Hepato-pancreato-biliary and Transplant Surgery Clinical Outcome

SGH reaches major milestone performing its 1000th minimally-invasive liver resection in early 2023. SGH is one of only a few institutions globally to reach this milestone. Case was an elderly patient with a giant 14-cm liver cancer who underwent laparoscopic right hepatectomy.

Multiple research studies have demonstrated that major HPB surgeries are best performed in specialized tertiary centers performing a high volume of cases for the best outcomes. High-volume centers are those performing over 35 pancreatoduodenectomies/ Whipples procedure per annum and over 20 minimally-invasive pancreatoduodenectomies per annum [15-16].

The department is presently one of the highest-volume and most experienced subspecialty departments in Southeast Asia currently performing about 400 major subspecialty HPB surgeries per annum (including > 200 major liver surgeries and > 100 major pancreatic surgeries per annum). As of 2022, it has performed over 4000 major liver surgeries and close to 2000 major pancreatic surgeries since the year 2000.

All patients undergoing major surgeries are cared for at Singapore General Hospital which is well-recognized globally for its high quality of care as evidenced by it being consistently ranked amongst the top hospitals in the world and top hospital in Asia according to the prestigious Newsweek annual rankings.

Enquiring patients and referring physicians, please email: hpbsurgery@sgh.com.sg
Information regarding diagnosis/condition and treatment/surgery required would be useful.

Department statistics:

A) Breakdown of Major Surgeries performed in HPB and Transplant Surgery Department in 2022

B) Laparoscopic cholecystectomies Performed in 2022

C) Evolution of MIS liver resections in SGH:
2006 – 2022 (967 cases)
244 major resections, 42 robotic

D) Evolution of MIS Pancreatic Surgery in SGH
2006-2022 (366 cases)
91 robotic (24.8%)

E) Evolution of major robotic HPB surgery at SGH
2013- 2022 (173 cases)
 

References

1. Goh BK, Lee SY, Teo JY, Kam JH, Cheow PC, Prema Raj J, Chow PK, Ooi LL, Chung AY, Chan CY. Changing trends associated with the adoption of minimally invasive hepatectomies: single institution experience with 400 cases. Surg Endosc 2018;32:4658-65 
2. Goh BK, Lee SY, Koh YX, Kam JH, Chan CY. Minimally-invasive major hepatectomies: a Southeast Asian single institution experience with its first 120 consecutive cases. ANZ J Surg 2020;90:553-57
3. Goh BK, Low TY, Teo JY, Lee SY, Chan CY, Chow PK, Chung AY, Ooi LL. Adoption of robotic liver, pancreatic and biliary surgery in Singapore: single institution experience with its first 100 consecutive cases. Ann Acad Med Singapore 2020;49:742-48.
4. Goh BK, Wang Z, Koh YX, Lim KI. Adoption of laparoscopic liver resection in Singapore: analysis of 300 cases. Ann Acad Med Singapore 20221;50:742
5. Chin KM, Linn YL, Cheong CK, Koh YX, Teo JY, Chung AY, Chan CY, Goh BK. Minimally-invasive vs open major hepatectomies for liver malignancies: a propensity-score matched analysis. J Gastrointestin Surg 2022;26:1041-53. 
6. Goh BK, Low TY, Koh YX, Lee SY, Teo JY, Kam JH, Jeyaraj PR, Cheow PC, Chow PK, Ooi LL, Chung AY, Chan CY. Changing trends and outcomes associated with the adoption of minimally invasive pancreatic surgeries: a single institution experience with 150 consecutive procedures in Southeast Asia. J Minim Access Surg 2020;16:404-10
7. Raghupathy J, Lee CY, Huan S, Koh YX, Tan EK, Teo JY, Cheow PC, Ooi LL, Chung AY, Chan CY, Goh BK. Propensity-score matched analysis comparing clinical outcomes of minimally-invasive vs open distal pancreatectomies: a single-centre experience. World J Surg 2022;46:207-214.
8. Liu R, Zeh H, Wakabayashi G, Palanivelu C, Boggi U, Tsung A. Yang K, Coratti A, Goh BK, et al. International consensus statement on robotic pancreatic surgery in 2018. Hepatobiliary Surg Nutr 2019;8:345-60
9. Nagakawa Y, Nakata K, Nishino H, Ohtsuka O, Ban D, Asbun HJ, Boggi U, He Jin, Kendrick ML, Palanivelu C, Liu R, Wang SE, Tang CN, Takaori K, Hilal MA, Goh BK, Honda G, Jang JY, Kang CM, Kooby DA, Nakamura Y, Shrikhande SV, Wolfgang CL, Yiengpruksawan A, Yoon YS, Watanabe Y,  Kozono S, Ciria R, Berardi G, Garbarino GM, Higuichi R, Ikenaga N, Ishikawa Y, Maekawa A, Murase Y, Zimmitti G, Kunzler F, Wang ZZ, Sakuma L, Osakabe H, Takishita C, Endo I, Tanaka M, Yamaue H, Tanabe M, Wakabayashi G, Tsuchida A, Nakamura M. International expert consensus on precision anatomy for minimally invasive  pancreaticoduodenectomy: PAM-HBP Surgery Project. J Hepatobiliary Pancreat Sci 2022;29:124-35
10. Ban D, Nishino H, Ohtsuka T, Nagakawa Y, Nakata K, , , Asbun HJ, Boggi U, He Jin, Kendrick ML, Palanivelu C, Liu R, Wang SE, Tang CN, Takaori K, Hilal MA, Goh BK, Honda G, Jang JY, Kang CM, Kooby DA, Nakamura Y, Shrikhande SV, Wolfgang CL, Yiengpruksawan A, Yoon YS, Watanabe Y,  Kozono S, Ciria R, Berardi G, Garbarino GM, Higuichi R, Ikenaga N, Ishikawa Y, Maekawa A, Murase Y, Zimmitti G, Kunzler F, Wang ZZ, Sakuma L, Osakabe H, Takishita C, Endo I, Tanaka M, Yamaue H, Tanabe M, Wakabayashi G, Tsuchida A, Nakamura M. International expert consensus on precision anatomy for minimally invasive  distal pancreatectomy: PAM-HBP Surgery Project. J Hepatobiliary Pancreat Sci 2022;29:161-73
11. Troisi RI, Berardi G, Morise Z, Cipriani F, Ariisumi S, Sposito C, Panetta V, Simonella I, Kim S, Goh BK, Kuno S, Tanaka S, Takeda Y, Ettorre GM, Russillilo N, Wilson GC, Cimino M, Montalti R, Giglio M, Igarashi K, Chan CY, Torzilli G, Cheung TT, Mazzaferro V, Kaneko H, Ferrero A, Geller DA, Han HS, Kanazawa A, Wakabayashi G, Aldrighetti L, Yamamoto. Br J Surg 2021;108(2):196-204.
12. Chong CC, Fuks D, Lee KF, Zhao JJ, Choi GH, Sucandy I, Chiow AK, Marino MV, Gastaca M, Wang X, Lee JH, Efanov M, Kingham TP, D’Hondt M, Troisi RI, Choi SH, Sutcliffe RP, Chan CY, Lai EC, Park JO, Di Benedetto F, Rotellar F, Sugioka A, Coelho FF, Ferrero A, Long TC, Lim C, Scatton O, Liu Q, Schmelzle M, Pratschke J, Cheung TT, Liu R, Han HS, Tang CN, Goh BK. Propensity-score matched analysis comparing robotic and laparoscopic right and extended right hepatectomy: an international multicenter study of 989 cases. JAMA Surgery 2022;157:436-444. 
13. Goh BK, Han HS, Chen KH, et al. International robotic and laparoscopic liver resection study group investigators. Defining global benchmarks for laparoscopic liver resections: an international multicenter study. Ann Surg 2022 in press
14. Chan KS, Srinivasan N, Koh YX, Tan EK, Teo JY, Lee SY, Cheow PC, Jeyaraj PR, Chow PK, Ooi LL, Chan CY, Chung AY, Goh BK. Comparison between long and short-term venous patencies after pancreatoduodenectomy or total pancreatectomy with portal/superior mesenteric vein resections stratified by reconstruction type. PLOS 2020;15:e0240737
15. Panni RZ, Panni U, Liu J, et al. Redefining a high volume center for pancreaticoduodenectomy. HPB;23:733-8.
16. Asbun HJ, et al. The Miami International Evidence-based guidelines on minimally invasive pancreas resection. Ann Surg 2020;271:1-14.