The management of chronic pancreatitis remains challenging, and while advances in endoscopy, imaging, and surgery have improved outcomes, it is harsh testimony that a total pancreatectomy, the earliest operation performed for CP back in 1946, is still a treatment option for a benign disease that was identified on autopsy more than 200 years ago.

Today we are joined by Professor Ajith Siriwardena, head of HPB at Manchester University, Past President of the E-AHPBA and internationally recognised for his work in pancreatic surgery and chronic pancreatitis. We will discuss practical decision-making in chronic pancreatitis,  from medical therapy and pain management through to complex resections.

Guest Bio: 

Professor Ajith Siriwardena is a Professor of HPB Surgery at the University of Manchester and Consultant Hepatobiliary and General Surgeon at Manchester Royal Infirmary.

Following training in Manchester and Edinburgh, he undertook advanced liver surgery training in Paris, and subsequently worked in Scotland’s national liver surgery unit before taking up his consultant position in Manchester in 1999. He has built an extensive academic and clinical career in HPB oncology, with particular expertise in liver and pancreatic surgery and colorectal liver metastases, alongside a substantial body of research spanning liver and pancreatic disease.

He was appointed Professor of HPB Surgery at the University of Manchester in 2008 and was recognised with the Silver Scalpel award for surgical training in 2007. His career has also included significant contributions to surgical research, education and international HPB collaboration, and he currently serves as Past President of the E-AHPBA.

References:

During this episode we turn our focus to one of the more demanding aspects of pancreatic surgery: vascular reconstructions and intra-operative emergencies. These are moments that test not only technical ability, but judgement, preparation, and teamwork. Knowing when and how to perform vascular reconstruction - and how to respond when things don’t go to plan, can be the difference between success and catastrophe. We’re joined by the esteemed Professor Shailesh Shrikhande, former deputy director of Tata Memorial Hospital in Mumbai and past president of the APHPBA. 

Episode Breakdown:

00:00 Introduction to episode

05:28 Early influences: Heidelberg

15:59 Vascular reconstruction training

20:52 Navigating the complexities of arterial reconstructions

26:16 Managing vascular emergencies

34:03 Technical challenges in surgery

40:28 SMA first approach

49:48 Closing thoughts and remarks

Professor Shailesh Shrikhande is a globally recognised hepatopancreatobiliary (HPB) and gastrointestinal surgical oncologist based in Mumbai, India. He is Professor of Surgical Oncology, Head of the GI and HPB Surgical Service, and Deputy Director at the Tata Memorial Centre, and is the immediate past president of the APHPBA. Internationally renowned for his expertise in complex pancreatic and gastrointestinal cancer surgery, he has trained at the Universities of Heidelberg and Bern, was the first Asian recipient of the IHPBA Kenneth Warren Fellowship, and has authored hundreds of peer-reviewed publications while making significant contributions to global HPB education and training.

References:

HPB surgery is defined by complexity, high stakes, and constant pressure, it’s easy to measure success in numbers: cases performed, papers published, positions held. But what does a sustainable, fulfilling career in HPB surgery really look like over decades of practice?

Dr Malini Bhana and Dr Brian Kiplagat Misoi are joined for our very first episode by Professor Eduard Jonas, President of the E-AHPBA. As head of surgical HPB training at the University of Cape Town, South Africa, Professor Jonas is extremely well published, with a special interest in CRLM and HCC.

However, the reason Professor Jonas was chosen to open this series extends far beyond his academic and clinical accomplishments. Having had the privilege of training under him during their fellowship, Malini and Brian witnessed firsthand not only his exceptional expertise, but also his leadership, genuine kindness, and remarkable approachability. These qualities, more than any title or achievement, embody what true success looks like.

Chapters:

00:00    Introduction of hosts and guests

02:16    Career and journey of Professor Eduard Jonas

06:34    The role of mentorship

11:11    Legacy initiatives in HCC

21:05    HPB Training programmes and support

26:20    Defining a meaningful legacy

Articles Referenced:

Jonas E, Smith M, Kassianides C, Luyirika E, Wendy Spearman C. IHPBA White Paper - The improvement of management pathways and access to care in sub-Saharan Africa for patients with hepatocellular carcinoma. HPB (Oxford). 2025 May;27(5):585-590. doi: 10.1016/j.hpb.2025.02.007. Epub 2025 Feb 18. PMID: 40037975.