Background : Exposure to various complex Hepato-Pancreato-Biliary (HPB) cases during fellowship in Severance Hospital in Korea improved my skills and knowledge in liver and pancreatic surgeries. As such, it may be interesting to note that a trend towards improvement in surgical technique and outcomes were seen before and after my homecoming.

Methods : Medical record of patients who underwent liver resection between 2018 and 2021 where retrospectively reviewed. The surgical outcomes of patients who were operated from 2018-2019 (before my training) and 2020-2021 (after training) were compared.

Results : Among 31 patients, 14 (45%) were operated between 2018-2019 while 17 (55%) between 2020-2021). There were more complex cases that were performed between 2020-2021 compared to 2018-2019, 12 (70%) vs 3 (21.4%), p = 0.025 respectively. Although, blood loss and operative time were significantly higher in 2020-2021 (337.1 ± 194 ml vs 589.9 ± 263 ml, p = 0.039; and 202.1 ± 85.5 mins vs 393.5 ± 134 mins, p = 0.005, respectively), there was no significant different for the surgical complications, p = 0.078. There was, no reported mortality in 2020-2021 compared to 2018-2019 were one died due to post-operative bleeding.

Conclusions : A trend towards improvement in surgical technique from a simple to a more complex procedure was observed in our institution after fellowship training Despite this, surgical outcome remains acceptable.