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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Dec 22, 2025; 16(4): 109860
Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.109860
Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.109860
Metabolic changes after hepatectomy: Implications for perioperative management and long-term outcomes
Joshua Zhuo Lee, Department of Medicine, Lee Kong Chian School of Medicine, Singapore 308232, Singapore
Sandra Joanne Kar Kwan Ng, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
Vishal G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Shelat VG conceptualized and designed the study, supervised, and made critical revisions; Lee JZ conducted the literature review, consolidated the data, drafted the original manuscript, and made critical revisions; Ng SJKK conducted the literature review; all authors contributed to preparation of the draft and approved the submitted version.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vishal G Shelat, Adjunct Associate Professor, FRCS, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singa
Received: May 26, 2025
Revised: July 12, 2025
Accepted: October 30, 2025
Published online: December 22, 2025
Processing time: 212 Days and 21.9 Hours
Revised: July 12, 2025
Accepted: October 30, 2025
Published online: December 22, 2025
Processing time: 212 Days and 21.9 Hours
Core Tip
Core Tip: This narrative review explores the intricate metabolic adaptations following hepatectomy, emphasising the shift towards gluconeogenesis and transient insulin resistance, increased lipid oxidation, imbalance in amino acids, and a heightened inflammatory response (especially in ischaemic reperfusion injury). It highlights the role of the liver in maintaining systemic metabolic homeostasis, and how surgical disruption affects liver metabolism. Metabolic changes post-hepatectomy influence recovery, and may serve as targets for optimising recovery, thereby guiding and enhancing perioperative care and ultimately improving surgical outcomes.