Pancreatic cancer is highly malignant and extremely difficult to operate, so it is called the “king of cancers”, which is often talked about by both doctors and patients. After 10 years of research, the pancreatic surgery team of Ruijin Hospital of Shanghai Jiaotong University School of Medicine has finally made a breakthrough by innovating surgical procedures, introducing minimally invasive concepts and leveraging advanced instruments, and the 1-year survival rate of pancreatic cancer has increased to 78.3% and the 5-year survival rate has reached 19.8%, ranking among the highest in the world. Recently, a 40-year-old patient with advanced pancreatic cancer came to Ruijin Hospital, having searched all over the country for other major hospitals, but the answers he received were “no chemotherapy, no surgery, no treatment”. The Ruijin pancreatic surgery team decided to accept the challenge, and two professors, Chenghong Peng, chief of general surgery, and Bo Yong Shen, vice president of general surgery, worked together to remove the entire pancreatic tumor and the tumor-invaded abdominal trunk artery, i.e., a highly difficult APPLEBY operation that is rarely reported worldwide. However, this patient already had cancer metastasis in the liver, for which the pancreatic surgery team also removed part of the liver where the tumor had metastasized, thus giving birth to a completely new surgical approach – “pancreatic tumor + invading blood vessels + partial liver resection”. To ensure the safety of the patient, the surgeon also performed intraoperative high-dose radiotherapy to the surgical field and supplemented with chemotherapy after surgery. Today, this patient has survived peacefully for more than 9 months. Shen Baiyong introduced that the pancreas is an important organ of the human digestive system, and its location behind several organs, early lesions are difficult to detect, and once cancer is detected, it is often advanced, according to the textbook, whether surgery or not, the survival period is only a few months. What is more worrying is that in China, due to the change of dietary structure, the incidence of pancreatic diseases has been increasing rapidly in recent years, among which the incidence of pancreatic cancer has increased four times in the past 20 years and has now reached 3.3/100,000. Ruijin Hospital has a fine tradition in the treatment of pancreatic diseases, and has a group of renowned experts at home and abroad, such as Zhang Shengdao and Li Hongwei. In recent years, the development of pancreatic surgery in the hospital has further accelerated, and the pancreatic disease consultation and treatment center last year reached 526 pancreatic tumor surgeries alone, the number of which is among the highest in the world. International recognition of Ruijin standards “As a nationally renowned tertiary hospital focusing on the treatment of difficult and serious diseases, we should not be satisfied with the number of patients in scale, but should seek a qualitative leap by boldly innovating clinical techniques based on standardized treatment, and strive for international leadership.” Qu Jieming, president of Ruijin Hospital, said. With the full support of the hospital, the Ruijin team has made many highlights in the field of pancreatic cancer treatment in recent years. For example, the scope of lymph node dissection has been scientifically standardized again. However, the Ruijin team found that this “standard range” was not enough to clear the metastatic lymph nodes, so they expanded the number of lymph nodes cleared by However, the Regent team found that this “standard range” was not enough to clear the metastatic lymph nodes, so they expanded the number of sweeps by a factor of one to completely contour the lymph nodes and improve long-term survival. The new standard has been recognized by international colleagues and has become the “gold standard” of Regent. Another example is the introduction of intraoperative radiotherapy for the first time. Only 20% of pancreatic cancers can be surgically removed, but the Regent team used 10 times the normal radiation therapy dose to irradiate those tumors that cannot be operated on, which doubled the survival of advanced patients from 4-6 months to 8-12 months, and greatly reduced pain and improved the quality of survival. An even greater breakthrough is the introduction of minimally invasive treatment for pancreatic cancer. Since the pancreas is densely vascularized, pancreatic tumor surgery is also known as the most difficult surgical procedure, and has been regarded as a forbidden area for minimally invasive surgery, which can only be performed openly, otherwise the tumor tissue cannot be removed. However, the Ruijin team saw a ray of hope for improving the outcome in the forbidden area – minimally invasive surgery not only provides quicker recovery, but more importantly, effectively maintains the patient’s immune system, which is crucial for improving survival rates. Robotic treatment has new ideas To go beyond the limitations of traditional minimally invasive laparoscopic surgery, the Regent team made full use of the most sophisticated medical device, the da Vinci robot. It comes with its own light source and is equipped with two cameras that can magnify the organs 10 times and present them in three dimensions. In the words of Chenghong Peng, “it is as if it is drilling into the patient’s stomach”: the robot arm reaches into four small holes of about 1 cm in diameter on the patient’s body, and its ability to be more flexible than human fingers enables it to enter many small spaces that are beyond the reach of human hands, breaking through blind spots and performing various delicate operations… …The results of the bold attempt proved that the recovery time after robotic surgery was significantly shorter and incisional infections were significantly reduced compared to open surgery, while there was no significant difference in tumor radicality, complication rate and perioperative mortality. Since the introduction of the da Vinci robot in 2010, the Ruijin team has performed more than 400 robotic pancreatic surgeries, ranking second in the world in terms of number, second only to the University of Pittsburgh School of Medicine, of which 1/3 were pancreatic cancer surgeries, and for the first time performed and completed the largest sample of “robotic-assisted preserved duodenal pancreatic head resection” in the world to date. “The first robotic-assisted preserved duodenal pancreatic head resection with the largest sample in the world was performed and completed, which was highly evaluated by the International Society for Clinical Robotic Surgery. In October this year, the new 150-bed Ruijin Hospital Pancreatic Disease Clinical Center will be officially opened, becoming the largest pancreatic disease treatment center in the world. At the same time, the Institute of Pancreatic Diseases of Shanghai Jiaotong University School of Medicine, located in Ruijin Hospital, has conducted long-term solid basic research on the mechanism of pancreatic disease development, recurrence and drug sensitivity, and is currently working with the Institute of Drug Research of the Chinese Academy of Sciences to develop three new drugs. In the development of “precision medicine”, Ruijin Hospital has also successfully applied for the first clinical license for pancreatic cancer gene sequencing in China, setting up a sequencing platform and data analysis platform, which is expected to provide individualized and comprehensive treatment plans for each patient through sequencing, according to their mutation gene types and different prognosis, and further improve the efficacy of treatment.