGROUND
Advanced training in hepato-pancreato-biliary (HPB) surgery is available at select centers. No approved fellowships have yet been established.
OBJECTIVE
To determine the level of training in HPB surgery during general surgery residency and to assess the need for additional training.
METHOD
All general surgical residency programs in the United States were surveyed. Resident Review Committee (RRC) and International Hepato-Pancreato-Biliary Association (IHPBA) requirements were compared to Accreditation Council of Graduate Medical Education (ACGME) data.
RESULTS
Eighty of 250 general surgical residency programs (32%) responded to the survey. Eighty percent felt their graduating residents had sufficient HPB training. The average number of pancreatic cases per graduating resident was 10.2 +/- 7.3. The average number of hepatic resections was 8.6 +/- 5.1, and for complex biliary cases, 5.3 +/- 1.3.
CONCLUSIONS
A significant portion of HPB surgery is performed at transplant centers or by HPB surgeons. Guidelines must be established to assure adequate training. When HPB surgery is the main focus of the future practice, residents should seek additional training.
背景
部分中心提供肝胰胆（HPB）手术的高级培训，但尚未设立经批准的进修项目。
目的
确定普通外科住院医师培训期间HPB手术的培训水平，并评估额外培训的需求。
方法
对美国所有普通外科住院医师培训项目进行了调查。将住院医师评审委员会（RRC）和国际肝胰胆协会（IHPBA）的要求与毕业后医学教育认证委员会（ACGME）的数据进行了比较。
结果
250个普通外科住院医师培训项目中有80个（32%）回复了调查。80%的人认为他们即将毕业的住院医师接受了足够的HPB培训。每位即将毕业的住院医师的胰腺手术平均例数为10.2±7.3。肝切除术的平均例数为8.6±5.1，复杂胆道手术的平均例数为5.3±1.3。
结论
HPB手术的很大一部分是在移植中心或由HPB外科医生进行的。必须制定指南以确保充分的培训。当HPB手术成为未来实践的主要重点时，住院医师应寻求额外的培训。
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