Evidence mapPaperPMID 41479864Full record

ArticleWorld journal of gastrointestinal pathophysiology2025

Metabolic changes after hepatectomy: Implications for perioperative management and long-term outcomes.

Joshua Zhuo Lee, Sandra Joanne Kar Kwan Ng, Vishal G Shelat

Abstract read
In one paragraph

Article in World journal of gastrointestinal pathophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Joshua Zhuo LeeDepartment of Medicine, Lee Kong Chian School of Medicine, Singapore 308232, Singapore.
Sandra Joanne Kar Kwan NgLee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Vishal G ShelatDepartment of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore. vgshelat@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatectomy triggers complex metabolic changes as the liver adapts to the loss of functional mass and initiates regeneration. These changes impact carbohydrate, lipid, and protein metabolism, as well as energy and oxygen dynamics. A deeper understanding of these shifts is essential for improving perioperative management and enhancing long-term outcomes.

aimTo review and synthesise the current understanding of metabolic changes following hepatectomy and explore their implications for perioperative care, postoperative recovery, and long-term patient outcomes.

methodsA narrative review was conducted using PubMed, Cochrane, and Scopus databases to identify relevant human studies published up to December 2024. Search terms included "hepatectomy", "liver resection", "metabolic changes", and related phrases. Studies focusing on metabolic adaptations-specifically changes in glucose, lipid, protein metabolism, and energy consumption-were included.

resultsHepatectomy induces a shift toward gluconeogenesis and transient insulin resistance, increased lipid oxidation, amino acid imbalance, and a heightened inflammatory response, especially during ischaemia-reperfusion injury. These changes vary with the extent of resection and the presence of underlying liver disease. Novel insights include the role of the physiologic Pringle manoeuvre (a pharmacologic alternative to mechanical clamping) and metabolomic biomarkers for assessing surgical risk and liver regeneration.

conclusionUnderstanding the metabolic adaptations following hepatectomy provides an opportunity to optimise perioperative care strategies such as nutrition, glucose and lipid management, and mitigation of ischaemia-reperfusion injury. Integrating these insights may enhance surgical outcomes, particularly in patients with hepatocellular carcinoma or non-alcoholic fatty liver disease.

Indexed as

Energy consumptionGlucose metabolismHepatectomyIschemic reperfusion injuryLipid metabolismLiver regenerationLiver resectionOxygen consumptionPhysiologic pringle manoeuvreProtein metabolism

Identifiers

PMID41479864
PMCPMC12754345

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.