In a clinical introductory program, each group of 9 fifth-year medical students rotated through 9 courses every 2 weeks. In each class, students evaluated the instructional abilities of the faculty. Eighty-two students answered 7 questions on a 5-point scale immediately after each class was completed. Because the questionnaire also served as a record of attendance, responses were obtained from all students who attended. Overall satisfaction was correlated most strongly with teaching skills, followed by contents of the class to achieve goals and the level of difficulty. The evaluation of faculty's instructional abilities by students can provide valuable information on areas to improve so that students can be educated more effbctively and with greater satisfaction.

Portal vein thrombosis (PVT) is a rare but serious postoperative complication of pancreaticoduodenectomy (PD). We reported a case of late-onset postoperative PVT with hemorrhage from the common hepatic artery (CHA) in a 73-year-old man who underwent pylorus-preserving pancreaticoduodenectomy (PPPD) for duodenum papilla cancer, followed by reconstruction using the modified Child's technique. The pancreaticojejunostomy was achieved by end-to-side, 2-layer invagination anastomosis without pancreatic duct stenting. Drain removal and hospital discharge were scheduled on postoperative day (POD) 18, but blood-stained fluid in the drain and sudden hematemesis were noted. Emergency surgery was performed because PVT and imaging findings were suggestive of necrosis of the lifted jejunum. Although no jejunal necrosis was identified during surgery, bleeding from the side of the CHA was detected and the bleeding point was suture-closed to achieve hemostasis. We suspected late-onset postoperative arterial hemorrhage and subsequent hematoma formation, which caused portal vein compression and PVT formation. We chose a conservative treatment strategy for PVT, taking into account the operation time, intraoperative vital signs and blood flow in the portal vein. Despite the complicated postoperative course, he was discharged home in a fully ambulatory state on POD 167.
Aged ; Duodenum ; Emergencies ; Hematemesis ; Hematoma ; Hemorrhage* ; Hemostasis ; Hepatic Artery* ; Humans ; Jejunum ; Necrosis ; Pancreatic Ducts ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy ; Portal Vein* ; Postoperative Complications ; Postoperative Hemorrhage ; Stents ; Venous Thrombosis* ; Vital Signs