Key components of a hepatobiliary surgery curriculum for general surgery residents: results of the FULCRUM International Delphi consensus

Nikdokht Rashidian, Wouter Willaert, Isabelle Van Herzeele, Zenichi Morise, Adnan Alseidi, Roberto I. Troisi, Saleh Alabbad, Maria B. Doyle, Javier Briceño-Delgado, Fulvio Calise, Eugene P. Ceppa, Kuo Hsin Chen, Daniel Cherqui, Tan T. Cheung, Charles C.W. Lin, Sean Cleary, Choon H. David Kwon, Ismael Dominguez-Rosado, Alessandro Ferrero, Susanne G. WarnerGian L. Grazi, Chet Hammill, Ho Seong Han, Paul Hansen, Scott Helton, Osamu Itano, Ali Jafarian, Rohan Jeyarajah, Hironori Kaneko, Yutaro Kato, Shoji Kubo, Jun Li, Valerio Lucidi, Pietro Majno, Erin Maynard, Roberto Montalti, Silvio Nadalin, Hiroyuki Nitta, Yuichiro Otsuka, Fernando Rotellar, Benjamin Samstein, Olivier Soubrane, Atsushi Sugioka, Minoru Tanabe, Guido Torzilli, Aude Vanlander, Go Wakabayashi

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Background: In general surgery residency, hepatobiliary training varies significantly across the world. The aim of this study was to establish an international consensus among hepatobiliary surgeons on components of a hepatobiliary curriculum for general surgery residents. Methods: A three-round modified Delphi technique was employed. Fifty-two hepatobiliary surgeons involved in general surgery training programs were invited. An initial questionnaire was developed by a group of experts in hepatobiliary and educational research after a systematic literature review. It comprised 90 statements about knowledge, technical skills, attitudes, and postoperative care. Panelists could add or alter items. The survey was delivered electronically and the panel was instructed to score the items based on 5-point Likert scale. Consensus was reached when at least 80% of panelists agreed on a statement with Cronbach's alpha value >0.8. Results: Forty-one (79%) experts have participated. Sixteen panelists are based in Asia, 14 in Europe, and 11 in the Americas. Eighty percent of all proposed skills (81/101) were considered fundamental including knowledge (39/43), technical skills (16/32), attitude (15/15), and postoperative care (11/11). Conclusion: An international consensus was achieved on components of a hepatobiliary curriculum. Acquiring broad knowledge is fundamental during residency. Advanced liver resection techniques require specialized hepatobiliary training.

Original languageEnglish
Pages (from-to)1429-1441
Number of pages13
Issue number10
Publication statusPublished - 10-2020

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology


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