Analysis of Authorship in Hepatopancreaticobiliary Surgery: Women Remain Underrepresented



Given the need to increase female representation in hepatopancreatobiliary (HPB) surgery, as well as the need to increase the academic pipeline of women in this subspecialty, we sought to characterize the prevalence of female authorship in the HPB literature. In particular, the objective of the current study was to determine the proportion of women who published HPB research articles as first, second, or last author over the last decade.


All articles pertaining to hepatopancreaticobiliary (HPB) surgery appearing in seven surgical journals (Annals of Surgery, British Journal of Surgery, JAMA Surgery, Annals of Surgical Oncology, HPB (Oxford), Surgery, and Journal of Gastrointestinal Surgery) were reviewed for the years 2008 and 2018. Information on sex of author, country of author’s institution, and article type was collected and entered into a computerized database.


Among the 1473 index articles included in the final analytic cohort, 414 (28%) publications had a woman as the first or last author, while the vast majority (n = 1,059, 72%) had a man as the first or last author. The number of female first authors increased from 15.6% (n = 92/591) in 2008 to 25.7% (n = 227/882) in 2018 (p < 0.001). There were no differences in the proportion of second (n = 123/536, 23.0% vs n = 214/869, 24.6%, p = 0.47) or last (n = 44/564, 7.8% vs n = 88/875, 10.1%, p = 0.15) authors. Women were more likely to publish papers appearing in medium-impact journals (OR 1.40, 95% CI 1.04–1.88) and articles with a female author were more likely to be from a North American institution (referent: North America, Asia OR 0.43, 95% CI 0.31–0.59 vs Europe OR 0.67, 95% CI 0.51–0.87).


Women first/last authors in HPB research articles have increased over the past 10 years from 22 to 32%. Women as last authors remain low, however, as only 1 in 10 papers had a senior woman author. These data should prompt HPB leaders to find solutions to the gap in female authorship including mentorship of young female researchers and surgeons.

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Author information




All authors participated in the following:

• Substantial contributions to the study conception and design, data acquisition or analysis, and data interpretation;

• Drafting the manuscript or reviewing it critically for important intellectual content;

• Approval of the final version of the manuscript.

The main role of the authors was as follows:

1. Guarantor of the integrity of the entire study: Mary E. Dillhoff

2. Study conception and design: Mary E. Dillhoff, Timothy M. Pawlik, and Ayesha Farooq.

3. Literature search: Ayesha Farooq, Kota Sahara, Aeman Muneeb, Khadija Farooq, and Diamantis Tsilimigras

4. Clinical studies: Katiuscha Merath, Anghela Z. Paredes, Rittal Mehta, Kota Sahara, Fabio Bagante, and Eliza W. Beal

5. Data analysis: Ayesha Farooq, Kota Sahara, and Madison Hyer

6. Statistical analysis: Ayesha Farooq, Kota Sahara, and Madison Hyer

7. Manuscript preparation: Ayesha Farooq and Kota Sahara

8. Manuscript review: Ayesha Farooq, Timothy M. Pawlik, and Mary E. Dillhoff

Corresponding author

Correspondence to Mary E. Dillhoff.

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Farooq, A., Sahara, K., Muneeb, A. et al. Analysis of Authorship in Hepatopancreaticobiliary Surgery: Women Remain Underrepresented. J Gastrointest Surg 24, 2070–2076 (2020).

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  • Authorship
  • Women surgeons
  • Mentorship