ObjectiveTo compare and analyze the clinical application of robot-assisted parenchymal-sparing pancreatectomy （R-PSP） and laparoscopic parenchymal-sparing pancreatectomy （L-PSP） in the treatment of pancreatic neuroendocrine neoplasm （pNEN）， and to evaluate the safety and efficacy of the R-PSP procedure. MethodsA retrospective analysis was performed for the clinical data of pNEN patients who underwent parenchymal-sparing pancreatectomy in Department of General Surgery， Peking Union Medical College Hospital， Peking Union Medical College， Chinese Academy of Medical Sciences， from December 2017 to August 2023， and according to the minimally invasive surgical procedure， they were divided into R-PSP group and L-PSP group. R-PSP and L-PSP were compared in terms of the efficacy of minimally invasive procedure， the outcome of postoperative complications， and oncological efficacy. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups； the Mann-Whitney U test was used for comparison of ranked data between two groups. ResultsA total of 45 pNEN patients were included， with 9 in the R-PSP group and 36 in the L-PSP group， and there were no significant differences in baseline data between the two groups （all P>0.05）. There were no significant differences between the two groups in time of operation， intraoperative blood loss， intraoperative blood transfusion， and the rate of conversion to laparotomy （all P>0.05）. Compared with the L-PSP group， the R-PSP group had a significantly longer length of postoperative hospital stay ［10.00 （9.00‍ ‍—‍ ‍15.00） days vs 7.50 （6.00‍ ‍—‍ ‍10.00） days， Z=-2.356， P=0.017］ and significantly higher hospital costs ［86 610.44 （81 905.39‍ ‍—‍ ‍114 401.24） yuan vs 38 781.20 （31 708.39‍ ‍—‍ ‍50 514.76） yuan， Z=-4.001， P<0.001］. There were no significant differences between the two groups in the incidence rates of serious postoperative complications （Clavien-Dindo grade ≥Ⅲ）， clinically relevant pancreatic fistula， delayed gastric emptying， and intra-abdominal infection （all P>0.05）. The postoperative 90-day mortality rate was 0% for both groups. ConclusionR-PSP has acceptable safety and efficacy in pNEN patients in clinical practice.

In recent years， significant progress has been made in the standardized diagnosis and treatment of pancreatic cancer in China. From the lack of treatment options and poor drug efficacy at the beginning to the current comprehensive treatment modality integrating surgery， chemotherapy， radiotherapy， immunotherapy， and targeted therapy under multidisciplinary decision-making， the diagnosis and treatment of pancreatic cancer has gradually achieved higher levels of individualization， refinement， and precision. With reference to the latest evidence-based medical data， this article discusses the hot topics in the diagnosis and treatment of pancreatic cancer and explores the future development directions of this field.

This article reviews the research advances in the characteristics and application progress of various new models for preclinical cancer research on pancreatic cancer， analyzes and discusses the history， current research status， and advantages and disadvantages of new models of pancreatic cancer， including patient-derived tissue xenograft， conditional reprogramming， and patient derived organoids， and it also reviews the studies that have achieved clinical transformation from preclinical models and proposes possible research prospects in the future.

The onset of pancreatic cancer is insidious, and most patients have accompanied by distant metastasis at the time of definite diagnosis. Previously, it was believed that regardless of the size, number and location of metastases, the surgical benefits of patients with metastatic pancreatic cancer were extremely limited. However, with the promotion of the concept of oligometastasis in recent years, an increasing number of studies have confirmed that surgical resection after induction therapy can significantly improve the clinical prognosis in some highly selected patients with oligometastatic disease of pancreatic cancer. However, there still remains many controversies about the clear definition, surgical treatment and perioperative management of oligometastatic disease of pancreatic cancer. Therefore, based on the latest research progress, this article proposes to discuss the related hot topics and disputes in the field of oligometastatic disease of pancreatic cancer for purpose of promoting the standardization of the treatment of oligometastatic disease of pancreatic cancer.

Pancreatic cancer is characterized by high malignancy and difficult early diag-nosis, with the majority of patients presenting at advanced, unresectable stages at the time of initial diagnosis. The efficacy of conventional treatments, including surgery, radiotherapy, and chemo-therapy, has reached a therapeutic plateau. The concept of precision medicine has gradually infiltrated the diagnosis and treatment of pancreatic cancer, driving the advancement of individua-lized therapies. Large-scale, multi-center studies have significantly advanced the molecular classifica-tion of pancreatic cancer, providing a basis for personalized treatment. Minimally invasive surgery, especially robotic surgery, has seen significant development and is increasingly entering clinical practice. The development of personalized drug screening, targeted therapy, and immunotherapy has paved new avenues for precision treatment. The authors review the latest research progress both domestically and internationally, discussing the application of precision medicine in the treat-ment of pancreatic cancer, aiming to improve patient prognosis.

Pancreatic cancer is characterized by high malignancy and difficult early diag-nosis, with the majority of patients presenting at advanced, unresectable stages at the time of initial diagnosis. The efficacy of conventional treatments, including surgery, radiotherapy, and chemo-therapy, has reached a therapeutic plateau. The concept of precision medicine has gradually infiltrated the diagnosis and treatment of pancreatic cancer, driving the advancement of individua-lized therapies. Large-scale, multi-center studies have significantly advanced the molecular classifica-tion of pancreatic cancer, providing a basis for personalized treatment. Minimally invasive surgery, especially robotic surgery, has seen significant development and is increasingly entering clinical practice. The development of personalized drug screening, targeted therapy, and immunotherapy has paved new avenues for precision treatment. The authors review the latest research progress both domestically and internationally, discussing the application of precision medicine in the treat-ment of pancreatic cancer, aiming to improve patient prognosis.

The onset of pancreatic cancer is insidious, and most patients have accompanied by distant metastasis at the time of definite diagnosis. Previously, it was believed that regardless of the size, number and location of metastases, the surgical benefits of patients with metastatic pancreatic cancer were extremely limited. However, with the promotion of the concept of oligometastasis in recent years, an increasing number of studies have confirmed that surgical resection after induction therapy can significantly improve the clinical prognosis in some highly selected patients with oligometastatic disease of pancreatic cancer. However, there still remains many controversies about the clear definition, surgical treatment and perioperative management of oligometastatic disease of pancreatic cancer. Therefore, based on the latest research progress, this article proposes to discuss the related hot topics and disputes in the field of oligometastatic disease of pancreatic cancer for purpose of promoting the standardization of the treatment of oligometastatic disease of pancreatic cancer.

Pancreatic cancer is a malignant tumor with extremely poor prognosis,and its biological behavior is closely related to its genetic characteristics.Traditional preclinical research models struggle to accurately simulate the complex genetic heterogeneity and histological characteristics of pancreatic cancer.In recent years,the development of organoid models and CRISPR(Clustered Regularly Interspaced Short Palindromic Repeats)technology has provided new tools for pancreatic cancer research.Organoids can simulate the genetic and histological features of primary tumors,while CRISPR technology enables precise genetic manipulation in organoids.CRISPR Gene-Editing Organoids can model the occurrence and evolution of pancreatic cancer,conduct gene function analysis,and perform drug screening.This review discusses the recent advancements in the application of organoid models combined with CRISPR technology in pancreatic cancer research,which are expanding our understanding of pancreatic cancer.

Abdominal surgery as a common type of clinical surgery, postoperative treat-ment and rehabilitation has always been the focus of surgeons. Somatostatin drugs are commonly used for postoperative bleeding, portal hypertension bleeding, and prophylactic treatment of com-plications such as acute pancreatitis. However, the standardized application of somatostatin still faces numerous challenges in clinical practice. The famous experts and their teams in the field of digestive surgery, medical insurance expert and lawyer, combined with the experience of their respective centers, under the new national medical insurance policy, explore the significance of treatment and rehabilitation after abdominal surgery and the application strategy of somatostatin drugs from different angles. Professor Zhang Taiping succinctly explained the incidence and harm of gastro-intestinal fistula, pointing out that "how to heal the fistula in a short time" is the main rehabilitation goal and the treatment is mainly comprehensive treatment. Professor Chen Chaowu comprehen-sively introduces diagnostic and treatment processes for several representative cases encountered in clinical practice while sharing his team′s rich clinical experience and posing reflective questions. Professor Li Fei starts with practical cases, focusing on duodenal fistula, including fistula caused by complications after endoscopic retrograde cholangiopancreatography, with special emphasis on Stanford classification and different types of treatment. Ms. Zhang Qun interprets national medical insurance policies. She emphasizes the significance of supervising medical insurance funds and shares experiences related to issues regarding autonomous management by healthcare institutions. Lawyer Li Hongqi provides comprehensive suggestions on rational use of drug based on policy guidance and practical cases.

Objective To explore the application value of deep learning image reconstruction(DLIR)with coronary computed tomography angiography(CCTA)using 100 kV.Methods Sixty patients who underwent CCTA were selected.The tube voltage of 100 kV,noise index of 24 were applied.The 60％adaptive statistical iterative reconstruction-Veo(ASIR-V)and DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DL1R-H)were reconstructed.The CT values and standard deviation(SD)values of the aortic root,left main artery,left anterior descending artery,left circumflex artery,right coronary artery and pericardial fat of the four groups of images were measured,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.Two radiologists with five-year working experience subjectively evaluated the image quality using a five-point method double-blindly.Results The differences in noise(SD values),SNR values and CNR values among the four groups of images were statistically significant(P＜0.001).As the reconstruction gradually changed of 60％ASIR-V,DLIR-L,DLIR-M and DLIR-H,the coronary SD values gradually decreased,while the SNR values and CNR values gradually increased,among which the DLIR-H had the lowest SD values and the highest SNR values and CNR values.The subjective scores of the four groups of images by two radiologists showed good consistency(Kappa value=0.929,P＜0.001),and the subjective scores were all above 3 points which met the clinical diagnosis criteria.The subjective scores of DLIR-L,DLIR-M and DLIR-H were significantly higher than those of 60％ASIR-V(P＜0.001),with the DLIR-H achieving the highest subjective score.Conclusion DLIR can significantly reduce image SD value and improve image quality of CCTA with 100 kV,among which DLIR-H has the best effect on improving CCTA image quality.