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World J Gastrointest Surg. May 27, 2026; 18(5): 117321
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.117321
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.117321
Gut-liver axis management and its surgical application: A perspective from “liver governing free flow”
Nian-Song Kang, Si-Hui Zheng, Department of Gastroenterology, Yuyao Hospital of Traditional Chinese Medicine, Yuyao 315400, Zhejiang Province, China
Hai-Jun Fang, Department of Anesthesiology, Yuyao Hospital of Traditional Chinese Medicine, Yuyao 315400, Zhejiang Province, China
Co-first authors: Nian-Song Kang and Hai-Jun Fang.
Author contributions: Kang NS and Fang HJ are co-first authors and made equal contributions to this work, including design of the study, acquiring and analyzing data from experiments, and writing of the manuscript; Fang HJ designed the experiments and conducted clinical data collection, performed postoperative follow-up and recorded the data; Kang NS and Zheng SH conducted the collation and statistical analysis, and wrote the original manuscript and revised the paper; all authors read and approved the final manuscript.
AI contribution statement: No AI tools of any kind, including ChatGPT, Grammarly, DeepL, or similar software, were involved in the creation of this manuscript at any stage. The entire main text (Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion) was written entirely by the authors, with no AI-generated content included. The study design, data analysis, and interpretation of results were all performed solely by the authors, without any AI participation. All images, figures, and tables in the manuscript were created manually by the authors, with no AI-generated elements.
Supported by 2020 Zhejiang Province Traditional Chinese Medicine “Xin Miao” Programme, Zhejiang Traditional Chinese Medicine (2021), No. 1; and 2021 Zhejiang Province Training Programme for Young and Middle-aged Clinical Famous Traditional Chinese Medicine Practitioners, Zhejiang Traditional Chinese Medicine (2021), No. 22.
Conflict-of-interest statement: The authors have no conflict of interests to declare.
Corresponding author: Nian-Song Kang, Department of Gastroenterology, Yuyao Hospital of Traditional Chinese Medicine, No. 1500 Zhongshan South Road, Yuyao 315400, Zhejiang Province, China. 18958331203@163.com
Received: December 26, 2025
Revised: January 20, 2026
Accepted: February 5, 2026
Published online: May 27, 2026
Processing time: 152 Days and 4.8 Hours
Revised: January 20, 2026
Accepted: February 5, 2026
Published online: May 27, 2026
Processing time: 152 Days and 4.8 Hours
Core Tip
Core Tip: This article innovatively integrates the traditional Chinese medicine theory of “liver governing free flow” with the modern medical concept of the gut-liver axis, extending its application to perioperative management in digestive surgery. By reviewing intervention strategies such as herbal medicine, acupuncture, and dietary therapy, it explores their potential mechanisms in regulating intestinal microecology, improving barrier function, and influencing hepatic metabolism. This provides a new theoretical perspective and practical pathway for the integrated prevention and treatment of digestive system diseases through the combination of traditional Chinese and western medicine.