The current status of hepatobiliary and pancreatic surgical literature

A rapidly growing knowledge base has evolved describing recently developed diagnostic and therapeutic techniques in the management of hepatic-pancreatic-biliary (HPB) disease. As such, it is expected that the current literature should reflect these trends in the emerging specialty of HPB surgery.

The content of 10 leading surgical journals was assessed for the separate years 1998 and 2002 using a combination of hand searching and Medline searching using the Pubmed search engine. Data retrieved for each journal included: total number/type of publication, specialty category, disease focus and comment on surgical technique.

A total of 817 HPB articles were reviewed (386 in 1998,431 in 2002). Half of the journals showed an absolute increase in the number of HPB articles published; the largest increase was for Surgery (12%; 2002: 64/431; 1998: 10/386, p<0.0001), while the British Journal of Surgery displayed the greatest decrease (11%; 2002: 56/431; 1998: 94/386, p<0.0001). Publication by the nature of disease revealed that overall, there was a trend towards a greater volume of publications on malignant disease over the 4-year period (1998: 41%; 2002: 56%). Furthermore, 91% (10/11) of articles published by the Canadian Journal of Surgery related to benign disease; while almost all (97%) of the articles published by the Annals of Surgical Oncology were on malignant disease. There was a difference in the pathology focus for each sub-category of HPB topics. Fifty percent (150/302) of the articles on hepatic disease focused on malignancy, as compared with 46% (124/272) of those on pancreatic disease and 21% (44/213) of those on biliary disease. A comment on surgical technique was uniform across all categories (47% hepatic, 48% pancreatic and 44% biliary).

Articles dealing with HPB topics are published widely across all reviewed journals. Although the absolute number of HPB articles published increased over a 4-year period, there is significant variability in overall topics and focus of publication between journals. Overall, there was a uniform paucity of basic science articles, evidence-based reviews and/or meta-analyses, indicating an opportunity for growth in the future.