WOFAPS 2025 8th World Congress of Pediatric Surgery

omar khamag, Thozama Siyotula

Division of Pediatric surgery, University of Cape Town (UCT); Red Cross War Memorial Children’s hospital

Background

Pediatric hepatobiliary pathologies demand specialized surgical expertise. While many

international centers perform hepatobiliary surgeries, few provide comprehensive

exposure for trainees. The Red Cross War Memorial Children’s Hospital serves as a leading

referral center in sub-Saharan Africa, offering a high surgical volume and intensive training

experience for registrars and international fellows.

Objective

To analyze the volume and diversity of hepatobiliary surgeries at Red Cross War Memorial

Children’s Hospital over five years, assess training exposure for registrars and fellows, and

compare this with international pediatric hepatobiliary centers.

Methods

A retrospective analysis of 261 pediatric hepatobiliary surgeries performed from January

2020 to December 2024 was conducted. Cases were categorized based on diagnosis,

surgical intervention, and trainee involvement. International comparisons were made using

data from European hepatobiliary centers.

Results

Annual surgical volume: 52.2 hepatobiliary surgeries per year.

• Registrar training exposure:

- Each senior registrar in the final two years of training participated in 31.32 surgeries

over two years (15.66 per year).

- This is three times the exposure reported in many European centers, where trainees

perform only 5–15 hepatobiliary procedures over their entire fellowship.

• International fellow training:

- One-year fellows participated in 26.1 surgeries annually, exceeding training volumes

in most comparable programs.

• Common surgical procedures included:

• Kasai portoenterostomy for biliary atresia (n=35)

• Hydatid cyst excision (n=40)

• Hepatectomy for hepatoblastoma (n=28)

• Choledochal malformation (n=25)

• Laparoscopic cholecystectomy for gallstones (n=20)

• Liver transplantation (n=21)

• Shunt surgeries (n=7)

• Miscellaneous (n=85)