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Copyright of Canadian Journal of Surgery is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Participation by surgical trainees in complex procedures is key to their development as future practicing surgeons. The impact of surgical fellows versus general surgery resident assistance on outcomes in pancreatoduodenectomy (PD) has not been well studied. The purpose of this study was to determine differences in patient outcomes based on level of surgical trainee.Methods: Consecutive cases of PD (n = 254) were reviewed at a single high-volume institution over a 2-year period (July 2013-June 2015). Thirty-day outcomes were monitored through the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) and Quality In-Training Initiative. Patient outcomes were compared between PD assisted by general surgery residents versus hepatopancreatobiliary fellows.Results: The hepatopancreatobiliary surgery fellows and general surgery residents participated in 109 and 145 PDs, respectively. The incidence of each individual postoperative complication (renal, infectious, pancreatectomy-specific, and cardiopulmonary), total morbidity, mortality, and failure to rescue were the same between groups.Conclusions: Patient operative outcomes were the same between fellow- and resident-assisted PD. These results suggest that hepatopancreatobiliary surgery fellows and general surgery residents should be offered the same opportunities to participate in complex general surgery procedures. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis is a substantial clinical problem accounting for 240,000 hospital admissions yearly in the United States. Obesity is epidemic and is clearly an independent risk factor for increased severity of acute pancreatitis (AP). Adipose tissue is an endocrine organ that secretes a variety of metabolically active substances termed adipokines. However, the role of adipokines in modulating acute pancreatitis severity remains incompletely understood. Dietary fish oil is rich in omega-3 free fatty acids and attenuates adipose tissue-induced inflammation. Therefore, we hypothesized that feeding obese mice diets rich in fish oil would alter the adipokine milieu and attenuate the severity of pancreatitis.Methods: Lean (C57BL/6 J) and obese (LepDb) mice were fed either a soybean oil- or fish oil-rich diet for 4 weeks. AP was induced by six hourly intraperitoneal injections of cerulein (50 μg/kg). Serum adipokine levels were measured, and pancreatitis severity was assessed histologically and by measuring pancreatic concentrations of interleukin-1 beta (IL-1β), interleukin-6 (IL-6), myleoperoxidase (MPO), and monocyte chemoattractant protein-1 (MCP-1).Results: Obese mice developed more severe pancreatitis than lean mice. Fish oil significantly decreased serum leptin (lean and obese) and increased serum adiponectin (lean only). Fish oil did not alter the baseline pancreatic inflammatory milieu, nor did it change histologic or biochemical pancreatitis severity.Conclusion: These data demonstrate that a diet rich in fish oil altered the adipokine milieu in lean and congenitally obese mice; however, fish oil did not improve pancreatitis severity induced with cerulein hyperstimulation. [ABSTRACT FROM AUTHOR]

Introduction: The 44th meeting of the Pancreas Club was held on May 1 and 2, 2010 in New Orleans., Discussion: The program consisted of 42 oral presentations (Table 1) and 61 abstracts chosen for poster presentation. Ten posters each day were chosen for presentation as part of the professor rounds portion of the formal poster viewing program. Summaries of the oral presentations are provided.

Purpose: Beginning in July 2003, residency programs will be required to incorporate new educational assessment methods as defined by the Accreditation Council for Graduate Medical Education (ACGME) outcome initiative. The Objective Structured Clinical Examination (OSCE) is an assessment tool that is favorably viewed by the ACGME. Our institution has utilized the OSCE for evaluation of surgery trainees since 1996. Despite the positive acceptance of the OSCE by students, residents expressed dissatisfaction with the examination. This study was therefore undertaken to specifically evaluate resident perception of the OSCE., Methods: Two sequential surveys were administered to surgery residents at the Medical College of Ohio. Response of medical students to a standard survey following completion of the OSCE was tabulated., Results: On the first, general survey, residents felt that the OSCE was not an adequate measure of either clinical (15 of 17 residents) or technical (15 of 18 residents) skills; 14 of 16 residents felt that the OSCE should not be used when considering promotion. When specifically queried in a follow-up survey, residents indicated that the OSCE was an adequate measure of clinical knowledge (2.2 +/- 0.3); however, most still felt that the OSCE should not be used when considering promotion (4.3 +/- 0.3). (Scores = mean +/- SEM on a Likert scale where 1 = strongly agree and 5 = strongly disagree). By contrast, 97.6% of 663 medical students surveyed (September 1996 through February 2002) felt the OSCE was useful., Conclusions: The OSCE has been shown to be a reliable and valid measure of basic clinical and technical competence. Despite our residents' current perception, we believe that the OSCE is an important method for resident evaluation, particularly within the context of the current ACGME outcome initiative.