The pancreatic islets of Langerhans, which are composed of α, β, δ, ε, and PP cells, orchestrate systemic glucose homeostasis through tightly regulated hormone secretion. Although the precise mechanisms involving β cells in the onset and progression of diabetes have been elucidated and insulin replacement therapy remains the primary treatment modality, the regulatory processes, functions, and specific roles of other pancreatic islet hormones in diabetes continue to be the subject of ongoing investigation. At present, a comprehensive review of the secretion and regulation of pancreatic islet cell hormones as well as the related mechanisms of diabetes is lacking. This review synthesizes current knowledge on the secretion mechanisms of insulin, glucagon, somatostatin, ghrelin, and pancreatic polypeptides, emphasizing their functional crosstalk in diabetes. Emerging advances include CRISPR‐based β‐cell regeneration, bioengineered islet transplantation, and bioelectronic interventions aimed at restoring pancreatic function. Future research directions highlight artificial intelligence‐guided prediction of hormone dynamics, therapeutics targeting the gut microbiome–islet axis, and tissue‐engineered artificial islets. By integrating mechanistic insights, physiological roles, and translational innovations, this review outlines precision strategies for targeting islet hormone networks, offering a roadmap toward restoring metabolic equilibrium in diabetes.

Objective: This study aimed to systematically compare the short-term outcomes of minimally invasive pancreatic enucleation (MI-pEn), including laparoscopic and robotic-assisted approaches, and open pancreatic enucleation (O-pEn). Methods: A systematic search of PubMed, MEDLINE, Embase, and Web of Science was conducted for studies published between January 1990 and December 2025 that compared various types of pancreatic enucleation. The literature screening, data extraction, and quality assessment followed the PRISMA guidelines. The meta-analysis was performed using RevMan 5.4.1 and R 4.3.0. Results: Fifteen studies were included, with thirteen comparative studies (463 MI-pEn, 547 O-pEn) incorporated into the meta-analysis. Two studies comparing laparoscopic and robot-assisted enucleation were also included. No significant difference in clinically relevant postoperative pancreatic fistula (CR-POPF) was detected between MI-pEn and O-pEn (OR = 0.78; 95% CI: 0.56–1.07; p = 0.12). However, MI-pEn was associated with significantly reduced operation time (MD = −21.24; p = 0.01), blood loss (MD = −75.88; p < 0.00001), hospital stay (MD = −2.07; p = 0.001), and wound infection (OR = 0.3; p = 0.03). Direct comparisons between robotic and laparoscopic enucleation revealed no significant differences in any outcomes. Conclusions: MI-pEn is safe and feasible and offers advantages in terms of operative time, blood loss, and recovery without increasing complications. Robotic and laparoscopic approaches yield comparable short-term outcomes in pancreatic enucleation, although the potential advantage of robotic surgery in reducing pancreatic fistula risk warrants further validation.

Mid-infrared (MIR) femtosecond lasers, resonant with the absorption bands of amide-related molecular groups in the range of 6.1 to 6.5 μm, have been demonstrated to be effective for tissue ablation. However, the flexible and stable delivery of such pulses to micrometer-scale tissue regions for controlled ablation remains challenging. Here, we utilize a silica-based anti-resonant hollow-core fiber (AR-HCF) to deliver high-power MIR femtosecond pulses with high temporal and spectral fidelity, featuring pulse durations of approximately 340 fs and peak power densities exceeding 1 GW/cm², for selective tissue ablation. Benefiting from the small numerical aperture of the AR-HCF, a relatively stable and consistent beam spot size can be maintained over a millimeter-scale propagation distance. Precise control of the ablation depth can be achieved by appropriately selecting the scanning parameters, with penetration depths reaching the sub-millimeter scale. Furthermore, for the first time, we systematically compare the tissue ablation performance of MIR femtosecond lasers at resonant wavelengths (6.4 and 6.1 μm) and a non-resonant wavelength (5.5 μm) under identical scanning conditions. An ablation depth ratio of more than 8:1 is observed, demonstrating the high efficiency and selectivity of the resonance-based ablation mechanism. These results establish flexible delivery of high-power MIR femtosecond pulses in tissue-resonant bands via silica-based AR-HCF as a powerful platform for selective, precise, and efficient tissue ablation, providing a promising approach for interventional and minimally invasive surgery.