1.The current status and challenges of pediatric liver transplantation in China
Chinese Journal of Digestive Surgery 2024;23(1):49-54
After more than 20 years of development, pediatric liver transplantation has become a routine surgical practice in China, and currently ranks first in the world in terms of surgery quantity yearly. Further improving of liver transplantation technique and enhancing postoperative management to enable pediatric liver transplantation patients to return to normal social life are challenges for the academic community. The development of precision surgery, minimally invasive technology, big data information interconnection, and artificial intelli-gence has also brought new opportunities to researchers. The authors discuss the indications, surgical techniques, postoperative management system, immune suppression and tolerance, social humanities and ethics of pediatric liver transplantation in China, in order to promote the development of related fields of pediatric liver transplantation in China.
2.Standardize the management of ERCP complications and accelerate the widespread populari-zation of ERCP in China
Wenbo MENG ; Xun LI ; Zhaoshen LI
Chinese Journal of Digestive Surgery 2024;23(1):55-58
The process of endoscopic retrograde cholangiopancreatography (ERCP) is inva-sive, and its related treatments have a potential risk of complications, which poses certain obstacles to its safe promotion. Therefore, it is very important to standardize the management of ERCP compli-cations and promote the widespread development of ERCP in China. The authors interpret the back-ground, significance, and key issues that need to be paid attention to in the Guidelines for the management of complications of duodenal perforation associated with ERCP in China ( 2023 edition), in order to facilitate ERCP physicians to better grasp and apply the guidelines, provide guidance and reference for the standardized management of ERCP related complications of duodenal perforation, and promote the popularization and widespread development of ERCP in China.
3.A "surgical ring" that embodies exquisite art and science
Chinese Journal of Digestive Surgery 2024;23(1):59-69
Surgeons hold a grand and sacred profession, with the privilege to operate on the human body being a divine gift. Over time, a thick callus forms on the ring finger of a surgeon′s right hand, known as the "Surgical Ring". This unique mark of the surgical profession signifies the thousands of operations performed and lives saved. It is the supreme reward for a surgeon. This ring embodies the art and science of surgery accumulated over centuries, reflecting surgeons′ sincere pursuit of truth in surgical medicine and their spirit of scientific exploration. To possess a shining "Surgical Ring" is our lifelong dream and pursuit. As surgeons we must continually enhance and perfect ourselves, enriching our understanding of the surgical profession through art, philosophy, literature, sports, and humor. This includes improving personal cultivation and professional quali-ties, encompassing clinical skills, research, teaching, international academic background, innovative logic and design thinking, medical professionalism, personal qualities, environ-mental and self-awareness, as well as personality and values. By utilizing our talents, intelligence, and professional ambition, we aspire to soon wear this glittering "Surgical Ring", becoming outstanding surgeons.
4.Current status and clinical issues of conversion therapy for advanced gastric cancer
Guoxin LI ; Liying ZHAO ; Huayuan LIANG
Chinese Journal of Digestive Surgery 2024;23(1):70-74
Advanced gastric cancer, characterized by high heterogeneity and poor prognosis, has traditionally been managed with a palliative care-centric comprehensive treatment. The concept of conversion therapy aims to reduce tumor staging and achieve complete tumor resection after comprehensive treatment of initially unresectable tumors, thereby improving patient prognosis. Recent large-scale clinical studies have demonstrated that immune checkpoint inhibitors combined with chemotherapy can significantly increase the objective remission rate and improve the survival of patients with advanced gastric cancer. Meanwhile, with the extensive development of multidisci-plinary teams and the advancement of surgical techniques, conversion therapy has shown great potential in improving the prognosis of advanced gastric cancer. However, due to the complexity of advanced gastric cancer in terms of local staging, metastatic sites, and molecular typing, there are still many controversies and unanswered questions in the field of conversion therapy. The authors systematically elaborate on the research progress of gastric cancer conversion therapy both domes-tically and internationally, and explore the current status and clinical issues of conversion therapy for advanced gastric cancer.
5.Re-understanding of surgical resection techniques for liver cancer
Qingguang LIU ; Tao SONG ; Huanhuan WANG
Chinese Journal of Digestive Surgery 2024;23(1):75-79
Liver cancer is still a major disease threatening the lives and health of the Chinese people. For early liver cancer with good liver functional reserve, surgical resection remains as the preferred treatment option. In the past several decades, great advances have been made in hepatectomy because of the refinement of surgical theories, advancements in surgical techniques, and improvements in surgical equipment. However, there are still different understandings in the academic community regarding whether to choose anatomic liver resection, how to choose the surgical margin, the design of surgical methods under the liver "territory theory", and the use of indocyanine green fluorescence imaging technology in liver cancer resection. The authors comprehensively review the current researches on the above issues and the research progress in hepatectomy for liver cancer, aiming to provide references for clinicians to optimize the surgical procedure.
6.Application of indocyanine green fluorescence imaging in biliary tract diseases
Fubao LIU ; Dong JIANG ; Xiaoping GENG
Chinese Journal of Digestive Surgery 2024;23(1):80-84
For the past few years, the indocyanine green fluorescence imaging has been widely used in the diagnosis and treatment of biliary tract diseases. Fluorescence visualization of the biliary system by indocyanine green accurately localize the diseased tissue and identify the biliary structures precisely, which effectively avoids the damage to the natural biliary structure and greatly improves the accuracy and safety of biliary surgery. However, the application of this new technology in biliary surgery is still at the exploratory stage, showing great potential for application while also exposing many problems and controversies. It is believed that with the continuous development and improvement, the indocyanine green fluorescence cholangiography will play a more important role in the diagnosis and treatment of biliary tract diseases in the future, and bring more benefits to patients.
7.Precision diagnosis and standardized treatment of mid-low rectal cancer
Yun YANG ; Chenglin XIN ; Zhongtao ZHANG
Chinese Journal of Digestive Surgery 2024;23(1):85-90
Colorectal cancer is a major digestive disease in China, with mid-low rectal cancer as the predominant cause. Over the years, Chinese colorectal surgery has made considerable strides, attaining certain successes in clinical diagnosis and treatment, scientific research, and data platform construction. Nevertheless, there is still room for improvement in terms of the accuracy of diagnosis and standardization of treatment. Furthermore, immune checkpoint therapy represented by programmed death-1 have demonstrated initial efficacy in the treatment of mid-low rectal cancer. Further research is required to better understand the relationship and role between immune checkpoint inhibitors and traditional radiotherapy and chemotherapy, and to apply them to precise clinical practice. The authors elaborate on current status of diagnosis and treatment for mid-low rectal cancer in China, in order to provide references for its precission diagnosis and standardized treatment.
8.Construction of digital intelligent minimally invasive research-oriented hepatobiliary and pancreatic surgery discipline
Jian YANG ; Xiwen WU ; Wen ZHU ; Haoyu HU ; Nan XIANG ; Ning ZENG ; Zhihao LIU ; Xuequan FANG ; Chihua FANG
Chinese Journal of Digestive Surgery 2024;23(1):91-97
The emergence and evolution of digital intelligent technology has profoundly influenced the development of minimally invasive research-oriented hepatobiliary and pancreatic surgery discipline. Over various periods, our team has always adhered to the principle of "being oriented by clinical issues and driven by clinical needs", continuously carried out innovative research across interdisciplinary boundaries, propelling the evolution of digital intelligent technology. Spanning over two decades, this journey includes the progression from digital virtual human, three-dimensional visualization, molecular fluorescence imaging, augmented reality and mixed reality, artificial intelligence, to the realm of human visualization meta-universe. This evolution facilitates the shift from two-dimensional empirical diagnoses of hepatobiliary and pancreatic surgical diseases to deep learning intelligent diagnostics, the transition from morphology-based tumor diagnoses to molecular imaging-based diagnostics, and from conventional empirical surgery to intelligent navigation surgery. The authors provide a comprehensive review of our developmental process and achievements within the realm of digital intelligent diagnostic and therapeutic technologies, with the aims to promote the development and application of digital intelligent medicine.
9.Finding quarrel in a straw and making utmost effort to cultivate new seedings: record of clinical research training course organized by Lau Wanyee
Qiping LU ; Jianqiang CAI ; Qiang GAO ; Peng ZHU ; Xiao LIANG ; Hong ZHAO
Chinese Journal of Digestive Surgery 2024;23(1):98-101
Professor Lau Wanyee, a member of the Chinese Academy of Sciences and a pro-fessor at the Chinese University of Hong Kong, actively advocates conducting clinical researches through "planting fruit trees" and "growing orchards", aiming to cultivate a team of dual-skilled talents in clinical practice and research, effectively improve the scientific and technological level of clinical medicine in China, make voice heard in the international medical science field, and better serve human health. He organized a clinical research training course in scholars′ forum for Hepatobiliary Young Expert Working Group of Chinese College of Surgeons. Throughout three sessions of the training course, a distinct theme was focused on how to enhance the level of clinical research in China and make voice heard by the international scholars. A group of multi-dimensional experts were gathered, including experts from surgery, methodology, and management, as well as both renowned experts and young talents. A lively teaching model was adopted, combining guided presentations with interactive discussion and debate sessions. A clean and upright academic spirit was strongly advocated, in which international rules were adopted to conduct in-depth analysis and sharp criticism of seven proposed clinical research projects and four published papers with high international influence to find quarrel in a straw. This clinical research training course provides a new model of guidance for young physicians in conducting clinical research. As a result, all attendees felt deeply educated and benefited greatly from the training session. This training activity not only laid a solid foundation for the development of scientization, standardization, and internationali-zation of clinical research in digestive surgery in China, but also demonstrated a correct path for cultivating a group of young and middle-aged clinical medical scientists with scientific spirit.
10.Research progress of robot-assisted function-preserving pancreatic surgery
Xueli BAI ; Yifan HONG ; Xiaoyu ZHANG ; Jiaqi YANG ; Tingbo LIANG
Chinese Journal of Digestive Surgery 2024;23(1):102-108
The application of function-preserving pancreatic surgery as a restrictive resection technique is primarily targeted towards benign or those with borderline or low-grade lesions. This approach has been shown to significantly improve both short-term and long-term quality of life outcomes for patients following surgical intervention. In comparison to conventional laparoscopic procedures, robotic surgical systems have demonstrated superior efficacy and precision when employed in pancreas surgeries, and the safety and reliability are widely recognized within the medical community. Nevertheless, there remains a dearth of research investigating the specific appli-cations of robotic-assisted function-preserving pancreatic surgery. Consequently, the authors compre-hensive review the latest progress on robot-assisted function-preserving pancreatic surgery, while highlighting of surgical scope, techniques utilized during these procedures as well as associated prognostic considerations.

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