Background. Effective biomarkers are needed to enable personalized medicine for pancreatic cancer patients. This study analyzes the prognostic value, in early pancreatic cancer, of single circulating tumor cell (CTC) and CTC clusters from the central venous catheter (CVC) and portal blood (PV). Methods. In total, 7 mL of PV and CVC blood from 35 patients with early pancreatic cancer were analyzed. CTC were isolated using a positive immunomagnetic selection. The detection and identification of CTC were performed by immunocytochemistry (ICC) and were analyzed by Epi-fluorescence and confocal microscopy. Results. CTC and the clusters were detected both in PV and CVC. In both samples, the CTC number per cluster was higher in patients with grade three or poorly differentiated tumors (G3) than in patients with well (G1) or moderately (G2) differentiated. Patients with fewer than 185 CTC in PV exhibited a longer OS than patients with more than 185 CTC (24.5 vs. 10.0 months; p = 0.018). Similarly, patients with fewer than 15 clusters in PV showed a longer OS than patients with more than 15 clusters (19 vs. 10 months; p = 0.004). These significant correlations were not observed in CVC analyses. Conclusions. CTC presence in PV could be an important prognostic factor to predict poor prognosis in early pancreatic cancer. In addition, the number of clustered-CTC correlate to a tumor negative differentiation degree and, therefore, could be used as a diagnostic biomarker for pancreatic cancer.

Fibrinogen-thrombin collagen patch reinforcement of high-risk colonic anastomoses in rats

Pancreatic surgery is considered one of the most challenging interventions by many surgeons, mainly due to retroperitoneal location and proximity to key and delicate vascular structures. These factors make pancreatic resection a demanding procedure, with successful rates far from optimal and frequent postoperative complications. Surgical planning is essential to improve patient outcomes, and in this regard, many technological advances made in the last few years have proven to be extremely useful in medical fields. This review aims to outline the potential and limitations of 3D digital and 3D printed models in pancreatic surgical planning, as well as the impact and challenges of novel technologies such as augmented/virtual reality systems or artificial intelligence to improve medical training and surgical outcomes.

Blood loss remains a major concern during surgery and can increase the morbidity of the intervention. The use of topical hemostatic agents to overcome this issue therefore becomes necessary. Fibrin sealants are promising hemostatic agents due to their capacity to promote coagulation, but their effectiveness and applicability need to be improved. We have compared the hemostatic efficacy of a novel nanostructured fibrin‐agarose hydrogel patch, with (c‐NFAH) or without cells (a‐NFAH), against two commercially available hemostatic agents in a rat model of hepatic resection. Hepatic resections were performed by making short or long incisions (mild or severe model, respectively) and hemostatic agents were applied to evaluate time to hemostasis, presence of hematoma, postoperative adhesions to adjacent tissues and inflammation factors. We found a significantly higher hemostatic success rate (time to hemostasis) with a‐NFAH than with other commercial hemostatic agents. Furthermore, other relevant outcomes investigated were also improved in the a‐NFAH group, including no presence of hematoma, lower adhesions, and lower grades of hemorrhage, inflammation and necrosis in histological analysis. Overall, these findings identify a‐NFAH as a promising hemostatic agent in liver resection and likely in a range of surgical procedures.