Objective To conduct preliminary evaluation of the reliability and safety of pancreatic duct-to-jejunum stent-bridging internal drainage as a supplementary approach to pancreaticojejunostomy in central pancreatectomy.Methods The clinical data of 28 patients who underwent robotic central pancreatectomy performed by our team between January 2021 and November 2024 were retrospectively collected,and and follow-up of postoperative endocrine and exocrine functions was performed.Based on the methods of digestive tract reconstruction adopted,the patients were divided into a conventional pancreaticojejunostomy group and a pancreatic duct-to-jejunum stent-bridging internal drainage group(PancreaticoJejunal-Stent bridge group).The operative time,digestive tract reconstruction time,and short-term complications were compared between the two groups.Results Among patients undergoing robotic central pancreatectomy,the digestive tract reconstruction time was shorter(t=5.168,P<0.001)in the PancreaticoJejunal-Stent bridge group([31.1±6.3]min)than that in the conventional pancreaticojejunostomy group([49.7±8.9]min)(t=5.168,P<0.001).The total operative time was(172.7±64.6)min in the PancreaticoJejunal-Stent bridge group and(200.1±52.7)min in the conventional pancreaticojejunostomy group,showing no statistically significant difference(t=1.215,P=0.235).In the PancreaticoJejunal-Stent bridge group,one patient developed a postoperative biochemical fistula,and 14 patients developed grade B pancreatic fistulas.Among the 14 patients with grade B pancreatic fistulas,1 case was complicated by fistula-related intra-abdominal infection,and 13 cases had drainage tube retention time of more than 21 days.In the conventional pancreaticojejunostomy group,2 patients developed postoperative biochemical fistulas,and 11 patients developed grade B pancreatic fistulas.Among the 11 patients with grade B pancreatic fistulas,1 case was complicated by fistula-related intra-abdominal infection,and 1 case was complicated by fistula-related intra-abdominal bleeding and infection.No postoperative gastroparesis,pancreatitis,or grade C pancreatic fistulas occurred in either group.There were no statistically significant differences between the two groups in overall postoperative complication rate(P=0.522),postoperative pancreatic fistula rate(P=0.583),intra-abdominal infection rate(P=0.583),or bleeding rate(P=0.464).Conclusion Pancreatic duct-to-jejunum stent-bridging internal drainage optimizes the anastomosis between the distal end of the pancreas and the jejunum during central pancreatectomy,shortens digestive tract reconstruction time,and reduces surgical complexity without increasing the risk of short-term severe postoperative complications.This approach is safe and feasible.

Objective To investigate the role and mechanism of lysine acetyltransferase 8(KAT8)on the prolifera-tion of colorectal cancer cells.Methods The expression of KAT8 in cancerous tissues and adjacent tissues of color-ectal cancer patients was analyzed by RNA-seq data of TCGA database.Cell proliferation was detected by colony-forming unit assays and CCK8.The GEO database was used to analyze the differential genes of KAT8 knockdown cells and control cells and perform functional pathway enrichment analysis.In the colorectal cancer database hosted on cBioPortal,that conducted an analysis examining the correlation between KAT8 and genes in the regulation of N6-methyladenosine(m6A)modification.Western blot technique was employed to assess the protein expression lev-els of KAT8 and METTL3.Results Compared to human normal colorectal tissue,KAT8 was highly expressed in colorectal cancer(P＜0.05).Knockdown or selective inactivation of KAT8 inhibited colorectal cancer cells prolifera-tion(P＜0.05).In colorectal cancer cell lines,knocking down KAT8 reduced m6A modification levels(P＜0.05).Knocking down KAT8 inhibited METTL3 expression(P＜0.05).Over-expression of METTL3 reversed cell prolifera-tion which was inhibited by knockdown KAT8(P＜0.05).Conclusions KAT8 facilitates the proliferation of color-ectal cancer cell lines through regulation of METTL3-mediated m6A modifications.

Objective:To evaluate the day-surgery unit-based training of laparoscopic cholecystectomy (LC).Methods:Perioperative data of 438 patients (187 males and 251 females) with a median age of 54 (aged 17 to 91) years undergoing LC during January 2019 to April 2021 in the day-surgery unit of Chinese PLA General Hospital were retrospectively collected and subdivided according to the training methods of surgeons [Group A( n=260): conventional training vs. Group B ( n=178): protocoled stepwise training]. The protocoled stepwise training consists of the rotation in open biliary surgery unit, the stimulator-based laparoscopic training, and the stepwise procedural tutoring. The conventional training features the traditional surgical practice following senior surgeons. The technical data involving operation time, blood loss, the percentages of intraoperative decision-making by senior surgeons and the handing-over of procedure to senior surgeons, etc. were statistically analyzed. Results:The operation time was shortened in Group B [(55±30) min vs. (61±33) min], with significantly decreased percentages of intraoperative decision-making by senior surgeons [7.9% (14/178)vs. 16.9%(44/260), P<0.05] and the handing-over of procedure to senior surgeons [3.4%(6/178) vs. 11.2%(29/260), P<0.05]. Conclusion:Based on the protocoled stepwise training and the consecutive, high-volumed and standardized procedures, the laparoscopic technical proficiency and competency of the trainee surgeons have been improved.

Objective To investigate the application value of fusion indocyanine green fluorescence imaging (FIGFI) in the laparoscopic anatomical liver resection (ALR).Methods The retrospective crosssectional study was conducted.The clinical data of 21 patients who underwent laparoscopic ALR using FIGFI in the Chinese People's Liberation Army General Hospital between December 2015 and February 2017 were collected.Indocyanine green (ICG) staining included positive staining and negative staining.Observation indicators:(1) intraoperative situations:surgical procedures,extent of liver resection,methods and results of ICG staining,operation time,volume of intraoperative blood loss,cases with blood transfusion;(2) postoperative situations:postoperative complications,duration of postoperative hospital stay,postoperative pathological examination;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the patients' survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as average (range).Results (1) Intraoperative situations:of 21 patients,20 underwent successful laparoscopic ALR and 1 had conversion to open surgery.The positive and negative stainings of ICG were respectively applied to 5 and 16 patients.Seventeen patients had successful staining and 4 had failed staining.Average operation time,average volume of intraoperative blood loss and cases with blood transfusion were respectively 268 minutes (range,120-360 minutes),388 mL (range,100-800 mL) and 3.(2) Postoperative situations:5 patients had postoperative complications,including 3 with Clavien-Dindo classification Ⅰ and 2 with Clavien-Dindo classification Ⅱ.Average duration of postoperative hospital stay of 21 patients was 9.3 days (range,6.0-14.0 days).Sixteen patients with malignant tumor had negative surgical margins.(3) Follow-up situations:all the 21 patients were followed up for 1.0-14.0 months,with a median time of 3.3 months.During follow-up,all the patients survived,and 1 patient had tumor recurrence.Conclusion The FIGFI is safe and feasible in the laparoscopic ALR,with a good short-term outcome.

Since the concept of molecular imaging was put forward in 1999,optical molecular imaging techniques have been widely applied in the field of biomedical and clinical research.Its unique application value is especially shown in hepatobiliary surgery,such as in liver tumor imaging,anatomical liver resection,liver transplant angiography,cholangiography,and bile or pancreatic leakage prevention.Optical molecular imaging technique "lights up" targeted areas in surgical operations and provides convenience in carrying out precision operation.This paper reviewed the advantages of optical molecular imaging technology in clinical research and discussed its limitations in translational surgery,and put forward possible directions in improvement for the future.