Understanding Upper Gastrointestinal and Hepatopancreaticobiliary Surgery in New Zealand

New Zealand is a low-volume center for upper gastrointestinal surgery, with most complex procedures concentrated in national cancer centers. There is evidence of regionalization, where larger centers perform procedures more frequently. Palliative procedures are more widely performed, but indigenous Māori are less likely to be treated in designated cancer centers. The challenge lies in optimizing complex surgery skills while ensuring equitable access for all patients.