Sutureless portal vein reconstruction in porcine orthotopic liver transplantation using a microvascular coupler: A randomized study with artificial intelligence-assisted histopathology

doi:10.4240/wjgs.120360

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 120360
Published online Aug 27, 2026. doi: 10.4240/wjgs.120360

Table 1 Anastomosis time, patency rates, and blood flow, mean ± SD

Parameter	Coupler group (n = 20)	Hand-sutured group (n = 20)	P value
Anastomosis time (minutes)	12.4 ± 2.2	24.5 ± 3.8	< 0.001^a
Patency (%)	100% (20/20)	95% (19/20)	1.000
Immediate bleeding (%)	0% (0/20)	10% (2/20)	0.487
Stenosis (%)	0% (0/20)	5% (1/20)	1.000
Preoperative velocity (cm/second)	22.8 ± 5.5	23.1 ± 5.6	0.865
Immediate postoperative blood flow (cm/second)	20.5 ± 3.1	18.3 ± 2.6	0.019^a
Postoperative week 4 blood flow (cm/second)	21.8 ± 3.3	19.7 ± 2.5	0.029^a
Postoperative week 8 blood flow (cm/second)	22.5 ± 3.3	20.6 ± 2.7	0.054
Postoperative week 12 blood flow (cm/second)	22.9 ± 3.4	20.8 ± 2.8	0.039^a

^aP < 0.05.

P values are two-sided. Continuous variables: Independentsamples t-test (Welch’s t if variances unequal); categorical variables: Fisher’s exact test.

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Table 2 Laboratory examination at 12 weeks, mean ± SD

Parameter	Coupler group (n = 20)	Hand-sutured group (n = 20)	P value
Hb (g/L)	116.3 ± 8.4	115.7 ± 9.1	0.829
ALT (U/L)	35.2 ± 5.5	38.4 ± 6.9	0.113
AST (U/L)	45.8 ± 6.3	48.3 ± 7.2	0.249
TBil (mg/dL)	3.37 ± 0.2	3.51 ± 0.3	0.091
Albumin (g/L)	38.1 ± 2.4	39.7 ± 2.5	0.046
ALP (U/L)	107.4 ± 13.8	116.2 ± 15.1	0.062
GGT (U/L)	49.9 ± 8.5	54.9 ± 10.3	0.098
Creatinine (μmol/L)	3.66 ± 0.71	4.75 ± 2.66	0.085
BUN (mmol/L)	109.5 ± 18.9	106.7 ± 15.2	0.609

Hb: Hemoglobin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBil: Total Bilirubin; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; BUN: Blood urea nitrogen.

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Table 3 Histological analysis of portal vein anastomotic sites, mean ± SD

Parameter	Coupler group (n = 20)	Hand-sutured group (n = 20)	P value
Macrophage count (HPF)	5.3 ± 1.1	8.6 ± 1.5	< 0.001
Lymphocyte count (HPF)	4.1 ± 0.8	5.8 ± 1.2	< 0.001
Plasma cell count (HPF)	2.4 ± 0.4	4.5 ± 1.0	< 0.001
Necrotic area proportion (%)	2.6 ± 0.5	8.0 ± 1.7	< 0.001
Inflammation score (0-3)	0.8 ± 0.3	2.4 ± 0.6	< 0.001
Tissue disorganization score (0-3)	1.1 ± 0.6	2.7 ± 0.5	< 0.001

Values are observer-verified after artificial intelligence assistance; 15 high-power fields per animal. HPF: High-power field (0.237 mm² at 400 ×).

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Citation: Li JJ, Yang J, Xie Y, Shang JM, Li J, Chen CY, Liu LN, Zhang ZY, Pan BH, Jiang WT. Sutureless portal vein reconstruction in porcine orthotopic liver transplantation using a microvascular coupler: A randomized study with artificial intelligence-assisted histopathology. World J Gastrointest Surg 2026; 18(8): 120360
URL: https://www.wjgnet.com/1948-9366/full/v18/i8/120360.htm
DOI: https://dx.doi.org/10.4240/wjgs.120360

Li JJ, Yang J, Xie Y, Shang JM, Li J, Chen CY, Liu LN, Zhang ZY, Pan BH, Jiang WT. Sutureless portal vein reconstruction in porcine orthotopic liver transplantation using a microvascular coupler: A randomized study with artificial intelligence-assisted histopathology. World J Gastrointest Surg 2026; 18(8): 120360 [DOI: 10.4240/wjgs.120360]

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