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.

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.

As a systemic disease,pancreatic cancer is highly malignant and has a high rate of recurrence and metastasis,which makes it particularly difficult in diagnosis,treatment and management.In recent years,with the concept of neoadjuvant therapy deeply rooted in the hearts of the people,the treatment of pancreatic cancer has increasingly emphasized the development of comprehensive and individualized treatment schemes in the whole process and multi-dimensional management of pancreatic cancer patients.However,there still remain many controversies about the application of neoadjuvant therapy for resectable pancreatic cancer.This review intended to discuss the hot topics and related controversies in the implementation of neoadjuvant therapy for patients with resectable pancreatic cancer based on domestic and foreign guidelines and the latest research progress,which may vastly promote the standardized application of neoadjuvant therapy for resectable pancreatic cancer.

Pancreatic surgery is one of the most challenging specialties in general surgery. Due to the variety of pancreatic diseases, the difficulty of surgery, and the differences in diagnosis and treatment among different diseases, treatment strategies for these diseases remain controversial. From the aspects of surgical treatment such as pancreatitis, pancreatic cystic neoplasms, pancreatic neuroendocrine neoplasms, and pancreatic cancer, as well as neoadjuvant therapy, adjuvant therapy, immunotherapy, and targeted therapy. We review and summarize the frontier progress of clinical and translational research in pancreatic surgery in 2023, in order to further standardize the diagnosis and treatment of pancreatic surgery.

Pancreatic cystic neoplasm (PCN) is characterized by cystic degeneration with a low incidence. With the development of imaging technology and the popularization of screening, the detection rate of this disease has been increasing in recent years, especially in the elderly population. Due to the multiple subtypes of PCN, difficult differential diagnosis, and the potential risk of malig-nant transformation, the formulation of reasonable diagnosis and treatment strategy is the key to treat PCN. Although many clinical guidelines have been released, the diagnosis and treatment strategies of PCN are still controversial. Elderly patients are generally weak, some with serious comorbidities, and have poor tolerance to surgery. In the process of diagnosis and treatment, clinicians need to pay special attention, carefully evaluate and weigh the advantages and disadvantages, so as to make the best plan for treatment. Based on the current guidelines and clinical experience, the authors summarize the diagnosis, surgical indications, and the whole-course management strategies of elderly patients with PCN, in order to provide suggestions for the diagnosis and treatment of this disease.

In February 2023, the European Neuroendocrine Tumor Society (ENETS) offi-cially released guidance paper for digestive neuroendocrine carcinoma. Based on the latest develop-ments and research results, the guidelines provide detailed explanations and practical recommen-dations on the epidemiology, diagnosis, prognostic indicators, treatment, and other aspects of digestive neuroendocrine carcinoma. The authors aim to interpret the key contents of the guidelines in order to further provide standardized clinical diagnosis and treatment processes.

With the development of neoadjuvant therapy, the treatment of pancreatic cancer has entered the era of comprehensive diagnosis and treatment consisting of surgery, chemo-therapy and radiotherapy. In recent years, the concept of 'total neoadjuvant therapy' has become one of the important treatment methods for locally advanced rectal cancer. The authors focus on pancrea-tic cancer, introduce the development status of total neoadjuvant therapy in pancreatic cancer and summarize the current controversies and challenges in the application of total neoadjuvant therapy in pancreatic cancer, in order to further standardize the diagnosis and treatment of pancreatic cancer and improve the overall level of pancreatic cancer treatment in China.