No Drain, No Problem: Serum-Based Marker Prediction of Clinically Relevant Postoperative Pancreatic Fistula.

Background: Postoperative day (POD) 1 drain amylase concentration (DAC) is considered the most accurate predictor for the development of a clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD). Recent studies have associated drain placement with negative postoperative outcomes. This study aims to evaluate multiple biochemical markers and their associations with CR-POPF development in order to identify a reliable, non-drain dependent alternative to DAC.

Teacher and Trainee Learning Together-Dual Console and the 3 Arms.

Objective: The purpose of this paper is to propose a method by which the trainer and the trainee can overcome their learning curves together.

Design/setting/participants: At a tertiary care facility where we have completely done away with the mandatory bedside procedure requirements, residents and fellows start all cases on the console and have graduated responsibilities assigned to them. Bedside assist cases were felt to take away from trainee precious console time when there were only on service for a limited period while providing laparoscopic skill training without any robot-specific experience.