ArticleWorld journal of gastrointestinal pathophysiology2025
Metabolic changes after hepatectomy: Implications for perioperative management and long-term outcomes.
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.
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1 citing paper in PubMed.
- Renal R2* as a noninvasive predictor of hepatorenal syndrome-acute kidney disease in cirrhotic patients with ascites: a retrospective cohort study.Quantitative imaging in medicine and surgery · 2026Article
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3 authors.
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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.
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