{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:34:51Z","timestamp":1782995691622,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Uganda has until recently mostly referred patients for complex hepato\u2010pancreato\u2010biliary (HPB) surgery abroad due to lack of local expertize. We report indications and a spectrum of surgeries performed in the first 4\u00a0years following the establishment of a routine HPB service at Lubaga Hospital (LH), Kampala, Uganda. We also detailed the challenges encountered in setting up this service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic, clinical parameters, surgery indications, procedures performed, and outcomes of consecutive patients that underwent HPB surgeries at LH from December 2018 to October 2022 were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Majority were females 72 (57.6%) with a median age of 50 (6\u201388) years. Forty\u2010one (32.8%) underwent surgery on the pancreas (PS), 34 (27.2%) on the liver (LS), and 50 (40.0%) on the bile ducts (CBS). The most common symptom was abdominal pain. Benign disease was present in 37 patients (29.6%) while 88 (70.4%) had malignancy. A total of 34 patients (27.2%) had unresectable pancreatic head cancer and distal cholangiocarcinoma missed at preoperative imaging and discovered intraoperatively thus underwent palliative hepaticojejunostomy. Only 34 (27.2%) patients received postoperative ICU care. In\u2010hospital mortality for this heterogenous group of patients was 6 (4.8%) for PS, 3 (2.4%) for LS, and 8 (6.4%) for CBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite many challenges like limited access to ERCP accessories, lack of endoscopic ultrasound scans and PET\u2013CT scans in the whole country, late presentation, and low quality imaging especially in preoperative determination of resectability of hepato\u2010pancreato\u2010biliary cancers, we managed to establish a functional HPB service. Patient results achieved were good in spite of these limitations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12097","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T12:38:18Z","timestamp":1707309498000},"page":"924-931","source":"Crossref","is-referenced-by-count":4,"title":["Advancing complex hepato\u2010pancreato\u2010biliary surgery in Uganda: Challenges and outcomes"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6192-036X","authenticated-orcid":false,"given":"Okello","family":"Michael","sequence":"first","affiliation":[{"name":"Department of Anatomy Makerere University College of Health Sciences  Kampala Uganda"},{"name":"Society of Uganda Gastrointestinal and Endoscopic Surgeons (SUGES)  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Darshit","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiconco","family":"Mary","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umar","family":"Mutekoba","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mugabi","family":"Timothy","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baseka Xavier","family":"Francis","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kakaire","family":"Denis","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyomugisha","family":"Edward","sequence":"additional","affiliation":[{"name":"Department of Surgery Lubaga Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okuku Fred","family":"Machyo","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ddungu","family":"Henry","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buwembo","family":"William","sequence":"additional","affiliation":[{"name":"Department of Anatomy Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ocama","family":"Ponsiano","sequence":"additional","affiliation":[{"name":"Department of Medicine Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29086"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000449339"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl19024"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010010\u20100275\u20103"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25345"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005340070047"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097\u20100142(19980401)82:7<1244::aid\u2010cncr6>3.0.co;2\u2010f"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2009.3.4.298"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijso.2018.10.002"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v9.i13.635"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw324"},{"issue":"5","key":"e_1_2_12_13_1","first-page":"S37","article-title":"Accomplishments in 2008 in the Management of Localized Pancreatic Cancer","volume":"3","author":"O\u2019Reilly E. 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