27 JULAI 2022 LAYOUT IOES CENSUS REPORT PDF

VATS
GENERAL SURGERYNo. Hospitals
INPATIENT, OUTPATI2E0N1T7, ENDO20S1C8OPY A20N1D9 Mean No. of No. of
SURGPErRoYce(dIuOrEeSs) Thoracic
CENSUS REPORT 2016 - 2019 Surgeon

1 Hospital Kuala Lumpur 44 87 107 79 1

2 HTAR Klang 29 43 23 32 THORACIC
SURGEON
3 HSAH Sungai Petani 16 0 2 6
1
4 Hospital Melaka 050 2 2
5 Hospital TaipViAngTS 113 2 2
2
6 HRPZ Kota Bahru 031 1 2
NMU1MEABNER 3
7 HSNZ KNuOala TerenggHaOnuSPITALS 1 2017 1 2018 12019
179 1
8 Hospital L12 angHHkoTAaspwRitKialal Knugala Lumpur 2 44 0 87 1 107 1362
9 HSB Alor3 SetHaSrAH Sungai Petani 2 29 43 23 12 2
16 0 0 0 2 012 1
01
10 HTJ Sere45mbaHHnoossppiittaall Melaka 2 0 0 5 00 011
11 Taiping 1 1 3 010
HSA Joho6r BHaRhPrZuKota Bahru 0 0 0 3 1 1 1206

12 Hospital S78 elaHHySoaNsnpZgitKaulaLalanTgekraewngi ganu 0 11 1 01 0
13 HoSHAS9TemHSeBrlAolhor Setar 0 2 0 1 0
2 1 0 0 0

14 Hospital 11S10ibuHHTSJASJeorheomrbBaanhru 0 2 1 0 0 0
TOTAL12 Hospital Selayang 0 0 1
97 0 143 1 139 0

13 HoSHAS Temerloh Table 7.6-5 : VATS b0y Hospital C1ategory 0
14 Hospital Sibu
010

TOTAL 97 143 139 126

7.6.2 Non-Trauma Thoracotomy Table 7.6.5 : VATS by Hospital Category

a) Total7.6.2 Non-Trauma Thoracotomy

a. Total

Non-Trauma Thoracotomy

180
160 155

140

No. of Porcedures 120 94

100
80

80

60

40

20

0 2018 2019
2017

Figure 7.6-7 : Total Number of Non-Trauma Thoracotomy
Figure 7.6.7 : Total Number of Non-Trauma Thoracotomy

General Surgery Services Ministry of Health Malaysia 151

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report163

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report163

b) By BMc.SBCyaBteMgoSryHospital Category
b) By BMS Category

Non-Trauma Thoracotomy
160 147 Non-Trauma Thoracotomy
147
140 160
No. of Procedures
No. of Procedures120 140
120 89
100 67100 89
80 67
80
60 60
40 40
20 20 12 4 124 4 4 1 1 1 4 1 4

00 Big Big Medium Medium Small Small

Hospital CHaotespgiotarlyCategory

2017 20128017 20210918 2019
FiguFriegu7re.67.8.6-:8NF:oiNgnuo-rnTe-rT7a.ru6a-mu8m:aaNToThnho-oTrrraaaccuomotaotomTmhyoybraybcBoytMoBmSMyCbSaytCeBgaMotSreyCgaotergyory

c) By BMb.ScB)HyoBBsypMBitSMalSCCHaatotesegpgoitraoylrCyategory

Non-trauma Thoracotomy
Non-trauma T(2h0o1r7ac- o2t0o1m9)y
(201M7ean- T2o0ta1l P9r)ocedures : 110
Mean no. of Procedures 90 80 90 80 2No. of Thoracic Surgeon
Mean no. of Procedures80 80 Mean Total PTrooctaeldBu&reEs :S1u1rg0eon : 1 2 No. of Thoracic Surgeon
70 70 Total B&E Surgeon : 1
60 60 1
50
40

50 30 9 3 3 2 2 2 1 1 1 1 1 1 1 1 0 0 1
40 20 00
30 10

20 9 0 0
10 3
3 2 2 2 1 1 1 1 1 1 1 1 0 0 0 0

00

Thoracic Surgeon
Figure F7i.g6u.9re:7N.6o-9n:-TNTrhoanou-rTamrcaiacumSTauhrToghreoaorncacoottoommyybybByMBSMHSosHpoitaslpCitaatelgCoraytegory
Figure 7.6-9 : Non-Trauma Thoracotomy by BMS Hospital Category

152 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

NON-TRAUMA THORACOTOMY

HOSPITAL CATEGORY 2017 2018 2019
Big 67 89 147
Medium 12 4
4
Small 11
4
TOTAL 80 94
155

Table 7.6.6 : Non-Trauma Thoracotomy by BMS Category

NON-TRAUMA THORACOTOMY

NO HOSPITALS 2017 2018 2019 MEAN THORACIC
SURGEON
1 Hospital Kuala Lumpur 40 74 126 NUMBER
2 HRPZ Kota Bahru 13 6 8 80 1
9
3 HSNZ Kuala Terengganu 7 2 0 2
4 HSB Alor Setar 3 2 3 3 2
5 HSAH Sungai Petani 5 1 1 3 2
6 HTAR Klang 2 2 1 2
7 Hospital Taiping 3 1 1 2 2
8 HRPB Ipoh 0 0 4 2
9 Hospital Selayang 2 2 0 1 3
10 Hospital Pulau Pinang 0 0 3 1
11 HSNI Batu Pahat 3 0 0 1 2
12 Institut Kanser Negara 1 1 1 1 3
13 HTJ Seremban 0 1 1 1 3
14 Hospital Tawau 0 0 2 1
15 Hospital DoK Sandakan 0 0 2 1 4
16 HSA Johor Bahru 0 0 1 1 1
0
17 Hospital Kajang 1 0 0
18 Hospital Queen Elizabeth 2 0 1 0 0
19 Hospital Sibu 0 1 0 0
0
TOTAL 80 94 155
110

Table 7.6.7 : Non-Trauma Thoracotomy by Hospital Category

General Surgery Services Ministry of Health Malaysia 153

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

General Surgery: InCpaEtNieSnUt,SORuEtPpaOtiReTnt2, 0E1n6do- 2sc0o1p9y, Surgery (IOES) Census Report165

7.7 Upper Gastrointestinal

List o7f p.r7oceUdupreps eserleGctead fsotrrUopipnetreGsasttirnoiantlestinal (UGI) workload measurement are:

i. OOeessooLppishhtaaogofgepoarcsotacrreedcditooummreysytsoemleyct(eHdeflolerrU’ps pPeror cGeadsutrroei)ntestinal (UGI) workload measurement are:
ii.

iii. TILvraoaprnasLiiirii.ho.i e. iswacOTOtoiarsaeepl/nssiOMcooshepp/cishhaTKoaathpaeogohlogeOrawoaageccsnetsoarcoOesrtpdccoehoitmsooapommygipcyeyhtacaostgmoseimycstty(eoHdmeOlyleers’soPprhoacgeedcutorem) y
iv.
v.

vi. Fundiovp. liIcvaotrioLenwis/ McKeown Oesophagectomy
vii. Undevr.u nLnainpgaroofscbolepeicdi/nTghuolrcaecroscopic assisted Oesophagectomy
viii. PGUv/i.P DFuUndSoipmlipclaetiOonmentum Patch Closure (Open)
ix. PGUv/iiP. DUnUdeSriumnpnlinegOomf belneteudminPgautclcheCr losure (Laparoscopic)

x. PGUv/iiPi. DPGUUP/aPrDtiUalSGimapstlereOctmomenytum Patch Closure (Open)

xi. Gastrixe.c toPmGUy / PDU Simple Omentum Patch Closure (Laparoscopic)

x. PGU / PDU Partial Gastrectomy

xi. Gastrectomy

a) Totala. Total

Upper GI Surgery

2000 1734 1630 1689
1800
No. of Procedures 1600
1400
1200
1000
800
600
400
200

0

2017 2018 2019

Figure 7.7-1 : Total Number of Upper GI Surgery
Figure 7.7.1 : Total Number of Upper GI Surgery

154 General Surgery Services Ministry of Health Malaysia

Mean No. of Procedures c) By BMc.ScB)HyBoByspBMiMtSaSl HHCooastspeipgtaoiltrCayalteCgoarytegory b) By BMb.SBCyatBeMgoSryCategory

0 250 General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report166

Centers withHospital Sungai Buloh 250 200 GENERAL SURGERY
Upper GIHospital Umum Sarawak
Surgeon
  200 150 INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
HSA Johor Bahru CENSUS REPORT 2016 - 2019
Centers withHospital Queen Elizabeth 100
Upper GI General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report166
Surgeon
 Hospital Pulau Pinang 150

50

100

0

50
Mean No. of Procedures No. of Procedures Upper GI Surgery
HRPB IHpooshpital Sungai Buloh No. of Upper GI Surgeon 0 200 100 300 200 300 600400 700 600 900
HSB AloHr oSseptiatarl Umum Sarawak No. of Procedures 500 800 b) By BMS Category
700
HTARHKoslapintaglHQSuAeeJonhEolrizBaabhertuh
Figure 7.7-3 : Upper GI Surgery by BMS Hospital Category HRPZ Kota BaHhorsupital Pulau Pinang 100 Big 500 900 790 785 812 790 785 812
400 800
Hospital Sibu 0

Hospital Selayang HRPB Ipoh 2017 2018 2019
HoHsSpiAtaHl SSeubnegraaingPeJtaaynHaiRHPSZHBTKAAoltRoarKBSaleahtnragur
2017 2018 2019
Hospital Miri Hospital Sibu
Centers with General Surgeons FFigiguurree 77..F77i-g.22ur:e: U7U.7pp-p2pe:erUrGpGpIeSIr uSGruIgSregurreygerbryyybbByyMBMBSSMCCaSatteCeggaoorrtyey gory
Upper GI Surgeon Hospital TaipingHospital Selayang Big
Figure 7.7-3 : Upper GI Surgery by BMS Hospital Category HHTTAJASeKreumaHnboHtsaaSpnniAtaHl SSHeuobnsegpraaitinagPl eMJtaaiynraii
Figure 7.7.3 : Upper GI Surgery by BMS Hospital Category Hospital Tawau Hospital Taiping

Centers with General Surgeons Hospital Bintulu HTAA Kuantan Upper GI Surgery Upp7e2r4G6I7S5ur6g9e1ry
Upper GI SurgeonHospital DoK Sandakan HTJ Seremban
Hospital Tawau Upper(2G01I7 S- 2u0r1g9e)ry
HSI Johor Bahru Hospital Bintulu M(T2eoat0nal1TUo7ptapl-ePr2rGo0IceS1duu9rrge)eso:n16: 864 Medium
Hospital MCeadtieumgory
Hospital MHeolaspkiatal DoK Sandakan Mean Total Procedures :1684
Total Upper GI Surgeon : 6
General Surgery Services Ministry of Health Malaysia 155 HSNZ Kuala TerengganuHSI Johor Bahru Hospital Category 724 675 691

HoSHAS Temerloh Hospital Melaka
HospitaHlSKNuIaBlaaLtuHuHmPSNoapshZupHairKtotaSulaHKlaAuTaSleaTreeLnmugmegraplonuhur

Hospital Teluk IntanHSNI Batu Pahat

Hospital KajaHnogspital Teluk Intan
HospHitaTlFAKmapnagnagrHHosopsHiptiaTtlaFAl KKmaapnjaagnnaggr
HEBHK Kluang HEBHK Kluang

Hospital Sarikei Hospital Sarikei
Hospital SegamatHospital Segamat
HPSF Muar 220 170 186
HPSF MuHaorspital Kuala Pilah
220 170 186
Hospital Kuala PilahHospital Serdang
Small
Hospital Serdang Hospital Kulim
Small
Hospital KuliHmospital Shah Alam
HHosopsiptiatlaSl KhaehnAinHlgoaHasmopHusiotpasiltpaSilteaLrliaKMheaandniDnjuganatguu
Hospital Seri Manjung HSIP Kuala Krai

Hospital Lahad DatHuospital Langkawi
HoHsSpiItPalKLuHaanolsagpkKiHtaaorwlasQHpiiiuoteaselpnTitaaEnllaPizhuatMbraeejtahray2ha

Hospital Tanah MerHaohspital Kuala Lipis

Hospital Putrajaya Hospital Kapit
Hospital Queen Elizabeth 2 Hospital Labuan

Hospital Kuala LHipoHisspoistaplitPaol rKt eDmicakmsoann
Hospital KInasptiittut Kanser Negara

Hospital LabuanHospital Banting

Hospital Kemaman 3

Hospital Port Dickson 23

Institut Kanser Negara 22

Hospital Banting 1

2

1

1

0

1

0

No. of Upper GI Surgeon

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report167

dd.) TTyyppeess ooffUUpppepreGrIGPrIoPcreoducreesdures

Types of Upper GI Surgery

2000
 

1800
  1734
  1689
 
1600
 
1630
 

1400
 

No.
 of
 Procedure
  1200
 

1000
 

800
 

600
 

400
 

200
 

0
  2018
  2019
 
2017
 

PGU
 /
 PDU
 Simple
 Closure
 Omentum
 Patch
 -­‐
 Open
  Gastrectomy
 -­‐
 Total
 /
 ParHal
 -­‐
 Open
 

Underunning
 of
 Bleeding
 ulcer
 (Duodenum/Gastric)
  Laparoscopic
 FundoplicaHon
 

PGU
 /
 PDU
 Simple
 Closure
 Omentum
 Patch
 -­‐
 Laparoscopic
  Esophagectomy
 (Ivor
 Lewis/
 McKeown/
 Open)
 

Esophagocardiomyotomy
  PGU/PDU
 ParHal
 Gastrectomy
 
 

Laparoscopic
 /
 Thoracoscopic
 assisted
 Esophagectomy
  Gastrectomy
 -­‐
 Total
 /
 ParHal
 -­‐
 Laparoscopic
 

Esophagogastrectomy
  Open
 FundoplicaHon
 

Transhiatal
 Esophagectomy
  Total
 Procedures
 

Figure 7.7-4 :Types of Upper GI Surgery
Figure 7.7.4 :Types of Upper GI Surgery

156 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

UPPER GI SURGERY

HOSPITAL CATEGORY 2017 2018 2019
Big 790 785 812
Medium 724 675 691

Small 220 170 186

TOTAL 1734 1630 1689

Table 7.7.1 : Upper GI Surgery by BMS Category

UPPER GASTROINTESTINAL SURGERY

PROCEDURE TYPE 2017 (%) 2018 (%) 2019 (%)
62% 957 57%
PGU / PDU Simple Closure Omentum 990 57% 1004 15% 268 16%
Patch - Open 9% 177 10%
4% 45 3%
Gastrectomy - Total / Partial - Open 343 20% 250 3% 60 4%

Underunning of Bleeding ulcer 171 10% 140 2% 54 3%
(Duodenum/Gastric) 2% 32 2%
0% 70 4%
Laparoscopic Fundoplication 63 4% 72 1% 13 1%

PGU / PDU Simple Closure Omentum 46 3% 46 1% 4 0%
Patch - Laparoscopic 1% 5 0%
1% 0 0%
Esophagectomy (Ivor Lewis/ 46 3% 31 4 0% 53%
McKeown/ Open) 100% 1689 100%

Esophagocardiomyotomy 16 1% 28

PGU/PDU Partial Gastrectomy 0 0% 1
13 1% 21
Laparoscopic / Thoracoscopic
assisted Esophagectomy 16 1% 15

Gastrectomy - Total / Partial -
Laparoscopic

Esophagogastrectomy 14 1% 10

Open Fundoplication 9 1% 9
Transhiatal Esophagectomy 0% 3 0%

TOTAL 1734 100% 1630

Table 7.7.2 : Types of Upper GI Surgery

General Surgery Services Ministry of Health Malaysia 157

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

UPPER GASTROINTESTINAL SURGERY

NO HOSPITALS 2017 2018 2019 MEAN NO. OF NO. OF UGI

1 Hospital Sungai Buloh 193 191 195 PROCEDURES SURGEON
2 Hospital Umum Sarawak 88 129 95 193 2
104 1
3 HSA Johor Bahru 72 101 111
4 Hospital Queen Elizabeth 86 80 112 95 1
5 HRPB Ipoh 66 34 87 93 1
6 HSB Alor Setar 85 56 45 62
7 HTAR Klang 52 60 71 62 1
8 HRPZ Kota Bahru 58 70 37 61 2
9 Hospital Sibu 62 61 38 55 2
10 Hospital Pulau Pinang 83 33 38 54 3
11 Hospital Selayang 43 64 41 51 1
12 HSAH Sungai Petani 37 44 59 49
13 Hospital Seberang Jaya 45 54 41 47 3
14 Hospital Miri 61 29 48 47 2299
15 Hospital Taiping 47 41 46 46
16 HTAA Kuantan 32 37 55 45 1
41
17 HTJ Seremban 42 49 28 2055
18 Hospital Tawau 37 40 40 40 1
19 Hospital Bintulu 41 33 32 39
20 Hospital DoK Sandakan 48 23 35 35 1931
21 HSI Johor Bahru 37 21 37 35 1884
22 Hospital Melaka 25 26 42 32 1877
23 HSNZ Kuala Terengganu 25 25 29 31 1861
24 HoSHAS Temerloh 24 28 27 26 1716
25 Hospital Kuala Lumpur 33 21 21 26 1707
26 HSNI Batu Pahat 32 22 20 25 1640
27 Hospital Teluk Intan 18 22 22 25 1589
28 Hospital Kajang 18 22 19 21 1430
29 Hospital Ampang 16 21 20 20 1300
30 HTF Kangar 19 15 22 19 2299
19 2157
31 HEBHK Kluang 19 17 14
32 Hospital Sarikei 12 19 14 17 2055
33 Hospital Segamat 16 9 19 15 1967
34 HPSF Muar 14 16 11 15 1931
35 Hospital Kuala Pilah 13 11 11 14 1884
36 Hospital Serdang 18 8 8 12 1877
37 Hospital Kulim 19 7 8 11 1861
38 Hospital Shah Alam 13 8 11 11 1716
39 Hospital Keningau 12 8 10 11 1707
40 Hospital Seri Manjung 11 4 13 10 1640
41 Hospital Lahad Datu 4 12 12 9 1589
42 HSIP Kuala Krai 10 9 7 9 1430
43 Hospital Langkawi 8 8 8 9 1300
44 Hospital Tanah Merah 10 8 5 8 2299
8 2157
45 Hospital Putrajaya 4 7 10
46 Hospital Queen Elizabeth 2 10 5 3 7 2055
47 Hospital Kuala Lipis 10 5 3 6 1967
48 Hospital Kapit 2 7 1 6 1931
49 Hospital Labuan 2 3 3 3 1884
50 Hospital Kemaman 0 2 5 3 1877
51 Hospital Port Dickson 1 4 0 2 1861
52 Institut Kanser Negara 1 1 0 2 1716
53 Hospital Banting 0 0 0 1 1707
0 1640
TOTAL 1734 1630 1689
1684 6

Table 7.7.3 : Upper GI Surgery by Hospital Category

158 General Surgery Services Ministry of Health Malaysia

Institut Kanser Negara

53 Hospital Banting 000 0

1630 1684 6
TOTAL GENERAL SURGERY1734 1689

Table 7.7-3 : Upper GI Surgery by Hospital Category

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

7.7.1 Heller’s Cardiomyotomy
7.7.1 Heller’s Cardiomyotomy

a) Totala. Total

Heller's Cardiomyotomy

35 32
30 28

No. of Procedures 25

20 16
15

10

5

0 2018 2019
2017

General SurgerFyig:FuIirngeupr7ae.7t7i..5e7-n:5tT:,oTOtaotulaNltpNuamumtibbeeenrrtoo,ffEHHneelldleleor’rss’scCoCapradyrid,omiSoyumortyogometyorym(yIOES) Census Report171

b) By BMb.SBCyaBteMgoSryCategory

Heller's Cardiomyotomy

18 16 16
14
No. of Procedures 16 14
5
14 11
12 Medium
Hospital Category
10

8

6

4

2 000
Small
0

Big

2017 2018 2019
Figure 7.7-6 : Heller’s Cardiomyotomy by BMS Category
Figure 7.7.6 : Heller’s Cardiomyotomy by BMS Category

c) By BMS Hospital Category

12 11 Heller's Cardiomyotomy Ministry of Health Malaysia 3
10 (2017 - 2019)
edure 159
Mean Total Procedures : 25 2
TotalGUepnpeerralGSIuSrguergryeoSner:v6ices

geon

0 Medium Small
Big

GENERAL SURGERYHospital Category

INPATIENT, OUTPATIENT, END20O17SC2O01P8Y A20N19D SURGERY (IOES)
CENSUS REPORT 2016 - 2019

Figure 7.7-6 : Heller’s Cardiomyotomy by BMS Category

c.cB) yBByMBMS SHHoossppittaallCCataegtoergy ory

12 11 Heller's Cardiomyotomy 3
10 (2017 - 2019) 2

Mean Total Procedures : 25
Total Upper GI Surgeon : 6
Mean No. of Procedure
No. of UGOI Surgeon
8 2
1
65
4

4

21 11 1
100 0
0
0 HSB Alor HTAA HTJ Hospital Hospital
Setar Kuantan Seremban Kuala Seberang
Hospital HSA Hospital Hospital Hospital Lumpur Jaya
Sungai Johor Umum Queen Pulau
Buloh Bahru Sarawak Elizabeth Pinang

Centers with Upper GI Surgeons Center with General Surgeon

Upper GI Surgeon
Figure 7.7-7: Heller’s Cardiomyotomy by BMS Hospital Category
Figure 7.7.7: Heller’s Cardiomyotomy by BMS Hospital Category

HELLER’S CARDIOMYTOMY

HOSPITAL CATEGORY 2017 2018 2019
Big 11 13 16
Medium 6 14 16

Small 0 0 0

TOTAL 17 27 32

Table 7.7.4 : Heller’s Cardiomyotomy by BMS Category

160 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

NON-TRAUMA THORACOTOMY

NO HOSPITALS 2017 2018 2019 UGI

SURGEON

1 Hospital Sungai Buloh 5 14 15 11

2 HSA Johor Bahru 069 5

3 Hospital Umum Sarawak 344 4

4 HSB Alor Setar 400 1

5 HTAA Kuantan 211 1

6 Hospital Queen Elizabeth 022 1

7 HTJ Seremban 200 1

8 Hospital Kuala Lumpur 010 0

9 Hospital Seberang Jaya 001 0

10 Hospital Pulau Pinang 000 0

11 Hospital Sungai Buloh 5 14 15 11

12 HSA Johor Bahru 069 5
General Surgery: TIOnTpAaLtient, Outpatient, Endo17scopy, S2u7rgery (I3O2 ES) Censu6s Report173

Table 7.7.5 : Heller’s Cardiomyotomy by Hospital Category

7.7.2 Esophagectomy

7.7.2 Esophagectomy
List of procedures selected for Esophagectomy workload measurement are:

i. EsophLaisgtoogfapsrtorcecetdoumreys selected for Esophagectomy workload measurement are:
ii. Transhiatal Esophagectomy
iii. Ivor Li.e wiEss/oMphcaKgeoogwanstrEescotopmhaygectomy
iv. Laparioi.s coTrpaincs/hTiahtaolrEascoopshcoapgieccatosmsisyted Esophagectomy

iii. Ivor Lewis/ McKeown Esophagectomy

iv. Laparoscopic / Thoracoscopic assisted Esophagectomy

a) Total
a. Total

Esophagectomy

90 80 76
80

No. of Procedures 70 65

60

50

40

30

20

10

0 2018 2019
2017

Figure 7.7-8 : Total Number of Esophagectomy
Figure 7.7.8 : Total Number of Esophagectomy

b) By BMS Category

General Surgery Services Ministry of Health Malaysia 161

Esophagectomy

No. of Procedures No. 30

20 GENERAL SURGERY
10
INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
0 2017 CENSUS REP2O01R8T 2016 - 2019 2019

Figure 7.7-8 : Total Number of Esophagectomy

b) By BMb.SBCyatBeMgoSryCategory

Esophagectomy

50 47
43
40 32
39

33

30 26

20

10 100
Small
0 Medium
Big Hospital Category

2017 2018 2019

FiguFriegu7r.e7.79.7:-9To: tTaoltNaluNmumbeberrooff EEssoopphhaaggecetcomtoymbyyBbMySBCMaSteCgoarytegory
General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report174

c. cB)yBByMBMSSHHoossppitaitlaCal tCegoarytegory

Mean No. of Procedures 45 40 Esophagectomy 3 No. of UGI Surgeons
(2017 - 2019) 2
40
Mean Total Procedures :74
35 Total Upper GI Surgeon : 6

30

25

20

15 7432 1

10 4331111111
5 0

0

Centers with Upper GI Center with General Surgeon
Surgeons
Upper GI Surgeon

Figure 7.7-10 : Esophagectomy by BMS Hospital Category

Figure 7.7.10 : Esophagectomy by BMS Hospital Category

45 40 Types of Esophagectomy 3
(2017 - 2019)

Mean No. of Procedures 40 Mean Total Procedures :74 2 No. of Upper GI Surgeon
35 Total Upper GI Surgeon : 6 2

30

25

20 1
1S5urgery
162 General 10 Ser7vices4 Ministry of Health Malaysia

5 32 43 3 1 1 1 1 1 1 1
1

GENERAL SURGERY

INPCAeTnIteErNs wT,ithOUUppTePrAGTI IENT, ENDOSCOPY ACNenDterSwUitRh GGeEnRerYal S(uIOrgeEoSn)
Surgeons CENSUS REPORUTppe2r G0I1S6urg-e2on019

Figure 7.7-10 : Esophagectomy by BMS Hospital Category

45 40 Types of Esophagectomy 3
(2017 - 2019)

40 Mean Total Procedures :74
35 Total Upper GI Surgeon : 6

30

25
Mean No. of Procedures 2
No. of Upper GI Surgeon2

20 1

15

10 7432 4 3 3 1 1 1 1 1 1 1
5 1

00

Centers with Upper GI Center with General Surgeon
Surgeons
Transhiatal esophagectomy
Esophagogastrectomy

Esophagectomy (Ivor Lewis / McKeown/ Open) Laparoscopic / Thoracoscopic Assisted Esophagectomy

Total Upper GI Surgeon

Figure 7.7-11 : Types of Esophagectomy by BMS Hospital Category

Figure 7.7.11 : Types of Esophagectomy by BMS Hospital Category

General Surgery Services Ministry of Health Malaysia 163

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report175

d) Typeds .ofTyEpsoepshoagf eEcstoompyhagectomy

Types of Esophagectomy

90 76
80

80

70 65

Mean No. of Procedures 60

50

40

30

20

10

0 2018 2019
2017

Transhiatal Esophagectomy
Esophagogastrectomy
Laparoscopic / Thoracoscopic assisted Esophagectomy
Esophagectomy (Ivor Lewis/ McKeown/ Open)
TOTAL

FigFuirgeur7e.77..172-1:2T:yTpyepsesoof fEEsosopphhaaggeecctotmomy y

ESOPHAGECTOMY

HEoSsOpiPtaHl ACGateEgCoTryOMY 2017 2018 2019
Big 32 26 33

MHeOdiSuPmITAL CATEGORY 47 2017 39 2018 43 2019
0 33
Big Small 1 32 0 26 76 43
MedTiuOmTAL 80 47 39
65 0
Small Table 7.7-6 : Esophagectom1y by BMS Category 0
76
TOTAL 80 65

Table 7.7.6 : Esophagectomy by BMS Category

164 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

ESOPHAGECTOMY

MEAN NO OF PROCEDURES

ESOPHAGO- TRANSHIATAL IVOR ESOPHAGECTOMY TOTAL NO. OF
GASTRECTOMY ESOPHAGECTOMY LEWIS/ - LAPAROSCOPIC / PROCEDURES UGI
NO HOSPITALS (a) MCKEOWN THORACOSCOPIC
(b) (a+b+c+d) SURGEON
(c) ASSISTED 40 2
(d)

1 Hospital Sungai 4 0 27 9
Buloh
0 01 5 71
2 HSA Johor
Bahru 1 03 0 41

3 Hospital Queen 1 21 0 4
Elizabeth 1 02 0 31

4 HSB Alor Setar 0 02 1 3
5 Hospital Pulau 0 03 0 3
0 11 0 21
Pinang
6 HTJ Seremban 0 01 0 1
7 HRPZ Kota Bahru 0 10 0 1
8 Hospital Umum 1 00 0 1
0 01 0 1
Sarawak 0 01 0 1
9 HRPB Ipoh
10 HTAR Klang 0 01 0 1
11 HTAA Kuantan 0 00 0 1
12 HTF Kangar
13 HSAH Sungai 9 5 46 14 74 6

Petani
14 Hospital Melaka
15 Hospital

Ampang
TOTAL

Table 7.7.7 : Types of Esophagectomy by Hospital Category

General Surgery Services Ministry of Health Malaysia 165

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report177

77.7..72.12.1EsoEpshaogpoghaastgreoctgoamystrectomy
a) By BaM.SBHyosBpMitaSl CHaotesgporiytal Category

Esophagogastrectomy

(2017 - 2019)

5 4 Mean Total Procedures : 10 3
5 Total Upper GI Surgeon : 6
Mean No. of Procedures
No. of UGI Surgeon
42

4

32

3

2 1 1 1
2 1 1 1
0 0
1 0
1 0 HTAA HSB Alor Hospital
Kuantan Setar Ampang
0

Hospital Hospital Hospital HSA Johor Hospital

Sungai Pulau Queen Bahru Umum

Buloh Pinang Elizabeth Sarawak

Centers with Upper GI Surgeons Center with General
Surgeon
Upper GI Surgeon

Figure 7.7-13 : Esophagogastrectomy by BMS Hospital Category
Figure 7.7.13 : Esophagogastrectomy by BMS Hospital Category

ESOPHAGOGASTRECTOMY

NO HosEpSitOal PHAGOGASTRECTO2M017Y 2018 2019 Mean No. of UGI
Procedure Surgeon

1 Hospital Sungai Buloh 670 4 2

2 NOHospital PulaHuOPSiPnIaTnAgLS 20174 2018 0 2019 0 MEAN NO. O1F NO. OF UG1I
3 1HTAHAospKituaal nSutanngai Buloh 61 71 2 PROCE4DURE1S
4 2HSBHoAslpoitraSl Peutalaru Pinang 43 00 0 0 11 SURGEON
5 3HosHpTitAaAl QKuuaenetnanElizabeth 10 11 0 2 11 2
6 4HSAHSJBohAolorrBSeatharru 30 01 2 0 10 1
0
1
1

7 5HosHpoitsaplitAaml Qpuaenegn Elizabeth 00 1 0 2 1 1 0 1
0
8 6HosHpSitAalJUohmoruBmahSraurawak 00 1 0 0 0 0 10 11
6
7TOTHoAsLpital Ampang 014 0 10 1 5 0
1
8 Hospital Umum SaraTwaablke 7.7-8 : Esopha0gogastrectom0y by BMS H0ospital Category 0

TOTAL 14 10 5 10 6

Table 7.7.8 : Esophagogastrectomy by BMS Hospital Category

166 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INGPAenTeIrEaNl TS,uOrgUeTryPC:AEITnNIpESaNUtiTeS,nERt,NEOPDuOOtpRSaTCtie2On0tP,1YE6nA-d2No0sDc1o9SpUy,RSGurEgReYry((IIOOEESS)) Census Report178

7.7.2.2 Trans-Hiatal Esophagectomy

7.7a.)2.B2y BTMraS nHso-sHpiitaaltaCal tEegsoorpy hagectomy

a. By BMS Hospital Category

Trans-Hiatal Esophagectomy
(2017 - 2019)

Mean Total Procedures : 5
Total Upper GI Surgeon : 6

2 2 3
1 2
2
Mean No. of Procedures
No. of B&E Surgeon1

1 2

1 1
1 00

1 1

1
00

0 000

0 0

Hospital Hospital HSA Johor Hospital Hospital HSB Alor HTAR HTF Hospital
Setar Klang Kangar Langkawi
Umum Pulau Bahru Queen Sungai

Sarawak Pinang Elizabeth Buloh

Centers with UGI Surgeons Centers with General Surgeons

Upper GI Surgeon

Figure 7.7-14 : Trans-hiatal Esophagectomy by BMS Hospital Category
Figure 7.7.14 : Trans-hiatal Esophagectomy by BMS Hospital Category

TRANSHIATAL ESOPHAGECTOMY

NO HOSPITALS 2017 2018 2019 Mean No. of UGI
0 Procedures Surgeon
1 THRSAB NAlSorHSIeAtaTrAL ESOPHAGE5CTOMY0
2

2 HTAR Klang 0 3 11 NSOU.ROGFEOU1GNI
N3O Hospital HUOmSuPmITASLaSrawak 20170 2018 0 2019 2 MPREOACNENDOU.RO1ESF
1
41 HHSoBsApilotarlSKetaanr gar 50 0 0 0 1 20
1
52 HHToAsRpKitlaalnPgulau Pinang 01 3 0 1 0 10
63 HHoossppitiatal lULmaunmgkSaawraiwak 11
754 HHHooSssAppiittJaaoll hPKuoalrnagBuaaPrhinraung 01 00 20 10 1
86 HHoQspEitIaKl LoatnagKkainwaibalu 0 0 1 00
1 0 0 0 0 0 0 12
97 HHSoAspJoithaol rSBuanhgruai Buloh 0 16
10 00 00 0
2
00 0 0 0 0 00

8 HTQOETI KAoLta Kinabalu 07 0 3 0 4 05

9 Hospital Sungai BulohTable 7.7-9 : Trans0-hiatal Esoph0agectomy by0Hospital Categor0y

TOTAL 734 5 6

Table 7.7.9 : Trans-hiatal Esophagectomy by Hospital Category

General Surgery Services Ministry of Health Malaysia 167

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019
GeneraGl SeunregrearlyS:uIrngpeartiye:nIt,nOpuattpieantite,nOt,uEtpnadtoiescnot,pyE,nSduorsgceorypy(I, OSEurSg)eCryen(sIuOsERSe)pCoret1n7s9us Report180
General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report179

7.7.2.3 Ivor Lewis /McKeown Esophagectomy

77.7.7.2..a23).37IB.v7yo.r2BIv.LM4oewSrLiHsLa/eopMsawpcriKotiasselco/CowMpanitecEcgs/oKoTrpeyhhooargwaeccnotosEmcosypoipc AhsasigsteedcEtosomphyagectomy

a) By BaMa).SBHyyoBsBpMiMtaSlSCHHaotsoepgsiotpraylitCaalteCgoartyegory

Esophagectomy - Ivor Lewis / McKeown/ Open

30 27 EEssoopphhaaggeecctotommyy-M(-Ie2(vaL02no10Tar71optL7a-ale-2rPwro02oi1sc0sec91d/o)u9rMp)esicc: 4K/4 eTohwonr/aOcopsecnopic Assisted 3
3025 27 MTeaontaTl oUtpalp(Per2roG0cIe1dS7uurreg-seo:2n404:169) 32

252100 9 Total UMpepaenr GTIoStaulrPgerocne:d6ures : 16 22 3
201598 Total Upper GI Surgeon : 6 21 2
15107 3 5 1 11 2
10 56 21 3211111 000 1
3211 3211111 0 0 0 10 1
5 0
5 04

03 0
2
1 000 100

0

Hospital HSA Johor Hospital Hospital Pulau Hospital HTJ Seremban HSB Alor HRPB Ipoh

Sungai Buloh Bahru Queen Pinang Umum Setar

Elizabeth Sarawak

Centers with UCGeInStuerrgsewonitsh UGI SurUgeppoenrsGI SurgeoCnenters with General SurCgeeonntserSsuwrgitehonGseneral
Centers with UGI Surgeons McKeUowpnpeErsGopI hSUaupgrpgecetorConGmeIny tSbeuyrrsBgMweoSinthHoGspeintaelraClaSteugrogryeons

Figure 7.7-15 : Ivor Lewis /

Figure 7F.7ig.1uFr5eiIg:7Vu.I7rvOe-o175Rr.7:L-ILe1v6owEr:iWLsLea/wIpiMSasr/co/MsKMcceoKpCoeiocwKw/nTnEhEEOossrooaWpcphoaNhsgcaeocEgptoiSecmOcAytsbPosyiHmsBteMAydSGbEHsyEopsBCphMiaTtagSlOeCcHMtaootmesYgyporbityyaBl MCSaHteogspoitrayl Category

NO HHIVHHHNoo1ssORooOppssPiippttRZaaiittHllaaKHLSQHllOoEuQSouOStnLsWueauPgpSenAeBaniIPgeItiPTIaanSIEVBhiHATlAlErBuOiSA/LuROzluuiaoRLSzOSlnbhMaoSePgLbShtaeICEhCiTthWOBKAuPILESlIoSOC/hMW/2T02C20N1820HK40781OE7EORSWAOC22NP01102O418E11H01448S718SA8COGOPHPEIA2C2C302G5011430T1351AE941O89CSSMTIOMSPYMTrPeo2aErYec0noa22De31cn7dN2e933Eu7dNoruS.oeroO.sefoMsPPfHreoaAScnGueS9UdNruEU12GguroCe21GgrI.oeeToInosfOn MYSuUr2GgeIon
NO1
12
23

34 HHHHHHHHHHHHHHHHHHHHHHHHHHoRoRSoSSToRoTRSoo4786523sssABAJJoSoRTSToSPPAPPsssspppsssppppBAABZBZSJFSHPiiiAJpppJttteiiiieKBSttttIoHoaaaiiiKKAIpaaaaJrlSrtttolllheehopoeaaaollllaIHHHHTHHHoultSrMoUPomormlllhQSUPaophentnrurhuOuHuSMPoUToSooRSamormmbgubgeBBnlnBlrsssehuOABSJaalaeaBmPaaaTuaubgegpppatlBarunieuenaSmhBlaSmhaakaiiiAuhAatJPrnPautttrhnirPPaaeimruokaaauhILeSIrliPruSBrEiTPnalllhopuratneluAeaTauSaiiPoQUroarmzltnranaLonaaarnuhaSbamuSiwrgbhnbwgllBnaeeeaiaaeuwgtaea7unatkmkn.hha7rPkr-E1uSi1nlaia:zrnLaaawgbpeaatr2kho02100524004s0541400c81014105020o7pic /Tho2r0a110014142020014100c0100100813o8110002100scopic A2s03s2130115i41s3121203102t90700010e1330100221d MEAN 9N3O2. OF NO5 . OF UGI 1
4N5O
5 61 EsoPphRaOgeCc21tE2331112101000o7212111113DmU11121111yRbEySHospitalS1C100000U6aRt111eGg11112111oErOy N 1
732
6 84 1
7 1
6
8 95
9160

10171

11182

12193 HHHTSFoAsHKpiSatunanlggSaareibPeeratanngi Jaya 100 01 0 30 1 11 0
131140 HHHoSsoBpsiAptaliotlarSlSeTebtaaeirpraing Jaya
141151 HTHHHHHTOooooTssOFoTssppsppKTiiApttiiattaaiALaantllallLgATlSMaeaAmeribpmlpaeianpkrangaaTgnnaggblJea7y.7a-10 021 00 0 01 0 10 0
1512 100 00 0 20 1 10 0
: Ivor Lewis40/0164M6cKeown Es301o01p3h1agectomy015b1y45H4ospital Categ104o04r4y4 16
13 6

14 Hospital TaipinTgable 7.7-10 : Ivor Lewis / M1cKeown Esop0hagectomy by0Hospital Categor0y 1

15 Hospital Ampang 001 0

TOTAL 46 31 54 44 6

Table 7.7.10 : Ivor Lewis / McKeown Esophagectomy by Hospital Category

168 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

General SurgeryC:EINnpSaUtiSenRt,EOPOutRpaTti2en0t1, 6E-n2d0os1c9opy, Surgery (IOES) Census Report180

77.7.7.2..24 .4LaLpaarposacoropiscc/ oThpoircac/osTchopoicraAcssoisstecdoEpsoicphAagsescitsotmeyd Esophagectomy
a) By BaM. SByHoBsMpitSalHCoatsepgoirtay l Category

Esophagectomy - Laparoscopic / Thoracoscopic Assisted
(2017 - 2019)

10 9 Mean Total Procedures : 16 3
9 Total Upper GI Surgeon : 6 2
2
8 1
1
7 5 0
6

5

4

3

2 000 100

1 HTJ Seremban HSB Alor HRPB Ipoh
Setar
0

Hospital HSA Johor Hospital Hospital Pulau Hospital

Sungai Buloh Bahru Queen Pinang Umum

Elizabeth Sarawak

Centers with UGI Surgeons Centers with General
Surgeons
Upper GI Surgeon

Figure 7.7-16 : Laparoscopic /Thoracoscopic Assisted Esophagectomy by BMS Hospital Category
Figure 7.7.16 : Laparoscopic /Thoracoscopic Assisted Esophagectomy
by BMS Hospital Category

LAPAROSCOPIC / THORACOSCOPIC ASSISTED ESOPHAGECTOMY

NO HOSPITALS 2017 2018 2019 Mean No. of UGI
Procedures Surgeon
LAPAROSCOPIC /
1 THHoOspRitAalCSuOngSaCi BOulPohIC ASSIST1E1D ESOP13HAGEC2TOMY 9 2

2 HSA Johor Bahru 0 7 2019 9MEAN NO. OF5 NO. OF UG1I
3NO HTJ SereHmObSaPnITALS 20171 2018 1 0PROCEDURES1
41 HHoossppitiatal lSuQnugeaeinBuElolihzabeth 2 SURGEON
532 HHHTSSJABSJeoArehlomorrbBaSanehtraur 11 0 13 0 9 1 90
64 HHoRspPiBtalIQpouheen Elizabeth 01 70 0 0 50 21
1
75 HHSoBsApilotarlSPetualrau Pinang 1 1 0 1 1

00 00 1 00 1
10 00 0 00
1

86 HHRoPsBpIiptaolhUmum Sarawak 00 0 0 1 0 0 0 1

7 THoOspTitAalLPulau Pinang 0 13 0 21 0 13 0 16 16

8 Hospital UTmabulme 7S.7a-1ra1w: Laakparoscopic /Th0oracoscopic 0Assisted Esop0hagectomy by H0ospital Category 1

TOTAL 13 21 13 16 6

Table 7.7.11 : Laparoscopic /Thoracoscopic Assisted Esophagectomy by Hospital Category

General Surgery Services Ministry of Health Malaysia 169

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
General Surgery: InCpEaNtieSnUtS, ORuEtPpOatRieTn2t,0E1n6d-o2s0c1op9y, Surgery (IOES) Census Report181
General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report181

7.7.3 Fundoplication

7.7.37.7F.u3ndFoupnlidcaotipolnication

a) Total a. Total No. oNfo.ProofcPerdoucreesdures Gastric Fundoplication
a) Total Gastric Fundoplication

90 81
8900
7800 72 81
6700
5600 72
4500
3400 45
2300 45
1200
100 2017 2018 2019

0

Fig2u0re177.7-17 : Total Number o2f0G1a8stric Fundoplication 2019

FiguFriegu7r.e77.1.77-1:7To: TtaoltaNl uNmumbbeerr ooff GGaasstrtricicFFuunndodpolipcalitcioantion

b) By BMb.SBCyatBeMgoSryCategory
b) By BMS Category

Gastric Fundoplication
60 Gastric Fund5o3plication

No. oNfo.ProofcPerdoucreesdures5600 53

4500 36 35
3400 36 28 35 28
2300 28 17
1200 17 28

100 Medium 100
0 Big HospitMaledCiautmegory 1 Sm0all 0

Big Small

Hospital Category
2017 2018 2019

Figure 7.7-18 : Gas2tr0ic17Fund2o0p1l8icatio2n01b9y BMS Category
Figure 7.7.18 : Gastric Fundoplication by BMS Category

Figure 7.7-18 : Gastric Fundoplication by BMS Category

c) By BMS Hospital Category
c) By BMS Hospital Category

170 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

c. By BMS Hospital Category

Figure 7.7.19 : Gastric Fundoplication by BMS Hospital Category

GASTRIC FUNDOPLICATION

HOSPITAL CATEGORY 2017 2018 2019
Big 36 28 17
Medium 35 53 28

Small 10 0

TOTAL 72 81 45

Table 7.7.12 Gastric Fundoplication by BMS Category

GASTRIC FUNDOPLICATION

NO HOSPITALS 2017 2018 2019 MEAN NO. OF UPPER UGI
SURGEON
1 Hospital Sungai Buloh 29 51 27 PROCEDURES
2 Hospital Umum Sarawak 11 5 3 36 2
6 1
3 HTAA Kuantan 2 4 9
4 HTJ Seremban 3 9 0 5 1
5 Hospital Pulau Pinang 8 0 0 4 1
6 HRPZ Kota Bahru 5 3 0 3
7 Hospital Queen Elizabeth 0 4 2 3 1
8 HSNZ Kuala Terengganu 3 3 0 2 1
9 Hospital Taiping 4 1 0 2 1
10 HSB Alor Setar 4 0 0 2 6
11 HRPB Ipoh 0 0 3 1
1
12 Hospital Tawau 2 1 0
13 Hospital Seberang Jaya 0 0 1 1
14 Hospital Bintulu 1 0 0 0
15 HSA Johor Bahru 0 0 0 0
0
TOTAL 72 81 45
66

Table 7.7.13 Gastric Fundoplication by Hospital Category

General Surgery Services Ministry of Health Malaysia 171

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019
GGeenneerraall SSuurrggeerryy:: IInnppaattiieenntt,, OOuuttppaattiieenntt,, EEnnddoossccooppyy,, SSuurrggeerryy ((IIOOEESS)) CCeennssuuss RReeppoorrtt118833

77..77..44 UUnnddeerrrruunnnniinngg ooff BBlleeeeddiinngg PPeeppttiicc UUllcceerr ((GGaassttrriicc && DDuuooddeennaall))
7.7.4 Underrunning of Bleeding Peptic Ulcer (Gastric & Duodenal)

aa)) TToottaalla. Total

Underrunning of Bleeding Peptic Ulcer

220000 117777
118800 117711

No. of Procedures 116600 114400
114400

112200
110000
8800
6600
4400

2200

00 22001188 22001199
22001177

FFiigguurree 77..77--2200 :: TToottaall NNuummbbeerr ooff UUnnddeerrrruunnnniinngg ooff BBlleeeeddiinngg PPeeppttiicc UUllcceerr
Figure 7.7-20 : Total Number of Underrunning of Bleeding Peptic Ulcer

bb)) BByy BBMbM.SSBCCyaaBtteeMggooSrryyCategory

Underrunning of Bleeding Peptic Ulcer

No. of Procedures 110000 8888 7744
7788 5588 6644

8800 6666

6600

4400 1199 1166 2255
2200

00 MMeeddiiuumm SSmmaallll
BBiigg HHoossppiittaall CCaatteeggoorryy

22001177 22001188 22001199
FFiigguurree 77..77--2211 :: UUnnddeerrrruunnnniinngg ooff BBlleeeeddiinngg PPeeppttiicc UUllcceerr bbyy BBMMSS CCaatteerrggoorryy
Figure 7.7.21 : Underrunning of Bleeding Peptic Ulcer by BMS Catergory

cc)) BByy BBMMSS HHoossppiittaall CCaatteeggoorryy

172 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report184

c. By BMS Hospital Category

Underrunning of Bleeding Peptic Ulcer
(2017 - 2019)

20 18 Mean Total Procedures : 163 3
18 Total Upper GI Surgeon : 6 2
Mean No. of Procedures 1
No. of Upper GI Surgeons160

14

12 10 9 9 9 7 7 6 6 6 5 5 5 4 4 4 4 4 4 3 3 3 2 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
10

8
6
4
2

0

Upper GI Surgeon

Figure 7.7-22 : Underrunning of Bleeding Peptic Ulcer by BMS Hospital Category

Figure 7.7.22 : Underrunning of Bleeding Peptic Ulcer by BMS Hospital Category

UNDERRUNNING OF BLEEDING PEPTIC ULCER

Hospital Category 2017 2018 2019

UNDEBMRiegRdUiumNNING OF BLEEDING P7784EPTIC56U68 LCER8648

Small 19 16 25
HOSPITTAOLTCAALTEGORY 2017 171 1402018 177 2019
Big Table 7.7-14 : Underrunning of Bleed7in8g Peptic Ulcer by BMS Ca6te6gory 88
64
Medium UNDERUNNING OF BL7E4EDING PEPTIC U5L8CER 2U5GI

Small 2017 19 2019 M1e6an No. of S1u7r7geon
No Hospitals 2018 1P4r0ocedures 2

TOTAL 171 1

1 Hospital Sungai Buloh 21 18 14 18 1
2 HSB Alor STaebtalre 7.7.14 : Underrun1n2ing of Ble8eding Pe9ptic Ulcer by BM10S Category
1
3 Hospital Melaka 7 2 19 9

4 HSA Johor Bahru 7 8 11 9

5 Hospital Selayang 8 11 7 9

6 HRPB Ipoh 5 6 11 7

7 Hospital Sibu 10 4 6 7

8 Hospital Taiping 369 6

9 Hospital Segamat 459 6

10 HTAR Klang 566 6

11 Hospital Pulau Pinang 743 5

12 HRPZ Kota Bahru 437 5

13 HTAA Kuantan 446 5

14 Hospital Queen Elizabeth 6 3 3 4

General Surgery Services Ministry of Health Malaysia 173

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

UNDERRUNNING OF BLEEDING PEPTIC ULCER

NO HOSPITALS 2017 2018 2019 MEAN NO. OF UGI

1 Hospital Sungai Buloh 21 18 14 PROCEDURES SURGEON
2 HSB Alor Setar 12 8 9 18 2
10 1
3 Hospital Melaka 7 2 19
4 HSA Johor Bahru 7 8 11 9 1
5 Hospital Selayang 8 11 7 9 1
6 HRPB Ipoh 5 6 11 9
7 Hospital Sibu 10 4 6 7 1
8 Hospital Taiping 3 6 9 7 2
9 Hospital Segamat 4 5 9 6 2
10 HTAR Klang 5 6 6 6 3
11 Hospital Pulau Pinang 7 4 3 6 1
12 HRPZ Kota Bahru 4 3 7 5 1
13 HTAA Kuantan 4 4 6 5
14 Hospital Queen Elizabeth 6 3 3 5 1
15 Hospital Seberang Jaya 6 2 4 4 2299
16 HSNZ Kuala Terengganu 5 5 1 4
4 1
17 Hospital Umum Sarawak 2 5 4
18 HSI Johor Bahru 9 2 0 4 1
19 HoSHAS Temerloh 1 6 4 4 1
20 Hospital Teluk Intan 2 2 5 4 1931
21 HSAH Sungai Petani 0 5 3 3 1884
22 Hospital Tawau 1 3 4 3 1877
23 HTJ Seremban 6 1 0 3 1861
24 Hospital Kajang 3 2 2 2 1716
25 HSNI Batu Pahat 2 3 2 2 1707
26 Hospital Kuala Pilah 2 2 2 2 1640
27 Hospital Miri 5 0 1 2 1589
28 Hospital Kulim 4 1 1 2 1430
29 Hospital DoK Sandakan 1 1 4 2 1300
30 HEBHK Kluang 3 0 2 2 2299
2 2157
31 Hospital Bintulu 2 3 0
32 HTF Kangar 1 0 3 2 2055
33 HPSF Muar 1 2 1 1 1967
34 Hospital Serdang 2 0 1 1 1931
35 Hospital Seri Manjung 1 1 1 1 1884
36 Hospital Tanah Merah 3 0 0 1 1877
37 Hospital Keningau 1 0 2 1 1861
38 Hospital Lahad Datu 0 1 2 1 1716
39 Hospital Kuala Lipis 2 1 0 1 1707
40 Hospital Ampang 1 1 0 1 1640
41 Hospital Putrajaya 1 0 1 1 1589
42 Hospital Langkawi 0 0 2 1 1430
43 Hospital Shah Alam 0 0 2 1 1300
44 HSIP Kuala Krai 0 2 0 1 2299
1 2157
45 Hospital Sarikei 1 0 1
46 Hospital Labuan 0 1 1 1 2055
47 Hospital Kuala Lumpur 0 0 1 1 1967
48 Hospital Queen Elizabeth 2 0 0 0 0 1931
49 Institut Kanser Negara 0 0 0 0 1884
50 Hospital Port Dickson 0 0 0 0 1877
51 Hospital Kemaman 0 0 0 0 1861
52 Hospital Kapit 0 0 0 0 1716
53 Hospital Banting 0 0 0 0 1707
0 1640
TOTAL 171 140 177
163 6

Table 7.7.15 : Underrunning of Bleeding Peptic Ulcer by Hospital Category

174 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

GGeenneerraall SSuurrggeerryy:: IICnnppEaaNttiSieeUnnStt,, OROEuuPttpOpaaRttiiTeenn2tt0,, E1E6nnd-d2oo0sscc1oo9ppyy,, SSuurrggeerryy ((IIOOEESS)) CCeennssuuss RReeppoorrtt118866

77..77..55 7.PP7GG.5UUPaanGnddUPPaDDnUUdSSuPurrDggUeerrySyurgery

-- ULLUiiiiiliiilsiiicsiiic...t...teeororfDiiiLf((ii.iP.i pPsPPP.u pPPP tDroDraGGGGaooPPPrdUorcUUUtcGaGUUteifei)ear)aUUndt//dlwi//plwaauu//PPGPPrGlloroorDDPPeUDDGaeracrDDsklssUUkcsaUUeUUtlstlesrsodroeeSSteSeSSrarulaciileiice(dmmiierdmmtPmmectcocoDmpptstmpptmppoemellUeelledllmedeesy)eeyaeaOOfwysOOfslOOoeuommuormmcrrmmrreeePktePeeemeennlmeonnenndttruuaettrettfuufnmmuudonommftmmrotrmaRRaaratRReertRRereeeppePeeadee:d:eaappsppGruiiaaGaarrfriioaii--errarrrssmOLa--t--atrtrpLOeieOLpicencadapapntpUpreUeoaanaGnllsrrcrcecoaoee:sosrsrctpcr(o(oiiPcPcppGGiicUcUUlc))eaarnnd(dPPPGeeUrrf)fooraraanttededdPDDeuurfoooddreaentneaadll
aa)) TToottaalla. Total

PPGGUU//PPDDUU SSuurrggeerryy

11220000 11003366 11005511 11008877
11000000

NoN.o.ofofPrPorcoecreureuses 880000

660000

440000

220000

00 22001177 22001188 22001199

FFiigguurree77..77--2233::TToottaallNNuummbbeerrooffPPGGUU//PPDDUUSSuurrggeerryy
Figure 7.7.23 : Total Number of PGU / PDU Surgery

bb)) BByy BBMMb.SSBCCyaatBteegMgooSrryyCategory

PPGGUU//PPDDUU SSuurrggeerryy

NoN.o.ofofPrPorcoecdeudruerses 660000 443388 550044 550088 441199 440088 442299
550000 MMeeddiiuumm

440000 HHoossppiittaall CCaatteeggoorryy

330000 117799 113399 115500
SSmmaallll
220000

110000

00 BBiigg

22001177 22001188 22001199
FigFuFirigeguu7rre.e777..2.774--22:44P::GPPUGGU/UP//DPPDUDUUSuSSrugurreggereyrryybbbyyyBBBMMMSSSCCCaaattetegegogorroyyry

General Surgery Services Ministry of Health Malaysia 175

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report187

c. Bc)yBByMBMSSHHoossppitiatlaClatCegaortyegory

Mean No. of Procedure 70 64 PGU / PDU Surgery 3
60 57 (2017 - 2019) 2
1
Mean Total Procedures :1055 0
Total Upper GI Surgeon : 6

50 43 40 39 38 38 38 38 37 35 34 32 31 29 29 28 27 25 25 22 21 21 19 19 16 16 14 14 14 13 13 10 10 9 9 9 8 8 8 8 8 7 7 6 5 5 3 2 2 1 0 0
40
30
20
10

0

Upper GI Surgeon
Figure 7.7-25 : PGU / PDU Surgery By BMS Hospital Category

Figure 7.7-25 : PGU / PDU Surgery By BMS Hospital Category

PGU / PDU Surgery

Hospital Category 2017 2018 2019
508
Big 438 504 429
150
PGMUedi/umPDU SURGERY 419 408 20181087
139 504
Small 179 408

HOTSOPITTAALL CATEGORY 1036 2017 1051 139 2019
Big Table 7.7-16 : : PGU / PDU S4ur3ge8ry By BMS Category 508
429
Medium 419
Small PGU / PDU17S9URGERY 150
20191087 (%)
Procedure Type TOTAL 10326017 (%) 1201581 (%)

PGU / PDU Simple ClosureTaObmleen7t.u7m.16Pa:t:chPG- U / PDU S9u9r0gery B9y6%BMS C1a0t0e4gory96% 957 88%
Open

PGU / PDU Simple Closure Omentum Patch - 46 4% 46 4% 60 6%
Laparoscopic
70 6%
PGU/PDUPGParUtial/GPasDtreUctoSmUy RGERY 0 0% 1 0% 1087 100%
1036 100% 1051 100%
TOTAL

Table 7.7-17 : Types of PGU / PDU Surgery (%) 2019 (%)
PROCEDURE TYPE 2017 (%) 2018

PGU / PDU Simple Closure Omentum 990 96% 1004 96% 957 88%
Patch - Open

PGU / PDU Simple Closure Omentum 46 4% 46 4% 60 6%
Patch - Laparoscopic 70 6%
1087 100%
Thoracotomy 0 0% 1 0%

TOTAL 1036 100% 1051 100%

Table 7.7.17 : Types of PGU / PDU Surgery

176 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

PGU / PDU SURGERY

MEAN NO OF PROCEDURES

NO HOSPITALS PGU / PDU PGU / PDU PGU / PDU- TOTAL MEAN NO. OF
SIMPLE SIMPLE CLOSURE PARTIAL PROCEDURES UGI
1 Hospital Queen Elizabeth OMENTUM PATCH
2 Hospital Umum Sarawak CLOSURE – LAPAROSCOPIC GASTRECTOMY (a+b+c+d) SURGEON
3 HTAR Klang OMENTUM (c) 1
PATCH – OPEN (b) 64 1
4 HSA Johor Bahru (a) 57 1
5 Hospital Selayang 43 2
6 HRPZ Kota Bahru 52 10 2 1
7 HSAH Sungai Petani 40
8 HRPB Ipoh 55 1 1 39 6
9 Hospital Sibu 40 1 2 38
10 Hospital Seberang Jaya 38
11 HSB Alor Setar 40 0 0 38
12 Hospital Tawau 38
13 Hospital Sungai Buloh 36 1 1 37
14 Hospital Taiping 36 0 2 35
15 Hospital Miri 38 0 0 34
16 Hospital Bintulu 34 2 2 32
17 Hospital DoK Sandakan 31
18 Hospital Pulau Pinang 37 1 0 29
19 HTAA Kuantan 29
20 HSI Johor Bahru 33 4 0 28
21 HTJ Seremban 29 5 1 27
22 HoSHAS Temerloh 32 1 0 25
23 HSNI Batu Pahat 31 0 1 25
24 Hospital Kuala Lumpur 22
25 Hospital Melaka 29 1 2 21
26 Hospital Teluk Intan 21
27 Hospital Kajang 28 0 1 19
28 HTF Kangar 24 5 0 19
29 HSNZ Kuala Terengganu 16
30 HEBHK Kluang 24 1 2 16
31 Hospital Sarikei 14
32 Hospital Ampang 26 1 0 14
33 Hospital Serdang 14
34 Hospital Shah Alam 23 0 2 13
35 HPSF Muar 23 2 0 13
36 Hospital Kuala Pilah 17 5 0 10
37 Hospital Keningau 21 0 0 10
38 Hospital Seri Manjung 21 0 0 9
39 Hospital Kulim 9
40 Hospital Lahad Datu 17 1 1 9
41 Hospital Segamat 19 0 0 8
42 HSIP Kuala Krai 16 0 0 8
43 Hospital Langkawi 14 2 0 8
44 Hospital Tanah Merah 14 0 0 8
45 Hospital Queen Elizabeth 2 8
46 Hospital Putrajaya 13 0 0 7
47 Hospital Kuala Lipis 7
48 Hospital Kapit 13 1 0 6
49 Hospital Kemaman 13 0 0 5
50 Hospital Labuan 5
51 Hospital Port Dickson 12 1 0 3
52 Institut Kanser Negara 2
53 Hospital Banting 73 0 2
90 1 1
TOTAL 90 0 0
90 0 0

90 0 1055

80 0
80 0
80 0
80 0

80 0

70 0
70 0
60 0
50 0
50 0
30 0
20 0
20 0

10 0
00 0
00 0

980 51 24

Table 7.7.18 : PGU / PDU Surgery By Hospital Category

General Surgery Services Ministry of Health Malaysia 177

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report191

7.77.5.7.1.5P.1GU PanGd UPDaUnSdimpPleDOUmeSnitmumpPlaetchOCmloseunret–uOmpePn atch Closure – Open 3
2
a) By BMaS .HBosypiBtaMl CSateHgooryspital Category 2
1
Open PGU / PDU Simple Omentum Patch Repair 1
(2017 - 2019) 0

60 Mean Total Procedures : 163
Total Upper GI Surgeon : 6

50
40
30
20
10
0
Mean No. of Procedures
No. of Upper GI Surgeons

Upper GI Surgeon

Figure 7.7-26 : Open PGU /PDU Simple Omentum Patch Closure by BMS Hospital Category

Figure 7.7.26 : Open PGU /PDU Simple Omentum Patch Closure by BMS Hospital Category

PGU / PDU SIMPLE OMENTUM PATCH CLOSURE - OPEN

No. Hospital Category 2017 2018 2019 Mean No. of UGI
Procedures Surgeon

1 Hospital Umum Sarawak 46 70 48 55 1

2 Hospital Queen Elizabeth 51 49 56 52 1

3 HTAR Klang 35 41 44 40

4 HSA Johor Bahru 49 42 28 40 1

5 HSAH Sungai Petani 30 37 48 38

6 Hospital Sibu 38 43 29 37

7 HRPZ Kota Bahru 36 52 21 36

8 Hospital Selayang 34 45 30 36

9 HRPB Ipoh 35 28 49 34

10 Hospital Seberang Jaya 35 40 24 33

11 Hospital Tawau 31 32 34 32

12 Hospital Sungai Buloh 37 22 34 31 2

13 HSB Alor Setar 32 39 16 29

14 Hospital Taiping 31 29 26 29

15 Hospital Miri 33 21 30 28

16 Hospital Pulau Pinang 25 22 31 26 1

17 Hospital DoK Sandakan 39 14 19 24

178 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

PGU / PDU SIMPLE OMENTUM PATCH CLOSURE
- OPEN

NO HOSPITALS 2017 2018 2019 MEAN NO. OF UGI

1 Hospital Umum Sarawak 46 70 48 PROCEDURES SURGEON
2 Hospital Queen Elizabeth 51 49 56 55 1
52 1
3 HTAR Klang 35 41 44
4 HSA Johor Bahru 49 42 28 40 1
5 HSAH Sungai Petani 30 37 48 40 1
6 Hospital Sibu 38 43 29 38
7 HRPZ Kota Bahru 36 52 21 37 1
8 Hospital Selayang 34 45 30 36 2
9 HRPB Ipoh 35 28 49 36 2
10 Hospital Seberang Jaya 35 40 24 34 3
11 Hospital Tawau 31 32 34 33 1
12 Hospital Sungai Buloh 37 22 34 32 1
13 HSB Alor Setar 32 39 16 31 2
14 Hospital Taiping 31 29 26 29
15 Hospital Miri 33 21 30 29 1
16 Hospital Pulau Pinang 25 22 31 28 2299
26
17 Hospital DoK Sandakan 39 14 19 1
18 Hospital Bintulu 26 26 19 24
19 HSI Johor Bahru 21 18 31 24 1
20 HTAA Kuantan 19 25 25 23 1
21 HoSHAS Temerloh 20 21 22 23 1931
22 HSNI Batu Pahat 28 17 17 21 1884
23 Hospital Melaka 15 21 20 21 1877
24 Hospital Kuala Lumpur 20 16 15 19 1861
25 HTJ Seremban 10 20 21 17 1716
26 Hospital Teluk Intan 11 20 17 17 1707
27 HTF Kangar 14 14 15 16 1640
28 Hospital Kajang 14 13 15 14 1589
29 HSNZ Kuala Terengganu 8 8 24 14 1430
30 Hospital Sarikei 10 18 12 13 1300
13 2299
31 HEBHK Kluang 15 17 7 2157
32 Hospital Ampang 13 11 12 13
33 Hospital Kuala Pilah 10 8 9 12 2055
34 Hospital Shah Alam 12 8 7 9 1967
35 Hospital Keningau 11 8 8 9 1931
36 HPSF Muar 6 11 9 9 1884
37 Hospital Seri Manjung 10 3 12 9 1877
38 Hospital Kulim 13 4 7 8 1861
39 Hospital Lahad Datu 4 10 10 8 1716
40 Hospital Segamat 9 4 10 8 1707
41 HSIP Kuala Krai 9 7 7 8 1640
42 Hospital Serdang 8 6 6 8 1589
43 Hospital Langkawi 7 8 5 7 1430
44 Hospital Tanah Merah 7 8 5 7 1300
7 2299
45 Hospital Queen Elizabeth 2 9 5 3 2157
46 Hospital Putrajaya 1 6 9 6
47 Hospital Kuala Lipis 8 4 3 5 2055
48 Hospital Kapit 2 6 1 5 1967
49 Hospital Kemaman 0 2 5 3 1931
50 Hospital Labuan 2 2 2 2 1884
51 Hospital Port Dickson 1 3 0 2 1877
52 Institut Kanser Negara 0 0 0 1 1861
53 Hospital Banting 0 0 0 0 1716
0 1707
TOTAL 990 1004 957 1640
980
6

Table 7.7.19 : Open PGU /PDU Simple Omentum Patch Repair by Hospital Category

General Surgery Services Ministry of Health Malaysia 179

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report193

77.7..75..25.2PGUPaGndUPaDUndSimPpDleUOmSeinmtupmlPeatOchmCleosnutrue m– LaPpaartocschopCiclosure – Laparoscopic
a) By BMaS. HBoyspBitMal SCaHtegoosrpy ital Category

Laparoscopic PGU / PDU Simple Omentum Patch Repair

(2017 - 2019)

12 10 Mean Total Procedures : 51 3
10 Total Upper GI Surgeon : 6
Mean No. of Procedures
No of Upper GI Surgeons85552
4
6

4 322211111111111000000 1
2

00

Upper GI Surgeon

Figure 7.7F.ig2u7re:7L.7a-p27a:rLoaspcaroopsciocpiPc GPGUU// PPDDUUSSimimplpe OlemOentmumePnattuchmClPoasutrce hbyCBMloSsHuroespibtayl CBaMtegSorHyospital Category

PGU / PDU SIMPLE OMENTUM CLOSURE - LAPAROSCOPIC

No. HPOGSUPIT/APLSDU SIMPLE O2M01E7 NTUM2018CLOS2U01R9E Mean No. of UGI
Procedures Surgeon
1 H- oLsApitPalAQRueOenSEClizOabPethIC
8 12 10 10 1

2NO HTJ SeremHbaOnSPITALS 82017 26018 20219 MEAN5NO. OF UGI
3 1 HHoospspitiatal lBQinuteuelun Elizabeth 98 312 410 PROC1E50DURES
4 2 HHSTBJ SAelroermSbeatanr 08 06 125 SURGEON
5 1
1
5 3 HHoospspitiatal lSBeibneturlaung Jaya 09 73 54 45
4 HHHooSsBpspiAtiatlaol lrSSSeeerbdtaaernragng Jaya 0 0 031505 23453 1
6 5 HHRoPsBpitIaploSherdang 7 0 1 7 13 2 1
7 6 3 7 0 1 51 22
005 121 1
8 7 HHoRsPpBitaIpl oKhajang 13 30 00 1
11 2
442 11
98 HHHHHSooSosIIpssJJppiotoiiatthhaaloollUrrUKBmBamaajuauhhmmnrruugSSaarraawwaakk 01 03 20 111 2
10190 00 11
2 0 2 0 03 1 3
2 2 302 1 1
1111 HHoospspitiatal lSSeelalayyaanngg 00 44 02 11
20 111 1
1
1212 HHoospspitiatal lTTaawwaauu 00 33 0 2
131143 HHHooospssppitiiattaal llDKDouoKaKlaSSaaLnnuddmaapkkuaarnn 0 10
1415 HHoospspitiatal lKTauaiplainLgumpur 0 0 0 0 0 1
0 1 1 0 2299
02 11 0 0
0 1
1516 HHoospspitiatal lTAamippinagng 21 12 0
0 1
1167111987 HHHHHooooTssAppssppRiittiiaattKaalllallSASPnimiubgblupauaunPginang 10 20 1
2 0 1931
0 0 0 0
1884
1820 HHoEsBpHitKalKPluualanugPinang 20 00
1
1921 HHHToSAAspRJitoKahlloaTernBlguakhIrnutan 00 01 1861
1716
22 1 0 1707
1640
23 HPSF Muar 1 0
2
24 Hospital Queen Elizabeth 2 1 0

25 Hospital Langkawi 0 0

26 Hospital Sungai Buloh 0 0

TOTAL 46 46 60 51 6

Table 7.7.20 : Laparoscopic PGU / PDU Simple Omentum Patch Closure by Hospital Category

180 General Surgery Services Ministry of Health Malaysia

22 Hospital Teluk Intan 100 0

23 HPSF Muar 100 0

GENERAL SURGERY25

26
24 Hospital Queen Elizabeth 2 1 0 0 0

HTHOIooNssTppPiiAttAaaLllTSLIuEannNggTka,iawBOuiUloThPCAETNIESNUTS,400ER6NEPDOORSTC4002O60P1Y6A- 2N06D10109SURGERY5001(IOES) 2
6

Table 7.7-20 : Laparoscopic PGU / PDU Simple Omentum Patch Closure by Hospital Category

77.7.7.5..35.3PGUPaGndUPDaUnPdarPtiaDl UGaPstarecrttoimayl Gastrectomy
a) By BMaS.HBoyspBitaMl CSatHegoorsypital Category

PGU / PDU Partial Gastrectomy

(2019)

Mean Total Procedures : 70

87 7 7 7 Total Upper GI Surgeon : 6 3
Mean No. of Procedures
No. of Upper GI Surgeons
7 66

65 2
5 44

4 33

3 222 1

2 11111

1

00

Upper GI Surgeon

FigurFeig7ur.e77.2.78-2:8 P: GPGUU// PPDDUUPParatiratliaGal sGtreactsotmrey cbytoBMmSyHbosypitBaMl CSateHgoorsypital Category

PGU / PDU - Partial gastrectomy
-PPGNAUoR. /THIPAosDpLitUGal ACaSteTgRorEyCTOMY
2019 UGI
Surgeon
1 HTAR Klang 7 UGI
NO 2 HTAA Kuantan HOSPITALS 7 2019 SURGEON

1 HTAR3KlanHgospital Queen Elizabeth 7 7 1
7
2 HTAA4 KuaHnotasnpital DoK Sandakan 7 1
17 1
3 Hosp5ital QHuRePeBn EIplizoahbeth 6 2
7 1
4 Hosp6ital DHoRKPSZanKdoatkaaBnahru 6 6 1
6 1
5 HRPB7IpohHospital Taiping 5 5 1
4 1
6 HRPZ8KotaHBoashpirtual Umum Sarawak 4 4 1
3 1
7 Hosp9ital THaiopsipnigtal Selayang 4 3 1
2 6
8 Hospital Umum Sarawak 2
2
9 Hospital Selayang 1
1
10 Hospital Sungai Buloh 1
1
11 Hospital Miri 1
0
12 HSB Alor Setar 70

13 Hospital Kuala Lumpur

14 Hospital Shah Alam
15 HSNZ Kuala Terengganu

16 Hospital Kajang

17 Hospital Serdang

18 HPSF Muar

19 HoSHAS Temerloh

20 Hospital Kapit

TOTAL

Table 7.7.21 : PGU / PDU Partial Gastrectomy by Hospital Category

General Surgery Services Ministry of Health Malaysia 181

18 HPSF Muar 1 1
6
19 HoSHAS Temerloh 1
20 HospiGtal KEaNpit ERAL SURGERY0
INPATTIEONTT,AOLUTPATIENT, ENDOSCOPY AND SURG70ERY (IOES)

Table 7C.7-E2N1 :SPUGSU R/ PEDPUOPRaTrtia2l0G1as6tr-e2ct0om1y9by Hospital Category

7.7.6 Total / Partial Gastrectomy
7.7.6 PGU and PDU Surgery
a) Totala. Total

Partial / Total GastrectomyNo. of Procedures

400 359
350
300 265 272
250
200
150
100
50

0

General Surgery: Inp2a01t7ient, Outpatient, E20n1d8oscopy, Surgery 2(0I1O9ES) Census Report196

Figure 7.7-29 : Total Number of Partial / Total Gastrectomy
Figure 7.7.29 : Total Number of Partial / Total Gastrectomy

b) By BMb.SBCyatBegMoSryCategory

Partial / Total Gastrectomy

No. of Procedures 250 144
195 103 111

200
147 150

150

100

50 Medium 20 15 11
Hospital Category Small
0
Big

2017 2018 2019
Figure 7.7-30 : Partial / Total Gastrectomy by BMS Category
Figure 7.7.30 : Partial / Total Gastrectomy by BMS Category

c) By BMS Hospital Category
d)

Partial / Total Gastrectomy
(2017 - 2019)

182 60 57ocedures Mean Total Procedures : 299 3
Gen5e0ral Surgery Services Ministry of Health MalaysiTaotal Upper GI Surgeon : 6 2

40 34 31

Mean NO. of Procedures50 20 15 11

Hospital Sungai Buloh0GENERAL SURGERYBig
HSA Johor Bahru
Medium Small
Hospital Umum Sarawak
Hospital Category
Hospital Queen Elizabeth N

Hospital Pulau Pinang
Hospital Miri

HSB Alor Setar
HRPB Ipoh

HTAR Klang
Hospital Sibu
HTJ Seremban
HSNZ Kuala Terengganu
HRPZ Kota Bahru
Hospital Kuala Lumpur
Hospital DoK Sandakan
Hospital Taiping
HSAH Sungai Petani
Hospital Seberang Jaya
Hospital Ampang
Hospital Bintulu
HTAA Kuantan
HSI Johor Bahru

HPSF Muar
Hospital Melaka

HTF Kangar
Hospital Selayang
HSNI Batu Pahat

Hospital Tawau
Hospital Teluk Intan

Hospital Kajang
HEBHK Kluang
HoSHAS Temerloh
Hospital Kulim
Hospital Putrajaya
Hospital Segamat
Hospital Sarikei
Hospital Serdang
Hospital Kuala Pilah
Institut Kanser Negara
Hospital Shah Alam
Hospital Port Dickson
HSIP Kuala Krai
Hospital Lahad Datu

No. of Upper GI Surgeons
INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS 2R01E7PO20R18T 2200119 6 - 2019

Figure 7.7-30 : Partial / Total Gastrectomy by BMS Category

c.cB) yBBy BMMSS HoospsiptailtCaalteCgoarytegory

d)

60 57 Partial / Total Gastrectomy 3
(2017 - 2019) 2
50 1
40 34 31 Mean Total Procedures : 299 0
30 17 Total Upper GI Surgeon : 6
20 14
15 11 11 11 9 7 7 6 6 6 5 5 5 5 4 4 3 3 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0
10

0

Upper GI Surgeon
Figure 7.7-31: Partial / Total Gastrectomy by BMS Hospital Category

Figure 7.7.31: Partial / Total Gastrectomy by BMS Hospital Category

TOTAL / PARTIAL GASTRECTOMY

HOSPITAL CATEGORY 2017 2018 2019
Big 195 147 150
Medium 144 103 111

Small 20 15 11

TOTAL 359 265 272

Table 7.7.22 : Partial / Total Gastrectomy by BMS Category

General Surgery Services Ministry of Health Malaysia 183

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

TOTAL / PARTIAL GASTRECTOMY

NO HOSPITALS 2017 2018 2019 MEAN NO. OF UGI

1 Hospital Sungai Buloh 56 48 66 PROCEDURES SURGEON
2 HSA Johor Bahru 16 34 53 57 2
34 1
3 Hospital Umum Sarawak 23 42 29
4 Hospital Queen Elizabeth 21 5 24 31 1
5 Hospital Miri 23 8 14 17 1
6 Hospital Pulau Pinang 31 7 4 15
7 HSB Alor Setar 22 9 3 14 1
8 HRPB Ipoh 23 0 11 11 2
9 HTAR Klang 12 10 11 11 2
10 Hospital Sibu 14 14 0 11 3
11 HTJ Seremban 8 11 3 9 1
12 HSNZ Kuala Terengganu 9 9 3 7 1
13 HRPZ Kota Bahru 9 8 2 7 2
14 Hospital Kuala Lumpur 13 3 1 6
15 Hospital DoK Sandakan 8 8 1 6 1
16 Hospital Taiping 6 4 6 6 2299
5
17 HSAH Sungai Petani 7 2 5 1
18 Hospital Seberang Jaya 4 5 5 5
19 Hospital Ampang 1 7 6 5 1
20 Hospital Bintulu 3 1 9 5 1
21 HTAA Kuantan 4 2 5 4 1931
22 HSI Johor Bahru 7 1 1 4 1884
23 HPSF Muar 6 3 0 3 1877
24 Hospital Melaka 3 3 1 3 1861
25 HTF Kangar 3 0 3 2 1716
26 Hospital Selayang 1 4 0 2 1707
27 HSNI Batu Pahat 2 2 1 2 1640
28 Hospital Tawau 3 1 1 2 1589
29 Hospital Teluk Intan 4 0 0 2 1430
30 Hospital Kajang 0 4 0 1 1300
1 2299
31 HEBHK Kluang 1 0 3 2157
32 HoSHAS Temerloh 3 1 0 1
33 Hospital Kulim 2 2 0 1 2055
34 Hospital Putrajaya 2 1 0 1 1967
35 Hospital Segamat 3 0 0 1 1931
36 Hospital Sarikei 1 1 1 1 1884
37 Hospital Serdang 1 1 0 1 1877
38 Hospital Kuala Pilah 1 1 0 1 1861
39 Institut Kanser Negara 1 1 0 1 1716
40 Hospital Shah Alam 1 0 0 1 1707
41 Hospital Port Dickson 0 1 0 0 1640
42 HSIP Kuala Krai 1 0 0 0 1589
43 Hospital Lahad Datu 0 1 0 0 1430
44 Hospital Queen Elizabeth 2 0 0 0 0 1300
0 2299
45 Hospital Langkawi 0 0 0 2157
46 Hospital Seri Manjung 0 0 0 0
47 Hospital Kemaman 0 0 0 0 2055
48 Hospital Tanah Merah 0 0 0 0 1967
49 Hospital Kapit 0 0 0 0 1931
50 Hospital Keningau 0 0 0 0 1884
51 Hospital Labuan 0 0 0 0 1877
52 Hospital Kuala Lipis 0 0 0 0 1861
53 Hospital Banting 0 0 0 0 1716
0 1707
TOTAL 359 265 272 1640
299
6

Table 7.7.23 : Partial / Total Gastrectomy by Hospital Category

184 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

General Surgery: InpCaEtiNeSnUt,SORuEtpPaOtiRenTt,2E0n1d6o-s2c0o1p9y, Surgery (IOES) Census Report199

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report199

7.8 Bariatric Surgery

7L.i8st ofB7par.ro8icaetdBruiacreSsriusaerlgeterctriecyd Surgery Surgery workload measurement are:

for Bariatric

List of proiiiic... edLiu.i sSSOrtelloteseShefelseevpvereeerlovBeGGeccatearaGeidssdaatturtrsfrereteoircccersttocoPsBemtmroaloemryycicaeyttderudicrfeSosruBrgaeriraytrwicoSrukrgloeardy workload measurement are:

measurement are:

a) Toiit.al ii.O tOhethreBr aBraiaritartircicPPrroocceedduurreess

a) Total Bariatric Surgery 122
a. Total Bariatric Surgery 122

125 113
1250
112105
No. ofNPor.oocfedPruroecsedures
1150 113

11005 103

1050 103

10905

950 2017 2018 2019
90
2F0i1g7ure 7.8-1: Total Numbe2r0o1f8Bariatric Surgery 2019
b) By BMS Category
FFiigguurree 77.8.8-1.1::TTootatal Nl Numumbebr oefrBoafrBiaatrriiac tSruicrgSeuryrgery

b) By BMbS. CBayteBgMorSy Category

Bariatric Surgery

90 81 Bariatric Surgery
80

No. ofNPor.oocfedPruroecsedures 9700 63 81

8600 52 48 51
7500 63 41
6400 52
5300 48 51
41

4200

3100 200
2 Sm0all 0
200
Small
10 Big Medium

0 Hospital Category
Big Medium

2017Hosp20it1a8l Ca2te0g1o9ry

FFigiguurree77..88.-22 :: BB2aa0rr1ii7aattrriicc2S0Su1ur8grgereyr2yb0y1bB9yMBSMCSatCegaotreygory
Figure 7.8-2 : Bariatric Surgery by BMS Category

General Surgery Services Ministry of Health Malaysia 185

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019
General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report200

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report200

c) By BMS Hospital Category
c. By BMS Hospital Category

c) By BMS Hospital Category Bariatric Surgery

40 Mean BToatraliaPrtorciecduSruesr:g1e1r3y

35 34 Mean Total Procedures : 113
Mean No. of Procedures 40
Mean No. of Procedures
30 35 34

25 30 19
20 20 20 1195
15
25 15
20

15 9 96 6 5 5 2 2 1 1 1 1 1 1 00
10
00 00
10
5

5
00

Figure 7FF.8iigg-3uur:reeB7a.78r.-i83a.t:3icB:aSBruiaargtriiecarStyiu.crBgSyeurByr.MgBeSyrBHyM.oBsSpyHitoBaslMpCitSaaltHeCgoaostrepygiotaryl Category

d) Typeds)ofTBypaersiaotfrBicaSriuatrrgicerSyurgery
d. Types of Bariatric Surgery

TypeTsyopfeBs aofriBaatrriiactSriucrSguerrgyery
140 122
140 120 113
122
120 100 113 103 34
No. of Procedures 103
No. of Procedures
100 80 58 44 34

80 60 58 44

60 40 55 59 88
40 20 88
59
20 0 55 2018 2019
2017

0 Sleeve Gastrectom20y18 Others TOTAL 2019

2017

Sleeve GFiagsutrreec7t.o8m-4y: TypeOs tohfeBrsariatriTcOSuTrAgeLry

Figure 7.8-4 : Types of Bariatric Surgery
Figure 7.8.4 : Types of Bariatric Surgery

186 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

BARIATRIC PROCEDURES

HOSPITAL CATEGORY 2017 2018 2019
Big 63 52 81
Medium 48 51 41

Small 20 0

TOTAL 113 103 122

Table 7.8.1 : Batiatric Surgery by BMS Category

BARIATRIC PROCEDURES

PROCEDURE TYPE 2017 (%) 2018 (%) 2019 (%)
57% 88 72%
Table 7.8-2 : Types of Bariatric Surgery 55 49% 59 43% 122 28%

Others 58 51% 44 100% 122 100%

TOTAL 113 100% 103

Table 7.8.2 : Types of Bariatric Surgery

BARIATRIC PROCEDURES

NO HOSPITALS 2017 2018 2019 MEAN NO. OF
PROCEDURES
1 Hospital Kuala Lumpur 26 18 57
2 HRPB Ipoh 34
3 Hospital Queen Elizabeth 2 20 19 21 20
4 Hospital Sungai Buloh 19
5 Hospital Taiping 7 18 33 15
6 HTJ Seremban 9
7 Hospital Umum Sarawak 16 21 8 6
8 HoSHAS Temerloh 5
9 HSNZ Kuala Terengganu 17 10 0 2
10 Hospital Putrajaya 1
11 HSIP Kuala Krai 890 1
12 HSA Johor Bahru 1
13 HTAA Kuantan 761 0
14 Hospital Kajang 0
610 0
TOTAL
101 113

110

200

001

100

100

113 103 122

Table 7.8.3 : Bariatric Surgery by Hospital Category

General Surgery Services Ministry of Health Malaysia 187

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report202

77.8..81.1SlSeleeveeGveastGreactsotmreyctomy
a) ByaB. MByS HBMospSitHaloCsapteigtoarly Category

Sleeve Gastrectomy
(2017 - 2019)

Mean No. of Procedures 35 30 Mean Total Procedures : 67
30

25

20

15 11 10

10 552211000
5

0

Figure 7F.i8g.u5re: 7S.l8e-5ev: eSleGevaesGtraestcretoctmomyy bbyyBBMMSSHHosopistpalitCaalteCgaortyegory

SLEEVE GASTRECTOMY

No. Hospital Category 2017 2018 2019
20 15
1 SHLoEspEitValEKGuaAlaSLTuRmEpuCr TOMY 54

2 Hospital Queen Elizabeth H2OSPITALS 6 14 2018 13
15
NO 2017 14 2019
31 HHoRsPpBitaIl pKouhala Lumpur 8
42 HHoTsJpiStaelrQemuebeannElizabeth 2 9 208 9 1354
6 69 3 0 13
53 HHRoPsBpiIptaolhSungai Buloh 5 93 6 6 13
3
64 HHToJsSpeitraelmTbaainping 1 66 1 00
0
75 HHoossppiitatallSUunmgauimBuSloahrawak 2 53 0 06
3 11 0
86 HHoosSpHitaAl STaTipeinmgerloh 2 20 0 00
97 HHHooSSsIpHPiAtaKSl uTUeammlauemKrlorSahairawak 0 320 00
1098 HHSSIPAKJuoahlaorKrBaai hru 0 00 59 0
1 00 1 0

1110 HHSSANJZohKour BalaahrTuerengganu 11
1121 HHSTNAZAKuKaluaaTnetraenngganu 01

12 THTOATAAKuLantan 55 159 88 0

Table 7.8T-O4T:ASLleeve Gastrectomy by Hospital Category 55 88

Table 7.8.4 : Sleeve Gastrectomy by Hospital Category

188 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report203

77.8..82.2OtOhetrhBearriBatarirciaPrtroiccedPurroescedures
a) ByaB.MBSyHBoMspiStaHl Coastepgiotray l Category

Other Bariatric Procedures

(2017 - 2019)

Mean No. of Procedures 12 10 10 8 Mean Total Procedures : 45
10 7
8

6 43
4 11100
2

0

Figure 7.8-6 : Total Number of Other Bariatric Procedures by BMS Hospital Category

Figure 7.8.6 : Total Number of Other Bariatric Procedures by BMS Hospital Category

OTHER BARIATRIC PROCEDURES

No. Hospital Category 2017 2018 2019 Mean
Procedures
1 HOosTpHitaElRSuBngAaiRBIuAloThRIC PROCEDUR11ES
18 2 10

2 HRPB Ipoh 11 11 8 10
MEAN NO. O8F
3NO Hospital Queen EliHzaObSePtIhTA2LS 1 2017 42018 201920 PROC1E0DURE7S

41 HHoossppiittaall STuanipgianigBuloh 16 11 4 18 20 10 4
52 HHoRsPpBitIaploKh uala Lumpur 6 11 3 11 83 83
63 HHoossppiittaall QUumeuemn ESliazarabwetahk2 5 1 34 20 1
74 HHooSspHitAalSTaTiepmingerloh 3 16 0 4
00 71

85 HHToJspSitearleKmubaalanLumpur 2 6 03 30 41

96 HHoossppiittaall UPmuturamjaSyaarawak 1 5 13 10 31
00 10
107 HHSoNSHZAKS TueamlaeTrloerhengganu 1 3 00 00 10
118 HHoTsJpSietarel mKbaajanng 1 2 00 0 32 1 45
9 THOosTpAitaLl Putrajaya 58 1 44 1
10 HSNZ Kuala TerenggaTnabule 7.8-5 : Other Bariatric Procedures b1y Hospital Ca0tegory 0 0

11 Hospital Kajang 10 00

TOTAL 58 44 32 45

Table 7.8.5 : Other Bariatric Procedures by Hospital Category

General Surgery Services Ministry of Health Malaysia 189

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)
CENSUS REPORT 2016 - 2019

GGeenneerraall SSuurrggeerryy:: IInnppaattiieenntt,, OOuuttppaattiieenntt,, EEnnddoossccooppyy,, SSuurrggeerryy ((IIOOEESS)) CCeennssuuss RReeppoorrtt220044

77..99 HH7ee.pp9aattooHppeaannpccrareetaaottiicpcooabbiinlliiacarrryye((aHHtPPiBcB))obiliary (HPB)

LLiisstt ooff pprroocceeddLuuisrrteeossfsspeelrloeeccctteeeddduffroeorrs HsHeeeleppcaattteoodppaafnoncrcrHreeeaapttiiacctooobbpiilaliianarcryyrewwaotoicrrkkollbooialaiaddrymmweeaoassrkuulroreeammdeemnntet aaarrseeu::rement are:
ii.. CChhoolleeccyysstteeccttoommyy
iiii.. CChhoolleecci.yyCssthteeoccltetoocmmyysyteaacnntddomccooymmmmoonn bbiillee dduucctt ((CCBBDD)) eexxpplloorraattiioonn

iiiiii.. HHeeppaatteeiic.ctCtoohmmoyylecystectomy and common bile duct (CBD) exploration
iivv.. WWhhiippppiilvilie.e.’H’WssehPPpirpraooptcecleeecd’dtsouuPmrrreeoycedure

aa)) TToottaall
a. Total

HHPPBB SSuurrggeerryy

55000000 44338800 44225599 44449977
44550000
NNo.o.ofofPrProocceeddurureses 44000000
33550000
33000000 22001177 22001188 22001199
22550000
22000000
11550000
11000000
550000

00

FFiigguurree 77..99--11 :: TToottaall NNuummbbeerr ooff HHPPBB SSuurrggeerryy
Figure 7.9.1 : Total Number of HPB Surgery

bb)) BByy BBMMbSS.CCBaaytteeBggoMorrySy Category

33000000 HHPPBB SSuurrggeerryy
22550000
22000000 22660066 22555500 22772299
11550000
NNooofofPrProocceeddurureses 11000000 11335533 11225588 11222266
550000
442211 445511 554422
00
BBiigg MMeeddiiuumm SSmmaallll

HHoossppiittaall CCaatteeggoorryy

22001177 22001188 22001199
FiFgFiiuggruuerree777.9..99.-2-22:::HHHPPPBBBSSSuuurrrgggeeerrryyy bbbyyyBBBMMMSSSCCCaattaeeggtoeorgryyory

190 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

GenIeNrPaAl STIuErNgTe,ryO:UInTPpAatTieIEnNt,TO, EuNtpDatOieSnCt,OEPndYoAscNoDpy,SSUuRrGgeErRyY(I(OIOESES) )Census Report205
CENSUS REPORT 2016 - 2019

c) By BMGeSneHraolsSpuitragleCrya:tIengpoartyient, Outpatient, Endoscopy, Surgery (IOES) Census Report205

cc). BByy BBMMSSHoHspoitsapl CitaatelgCoryategory HPB Surgery

Mean No. of Procedures 600 (2017 - 2019) 4
HPB Surgery 3
Mean No. of Procedures500 600 M(e2Na0on1.To7oft-Hal2PP0Br1oSc9ue)rdgueroenss: 4379 No. of HPB Surgeon 2
400 500 Mean Total Procedures : 4379 :8 4 1
3 No. of HPB Surgeon0
300 400 No. of HPB Surgeons : 8 2
1
200 300 0

100 200

0 100

0

CenCteenrtsers CeCnternwteirthwGitehneGraelnSeurragleSonurgeon

witwh iHthPHBPB No.Noof .HoPfBHSPuBrgeSounrgeon
SurSguerogneosns

FFiFiggiguurrueer77e.9.9-73-.39: :H.3HPB:PHBSuPSrBguerSrgyuebrrygyBebMyrySBHbMoySspBHitMaolsSCpiaHttaeolgsoCrpayitteagloCryategory

d) ddT).ypTTeyysppeoesfosHf oHPfBPBHSSPuurBrggeSerruyyrgery

5000 Types of HPB Procedures

50040500 Types of HPB Procedures
45040000
4380 4497

4380 4259 4497
2019
4259

No. of Procedures 40030500

No. of Procedures35030000

2500

3000

2000

2500

1500

20010000

1500500

1000 0 2017 2018 2019
500
Laparoscopic Cholecystectomy
0 Open Cholecystectomy
Open Cholecystectomy with CBD Exploration
2017 Hepatectomy 2018

Whipple's Operation

FigureL7a.9p-a4r:oTscyopepsicofCHhPoBleScuyrsgteercytomy
Open Cholecystectomy
Open Cholecystectomy with CBD Exploration
Hepatectomy
Whipple's Operation

FiFgiugruer7e.97-4.9:.4Ty:pTeyspoef Hs PoBf HSuPrBgeSruyrgery

General Surgery Services Ministry of Health Malaysia 191

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

HEPATOPANCREATICOBILIARY

HOSPITAL CATEGORY 2017 2018 2019
Big 2606 2550 2729
Medium 1353 1258 1226

Small 421 451 542

TOTAL 4380 4259 4497

Table 7.9.1 : Total Number of HPB Surgery by BMS Category

HEPATOPANCREATICOBILIARY

PROCEDURE TYPE 2017 (%) 2018 (%) 2019 (%)
2675 61.1 2594 60.9 2710 60.3
Laparoscopic Cholecystectomy 1072 24.5 1076 25.3 1056 23.5

Open Cholecystectomy 266 6.1 251 5.9 301 6.7
Open Cholecystectomy with CBD
Exploration 198 4.5 164 3.9 236 5.2
Hepatectomy 169 3.9 174 4.1 194 4.3
Hepatectomy 100.0 4497 100.0

TOTAL 4380 100.0 4259

Table 7.9.2 : Types of HPB Surgery

192 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

HEPATOPANCREATICOBILIARY

NO HOSPITALS 2017 2018 2019 MEAN NO. OF HPB

1 Hospital Selayang 483 498 567 PROCEDURES SURGEON
2 HSB Alor Setar 350 249 337 516 3
312 2
3 Hospital Queen Elizabeth 288 254 364
4 Hospital Umum Sarawak 285 302 276 302 1
5 HSA Johor Bahru 194 229 220 288 2
6 Hospital Sibu 156 136 151 214
7 HRPZ Kota Bahru 147 129 149 148 1
8 HTAR Klang 152 120 148 142 2
9 HSNZ Kuala Terengganu 121 135 140 140 2
10 HTJ Seremban 109 120 108 132 3
11 Hospital Melaka 139 146 44 112 1
12 Hospital Seberang Jaya 114 104 98 110 1
13 Hospital Pulau Pinang 98 93 108 105 2
14 HRPB Ipoh 101 114 80 100
15 HSAH Sungai Petani 85 97 107 98 1
16 HSI Johor Bahru 92 72 124 96 2299
96
17 HTAA Kuantan 82 93 97 1
18 Hospital Taiping 70 103 79 91
19 HSNI Batu Pahat 81 77 59 84 1
20 Hospital Kuala Lumpur 57 68 91 72 1
21 Hospital DoK Sandakan 53 77 79 72 1931
22 Hospital Miri 64 60 84 70 1884
23 Hospital Sungai Buloh 78 71 55 69 1877
24 HPSF Muar 76 61 63 68 1861
25 Hospital Bintulu 65 43 79 67 1716
26 Hospital Ampang 60 55 71 62 1707
27 HoSHAS Temerloh 75 61 45 62 1640
28 Hospital Serdang 86 80 10 60 1589
29 Hospital Shah Alam 30 51 73 59 1430
30 Hospital Kajang 57 44 51 51 1300
51 2299
31 Hospital Segamat 46 47 56 2157
32 HTF Kangar 53 32 47 50
33 Hospital Putrajaya 45 45 42 44 2055
34 Hospital Tawau 51 38 33 44 1967
35 Hospital Teluk Intan 33 44 37 41 1931
36 Hospital Kuala Pilah 36 46 26 38 1884
37 HEBHK Kluang 31 31 44 36 1877
38 Hospital Seri Manjung 53 29 20 35 1861
39 HSIP Kuala Krai 11 27 59 34 1716
40 Hospital Tanah Merah 21 37 20 32 1707
41 Hospital Langkawi 22 23 27 26 1640
42 Hospital Kulim 35 18 17 24 1589
43 Hospital Sarikei 8 23 29 23 1430
44 Hospital Keningau 20 18 14 20 1300
17 2299
45 Hospital Kuala Lipis 21 14 11 2157
46 Hospital Kemaman 15 12 17 15
47 Hospital Port Dickson 11 9 23 15 2055
48 Hospital Labuan 4 5 9 14 1967
49 Hospital Lahad Datu 4 5 7 6 1931
50 Hospital Queen Elizabeth 2 10 1 0 5 1884
51 Hospital Kapit 0 7 0 4 1877
52 Hospital Banting 2 5 0 2 1861
53 Institut Kanser Negara 0 1 2 2 1716
1 1707
TOTAL 4380 4259 4497 1640
4379
8

Table 7.9.3 : HPB Surgery by Hospitals

General Surgery Services Ministry of Health Malaysia 193

GENERAL SURGERY

GGeeInnNeePrrAaallTSSIEuuNrrTgg,eeOrryyU::TIIPnnCAppEaaTNIttiiESeeNnnUTttS,,, OOERNuuEPDttppOOaattRSiieeTCnn2Ott,,0PEE1Ynn6ddA-oo2Nss0ccD1oo9ppSyyU,,RSSGuurrEggReeYrryy(((IIIOOOEEESSS))) CCeennssuuss RReeppoorrtt220088

77..99..11 CChhoolleeccyysstteeccttoommyy ((OOppeenn aanndd LLaappaarroossccooppiicc))

7.9.1 Cholecystectomy (Open and Laparoscopic)
aa)) TToottaalla. Total

CChhoolleeccyysstteeccttoommyy

44000000 33774477 33667700 33776666

33550000

NoN.o.ofofPrPorcoecdeudruerses 33000000

22550000

22000000

11550000

11000000

550000

00 22001177 22001188 22001199

FFiigguurree 77..99--55 :: TToottaall nnuummbbeerr ooff CChhoolleeccyysstteeccttoommyy
Figure 7.9.5 : Total number of Cholecystectomy

bb)) BByy BBMMb.SSBCCyaattBeeMggooSrryyHospital Category

CChhoolleeccyysstteeccttoommyy

NoN.o.ofofPrPorcoecdeudruerses 22550000 22002222 22000088 22007799
22000000
11550000 11331155 11222222 11117700
11000000
441100 444400 551177
550000 SSmmaallll

00 BBiigg MMeeddiiuumm
HHoossppiittaall CCaatteeggoorryy

22001177 22001188 22001199
FigurFFeiigg7uu.rr9ee.677..99: --C66h::oCClhheooclleeyccsyytssettceecctttooommmyyybbbyyyBBMBMMSS SCCaaCtteeaggtooerrgyyory

194 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report209
General Surgery: Inpatient, Outpatient, Endoscopy, Surgery (IOES) Census Report209

c) By BMS Hospital Category

c. cB) yByBBMMSS HHosopistapl CitaatelgoCryategory

350 CChh((22oo00llee11cc77yy-s-stt22ee0c0c1t1too99mm)) yy 4
350 Mean Total Procedures : 3728 4
MeMaenanNo.Noo.foPfroPrcoecdeurdeusres 300 MeNano.TooftaHlPPBroSceudrguereosns: 3: 7828 3 No.Noo.fofHPHBPSBurSguregoenosns
300 No. of HPB Surgeons : 8 3
250 2
250 2
200 1
200 1
150 0
150 0
100
100
50
50
0
0

wwSSCCuiuitteerrhhggnneHeHtteeooPPrrnnssBBss CCeenntteerr wwiitthh GGeenneerraall SSuurrggeeoonn

HPB Surgeon
HPB Surgeon
Figure 7.9-7 : Cholecystectomy by BMS Hospital Category

FigurFeig7ur.e97..79-7: :CChhoolelceysctecytosmtey bcytBoMmS HyobspyitalBCMateSgoHryospital Category

MeMaenanNoN.o.ofofPrPorcoecdeudruerses 335500 CChh((22oo00llee11cc77yy-s-stt22ee0c0c1t1too99mm)) yy 44 NoN.o.ofofHPHPBBSuSrugregoenosns
330000 33
225500 MMeeNNaaonon..TTooooffttHaHallPPPPBBrrooSSccueuerdrdgguueerroeoensnsss:::3:387872288 22
11
220000 00
115500
110000
5500
00

wwSSCCuiuitteerrhhggnneHeHtteeooPPrrnnssBBss CCeenntteerr wwiitthh GGeenneerraall SSuurrggeeoonn

LLaappaarroossccooppiicc CChhoolleeccyysstteeccttoommyy OOppeenn CChhoolleeccyysstteeccttoommyy HHPPBBSSuurrggeeoonn

Figure FF7iigg.u9urr.ee877..:99--T88y::pTTyyeppeesss ooofffCCChhoohlleecocyyslsetteecccttooymmsyytbebyycHHtooossppmiittaayll CCbaatyteeggoHorryoy spital Category

CHOLECYSTECTOMY

HOSPITAL CATEGORY 2017 2018 2019
Big 2022 2008 2079
Medium 1315 1222 1170

Small 410 440 517

TOTAL 3747 3670 3766

Table 7.9.4 : Cholecystectomy by BMS Category

General Surgery Services Ministry of Health Malaysia 195

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

CHOLECYSTECTOMY

NO HOSPITALS LAPAROSCOPIC OPEN TOTAL NO. OF HPB

1 Hospital Selayang CHOLECYSTECTOMY CHOLECYSTECTOMY 293 SURGEONS
2 Hospital Queen Elizabeth 165 128 240 3
194 46

3 Hospital Umum Sarawak 124 113 237 2
4 HSB Alor Setar 166 37 203 2
5 HSA Johor Bahru 101 71 172 1
6 Hospital Sibu 118 23 140
7 HTAR Klang 88 38 126
8 HRPZ Kota Bahru 115 10 125
9 HTJ Seremban 97 13 110
10 HSNZ Kuala Terengganu 71 38 109
11 HSAH Sungai Petani 69 27 96
12 Hospital Seberang Jaya 63 32 96
13 Hospital Pulau Pinang 58 36 93
14 HSI Johor Bahru 75 18 93
15 HRPB Ipoh 77 16 93
16 Hospital Melaka 65 23 88

17 Hospital Taiping 66 17 82
18 HTAA Kuantan 58 18 76
19 HSNI Batu Pahat 51 22 72
20 Hospital Kuala Lumpur 49 22 71
21 Hospital Miri 42 26 68
22 Hospital Sungai Buloh 47 18 65
23 HPSF Muar 40 24 64
24 Hospital DoK Sandakan 41 22 64
25 Hospital Ampang 58 3 61
26 Hospital Bintulu 44 18 61
27 Hospital Serdang 41 17 58
28 HoSHAS Temerloh 37 17 54
29 Hospital Shah Alam 39 12 51
30 Hospital Kajang 34 16 50

31 Hospital Putrajaya 34 10 44
32 Hospital Segamat 24 19 43
33 HTF Kangar 26 15 41
34 Hospital Tawau 31 9 40
35 Hospital Teluk Intan 28 10 38
36 Hospital Kuala Pilah 29 7 36
37 HEBHK Kluang 21 13 34
38 Hospital Seri Manjung 30 4 34
39 HSIP Kuala Krai 23 9 32
40 Hospital Tanah Merah 16 10 26
41 Hospital Kulim 20 3 23
42 Hospital Langkawi 15 8 23
43 Hospital Sarikei 7 12 19
44 Hospital Keningau 16 1 17

45 Hospital Kuala Lipis 13 2 15
46 Hospital Kemaman 9 5 15
47 Hospital Port Dickson 12 2 14
48 Hospital Labuan 4 26
49 Hospital Lahad Datu 2 35
50 Hospital Queen Elizabeth 2 2 13
51 Hospital Kapit 2 02
52 Hospital Banting 2 02
53 Institut Kanser Negara 1 01

TOTAL 2660 1068 3728 8

Table 7.9.5 : Cholecystectomy by Hospital Category

196 General Surgery Services Ministry of Health Malaysia

51 Hospital Kapit 20 2
2
52 Hospital Banting 20 1
53 GENERALInstitut Kanser Negara S1URGERY 0 3728
INTPAOTTIEANLT, OUTPATIENT, ENDO2S6C6O0 PY AND SURG1E0R6Y8 (IOES) 8

CTEaNbleS7U.9S-5R:ECPhoOleRcyTste2ct0om1y6b-y2H0o1sp9ital Category

7.9.2 Cholecystectomy with Common Bile Duct (CBD) Exploration
7.9.2 Cholecystectomy with Common Bile Duct (CBD) Exploration
a) Totala. Total

Open Cholecystectomy & CBD Exploration

350

301

300 266 251

No. of Procedures 250

200

150

100

50

0

General Surgery: In2p0a1t7ient, Outpatient, E20n18doscopy, Surgery2(0I1O9 ES) Census Report212

Table 7.9-6 : Total Number of Open Cholecystectomy and CBD Exploration
Table 7.9.6 : Total Number of Open Cholecystectomy and CBD Exploration

b) By BMb.SBCyatBeMgoSryCategory

No. of Procedures Open Cholecystectomy & CBD Exploration

250 225 212 235
200

150

100 30 30 46 11 9 20
Small
50 Medium
Hospital Category
0
Big

2017 2018 2019
FigureF7i.g9u.r9e:7O.9p-9e:nOCpehnoClehcoylesctyesctetcotommyy aannddCCBBDDEExxpplolroartaiotniobny bByMBSMCaSteCgaortey gory

c) By BMS Hospital Category

No. of Procedure 90 79 Open Cholecystectomy & CBD Exploration 4
80 (2017 - 2019) 3
70 2
60 Mean Total Procedures : 273
50 No. of HPB Surgeons : 8
40
30 26 General Surgery Services Ministry of Health Malaysia 197

24

No. of 100

50 30 30 46 11 9 20

GENERAL SURGERY0
Big
Medium Small

INPATIENT, OUTPATIENT, ENDHoOspSitaCl COatePgoYryAND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

2017 2018 2019

Figure 7.9-9 : Open Cholecystectomy and CBD Exploration by BMS Category

c. By BMS Hospital Category

c) By BMS Hospital Category

Mean No. of Procedure 90 79 Open Cholecystectomy & CBD Exploration 4 No. of HPB Surgeon
80 (2017 - 2019) 3

70 Mean Total Procedures : 273
No. of HPB Surgeons : 8

60

50 2
1
40 26 0
17
30 24
14 13 12 11 7 7 7 6 5 5 5 3 3 2 2 2 2 2 1 1 1 1 1 1 1 0 0 0 0
20 11

10

0

Centers Center with General Surgeon
with HPB
Surgeons HPB Surgeon

Figure F7i.g9u.r1e07.9:-O10p: OepnenCChhoolelecycstyecstotemycatnodmCByDaEnxpdlorCatBioDn bEyxBpMlSoHraostpioitanl CbaytegBoMry S Hospital Category

CHOLECYSTECTOMY WITH CBD EXPLORATION

HOSPITAL CATEGORY 2017 2018 2019
Big 225 212 235
Medium 30 30 46

Small 266 251 20

TOTAL 266 251 301

Table 7.9.7: Open Cholecystectomy and CBD Exploration by BMS Category

198 General Surgery Services Ministry of Health Malaysia

GENERAL SURGERY

INPATIENT, OUTPATIENT, ENDOSCOPY AND SURGERY (IOES)

CENSUS REPORT 2016 - 2019

CHOLECYSTECTOMY WITH CBD EXPLORATION

NO HOSPITALS 2017 2018 2019 MEAN NO. OF HPB

1 Hospital Selayang 90 75 73 PROCEDURES SURGEON
2 HSA Johor Bahru 17 32 30 79 3
26 1
3 Hospital Queen Elizabeth 16 20 37
4 HSB Alor Setar 21 8 23 24 1
5 HTAR Klang 19 13 9 17 2
6 HSNZ Kuala Terengganu 10 18 12 14
7 HTAA Kuantan 10 12 15 13 1
8 HRPZ Kota Bahru 13 8 13 12 2
9 Hospital Umum Sarawak 6 14 12 11 2
10 Hospital Seberang Jaya 6 9 6 11 2
11 Hospital Sibu 4 1 15 7 1
12 Hospital Segamat 5 2 13 7 1
13 Hospital DoK Sandakan 5 5 7 7 2
14 HRPB Ipoh 5 4 6 6
15 HoSHAS Temerloh 0 8 6 5 1
16 Hospital Pulau Pinang 9 3 2 5 2299
5
17 Hospital Sungai Buloh 3 4 2 1
18 HSI Johor Bahru 3 4 2 3
19 Hospital Melaka 4 2 1 3 1
20 HPSF Muar 4 2 1 2 1
21 HTF Kangar 1 0 5 2 1931
22 HTJ Seremban 2 2 2 2 1884
23 Hospital Miri 2 1 2 2 1877
24 HEBHK Kluang 1 0 3 2 1861
25 Hospital Kuala Lumpur 3 1 0 1 1716
26 Hospital Ampang 0 0 2 1 1707
27 Hospital Tawau 1 0 1 1 1640
28 Hospital Serdang 2 0 0 1 1589
29 Hospital Queen Elizabeth 2 2 0 0 1 1430
30 Hospital Sarikei 0 2 0 1 1300
1 2299
31 Hospital Taiping 0 0 1 2157
32 HSAH Sungai Petani 1 0 0 0
33 Hospital Kajang 0 1 0 0 2055
34 Hospital Bintulu 1 0 0 0 1967
0
TOTAL 266 251 301 1
273 1

8

Table 7.9.8 : Open Cholecystectomy and CBD Exploration by Hospital Category

General Surgery Services Ministry of Health Malaysia 199

33 0
3334

GENERAL SURGERY34
Hospital Kajang 010
HHoossppiittaall KBainjatnuglu 01 10 00 00
HospitaTl OBiTnAtuLlu 2166 2051 3001 2073
7O.9U-8T:POApeTnIECNhoTle,cEy2sN6te6DctoOmSy CanOd CPB2YD5A1ExNplDoraStiUonRbG3y 0HE1oRspYita(lICOaEteSgo)ry273 8
ITNOPATTAILETaNbTle, 8

Table 7.9-8 : OCpeEnNCShUoleScyRstEecPtoOmyRaTnd2C0B1D6E-x2p0lo1ra9tion by Hospital Category

7.9.3 Hepatectomy
7.9.37.9H.e3paHteecptoamtyectomy

a) Total
a) Totala. Total

HHeeppaatteeccttoommyy 236
236
250
2019
250 2019
198

No.Noo.f oPfroPcreodceurdeusres 200 198 164
200

164
150

150

100
100

50
50

0 2018
0 2017 2018

2017

Figure 7.9-11: Total Number of Hepatectomy
FiguFreigu7r.e9.71.91-:1T1o:tTaoltNaluNmumbeberrooffHHeeppaatetectcotmoymy

b) BByy BBMbM.SSBCCyaatBteeMggooSrryyCategor y
b)

250 227 HHeeppaatteeccttoommyy
250 195 227
No.Noo.f oPfroPcreodceurdeusres 200
200 195 162
150 162

150

100

100

50 305 024
50 305 024

0 Small
Small
0 Big Medium

Big HospMitaeldiCumategory
Hospital Category

2017 2018 2019
2017 2018 2019

Figure 7.9-12 : Total Number of Hepatectomy by BMS Category
FigureFi7gu.9r.e172.9:-T1o2t:aTl oNtaulmNbumerbeorfoHf eHpeapatetecctoommyybybByMBSMCSaCteagoterygory

200 General Surgery Services Ministry of Health Malaysia