Surgeons trained in dedicated hepato-pancreato-biliary fellowships see better patient outcomes after HP cancer surgeries.

• Graduates of HPB fellowships achieved a 47.7% likelihood of textbook outcomes (TOS), compared to 45.2% for surgical oncology and 42.8% for transplant fellowship graduates.
• Patients operated by HPB fellowship graduates often had higher comorbidity scores and greater urgencies, highlighting the need for tailored surgical approaches.

Improving HP surgery training for general surgical oncology fellows could enhance overall outcomes.

• Early and mid-career HPB fellowship graduates notably outperform their peers in achieving TOS.