Building effective relationships in global surgery: an exploratory qualitative study.

Background: The rise in malignant hepatopancreatobiliary tumors disproportionately affects low- and middle-income countries (LMICs) due to systemic challenges. In 2023, the International Hepatopancreatobiliary Association (IHPBA) launched a relationship-building initiative to mitigate outcome disparities by increasing capacity and quality. This study aimed to understand the dynamics and value of such collaborations.

Methods: This was a qualitative, descriptive study utilizing virtual, semi-structured interviews of surgeons and proceduralists engaged in international HPB surgery collaborations. Transcripts were coded inductively, allowing themes to emerge.

Results: Sixteen surgeons and one proceduralist participated from six world regions. Six were from high-income countries and 11 from LMICs. Overarching themes were: Interconnected Resources, Relationships, and Experiences. Country resources, professional relationships, and previous and ongoing collaborations were highly inter-connected. The IHPBA and individuals' resources presented both barriers and facilitators to collaboration.

Conclusion: Increasing access to and mutual understanding of resources is foundational for successful partnerships. Professional networks are also essential, and access to networking should be expanded and diversified. Partners must understand environments' constraints and needs. Associations like IHPBA should be networking drivers, increasing surgeons' informal and formal platform use. Surgical associations have a responsibility to create a culture that promotes and prioritizes participants' experiences beyond productivity.