Influencing factors of liver regeneration after laparoscopic anatomic liver resection and its relationship with prognosis

BI Jing-peng; CHANG Qing-qing; ZHANG Jian-guo

doi:10.11659/jjssx.10E024081

您当前的位置：

首页 >

文章列表页 >

Influencing factors of liver regeneration after laparoscopic anatomic liver resection and its relationship with prognosis

Clinical Research | 更新时间：2025-07-23

- Influencing factors of liver regeneration after laparoscopic anatomic liver resection and its relationship with prognosis
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 7, Pages: 621-625(2025)
- 作者机构：
  
  1.山东第一医科大学附属人民医院肝胆血管外科，山东济南 271100
  2.山东第一医科大学附属人民医院内分泌代谢病科，山东济南 271100
  3.火箭军特色医学中心肝胆外科，北京100088
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.10E024081
  CLC： R734.2
- Received：22 October 2024，
  
  Published：25 July 2025
- 稿件说明：
移动端阅览
毕京鹏,常青青,张建国.腹腔镜解剖性肝切除术后肝再生的影响因素及其与预后的关系[J].局解手术学杂志,2025,34(07):621-625.

BI Jing-peng,CHANG Qing-qing,ZHANG Jian-guo.Influencing factors of liver regeneration after laparoscopic anatomic liver resection and its relationship with prognosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(07):621-625.
毕京鹏,常青青,张建国.腹腔镜解剖性肝切除术后肝再生的影响因素及其与预后的关系[J].局解手术学杂志,2025,34(07):621-625. DOI： 10.11659/jjssx.10E024081.

BI Jing-peng,CHANG Qing-qing,ZHANG Jian-guo.Influencing factors of liver regeneration after laparoscopic anatomic liver resection and its relationship with prognosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(07):621-625. DOI： 10.11659/jjssx.10E024081.

摘要

目的

分析影响腹腔镜解剖性肝切除术（LALR）后肝再生的危险因素，并探究术后肝再生能力与患者预后的关系。

方法

回顾性分析2021年1月至2023年12月山东第一医科大学附属人民医院收治的156例接受LALR治疗的肝癌患者临床资料。根据CT检查进行肝三维重建及模拟切除，计算术后肝再生率。以术后1个月中位肝再生率为基准，将患者分为高再生组和低再生组，单因素及多因素分析影响术后肝再生的危险因素；采用

Kaplan

Meier

生存曲线分析术后肝再生能力与患者无瘤生存率及总生存率的关系。

结果

术后1周再生后肝体积（FRLV）与术后残肝体积（RLV）比较，差异有统计学意义（

0.05）；术后1个月和3个月肝再生率明显高于术后1周（

0.05）；术后1周肝体积净增长率明显高于术后1个月和3个月（

0.05）。术后1个月中位肝再生率为27.81%。单因素分析显示，性别、年龄、饮酒史、合并肝硬化、术前预测RLV、术前预测标准残肝体积（SRLV）及术后血小板计数（PLT）与术后肝再生相关（

0.05）；多因素分析显示，合并肝硬化、高术前预测RLV及SRLV是影响术后肝再生的独立危险因素（

0.05）。术后随访显示，高再生组患者累计无瘤生存率低于低再生组（61.20%

vs.

75.28%，

Log

rank χ

=3.577，

=0.043），2组患者累计总生存率比较差异无统计学意义（74.63%

vs.

80.89%，

Log

rank χ

=1.024

，P

=0.312）。

结论

对于接受LALR的肝癌患者，并发肝硬化、高术前预测RLV及SRLV是影响术后早期肝再生的独立危险因素，且患者术后肝再生能力越高，无瘤生存率越低。

Abstract

Objective

To analyze the risk factors affecting liver regeneration after laparoscopic anatomic liver resection （LALR），and to explore the relationship between postoperative liver regeneration and the prognosis of patients.

Methods

A retrospective analysis was conducted on the clinical data of 156 patients with liver cancer who underwent LALR treatment at the People's Hospital Affiliated to Shandong First Medical University from January 2021 to December 2023. Three-dimensional liver reconstruction and simulated resection were performed based on CT examination，and the postoperative liver regeneration rate was calculated. The patients were divided into the high regeneration group and the low regeneration group based on the median liver regeneration rate 1 month after surgery，and the univariate and multivariate analyses were performed to analyze the risk factors affecting postoperative liver regeneration. The relationships between postoperative liver regeneration capacity and tumor-free survival rate and overall survival rate of patients were analyzed using the

Kaplan-Meier

survival curve.

Results

Significant difference was observed between the future remnant liver volume（FRLV） 1 week after operation and the remnant liver volume （RLV） after operation （

0.05）. The liver regeneration rates 1 month and 3 months after operation were significantly higher than that 1 week after operation （

0.05）. The net growth rate of liver volume 1 week after operation was significantly higher than that 1 month and 3 months after operation （

0.05）. The median liver regeneration rate 1 month after operation was 27.81%. Univariate analysis showed that gender，age，drinking history，combined with liver cir

rhosis，preoperative predictional RLV，preoperative predictional standard residual liver volume （SRLV），and postoperative platelet count （PLT） were closely related to liver regeneration after operation （

0.05）. Multivariate analysis showed that combined with liver cirrhosis，and high preoperative predictional RLV and SRLV were the independent factors affecting liver regeneration after operation （

0.05）. The postoperative follow-up showed that the cumulative tumor-free survival rate of the high regeneration group was lower than that of the low regeneration group （61.20%

.75.28%，

Log

rank χ

=3.577，

=0.043），and there was no statistically significant difference in the cumulative overall survival rate between the two groups （74.63%

.80.89%，

Log-rank χ

=1.024，

=0.312）.

Conclusion

For patients with liver cancer undergoing LALR，combined with liver cirrhosis，and high preoperative predictional RLV and SRLV are the independent risk factors influencing early postoperative liver regeneration. Moreover，the higher the patients' postoperative liver regeneration capacity，the lower the tumor-free survival rate.

关键词

Keywords

references

Michalopoulos GK ， Bhushan B . Liver regeneration：biological and pathological mechanisms and implications ［J］. Nat Rev Gastroenterol Hepatol ， 2021 ， 18 （ 1 ）： 40 - 55 . doi： 10.1038/s41575-020-0342-4 http://dx.doi.org/10.1038/s41575-020-0342-4 .

Yagi S ， Hirata M ， Miyachi Y ， et al . Liver regeneration after hepatectomy and partial liver transplantation ［J］. Int J Mol Sci ， 2020 ， 21 （ 21 ）： 8414 . doi： 10.3390/ijms21218414 http://dx.doi.org/10.3390/ijms21218414 .

Zhang Y ， Li B ， He Q ， et al . Comparison of liver regeneration between donors and recipients after adult right lobe living-donor liver transplantation ［J］. Quant Imaging Med Surg ， 2022 ， 12 （ 6 ）： 3184 - 3192 . doi： 10.21037/qims-21-1077 http://dx.doi.org/10.21037/qims-21-1077 .

Gadd VL ， Aleksieva N ， Forbes SJ . Epithelial plasticity during liver injury and regeneration ［J］. Cell Stem Cell ， 2020 ， 27 （ 4 ）： 557 - 573 . doi： 10.1016/j.stem.2020.08.016 http://dx.doi.org/10.1016/j.stem.2020.08.016 .

韩俊峰，沈中阳，高伟，等 . 肝脏切除术后肝再生对肿瘤复发影响的实验研究［J］. 实用器官移植电子杂志， 2022 ， 10 （ 5 ）： 413 - 417 . doi： 10.3969/j.issn.2095-5332.2022.05.007 http://dx.doi.org/10.3969/j.issn.2095-5332.2022.05.007 .

Milana F ， Famularo S ， Diana M ， et al . How much is enough？A surgical perspective on imaging modalities to estimate function and volume of the future liver remnant before hepatic resection ［J］. Diagnostics （Basel）， 2023 ， 13 （ 17 ）： 2726 . doi： 10.3390/diagnostics13172726 http://dx.doi.org/10.3390/diagnostics13172726 .

Hora S ， Wuestefeld T . Liver injury and regeneration：current understanding，new approaches，and future perspectives ［J］. Cells ， 2023 ， 12 （ 17 ）： 2129 . doi： 10.3390/cells12172129 http://dx.doi.org/10.3390/cells12172129 .

Ben-Moshe S ， Veg T ， Manco R ， et al . The spatiotemporal program of zonal liver regeneration following acute injury ［J］. Cell Stem Cell ， 2022 ， 29 （ 6 ）： 973 - 989.e10 . doi： 10.1016/j.stem.2022.04.008 http://dx.doi.org/10.1016/j.stem.2022.04.008 .

欧阳高雄，肖燕燕，任远，等 . 肝切除术后肝脏再生临床应用研究进展［J］. 医学综述， 2019 ， 25 （ 2 ）： 296 - 301 . doi： 10.3969/j.issn.1006-2084.2019.02.017 http://dx.doi.org/10.3969/j.issn.1006-2084.2019.02.017 .

Gong WF ， Zhong JH ， Lu Z ， et al . Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma ［J］. Biosci Rep ， 2019 ， 39 （ 8 ）： BSR20190088 . doi： 10.1042/BSR20190088 http://dx.doi.org/10.1042/BSR20190088 .

保梅，张嘉军，刘普文，等 . 半肝切除术后早期肝再生的影响因素分析［J］. 精准医学杂志， 2022 ， 37 （ 2 ）： 126 - 130 . doi： 10.13362/j.jpmed.202202007 http://dx.doi.org/10.13362/j.jpmed.202202007 .

Aierken Y ， Kong LX ， Li B ， et al . Liver fibrosis is a major risk factor for liver regeneration：a comparison between healthy and fibrotic liver ［J］. Medicine （Baltimore）， 2020 ， 99 （ 22 ）： e20003 . doi： 10.1097/MD.0000000000020003 http://dx.doi.org/10.1097/MD.0000000000020003 .

邓秀秀，李晖，张泽凤，等 . 肝窦内皮细胞调控肝脏微环境影响肝纤维化的研究进展［J］. 中华肝脏病杂志， 2020 ， 28 （ 4 ）： 357 - 360 . doi： 10.3760/cma.j.cn501113-20190715-00247 http://dx.doi.org/10.3760/cma.j.cn501113-20190715-00247 .

中华人民共和国国家卫生健康委员会医政司 . 原发性肝癌诊疗指南（2024年版）［J］. 协和医学杂志， 2024 ， 15 （ 3 ）： 532 - 559 . doi： 10.12290/xhyxzz.2024-0304 http://dx.doi.org/10.12290/xhyxzz.2024-0304 .

Memeo R ， Conticchio M ， Deshayes E ， et al . Optimization of the future remnant liver：review of the current strategies in Europe ［J］. Hepatobiliary Surg Nutr ， 2021 ， 10 （ 3 ）： 350 - 363 . doi： 10.21037/hbsn-20-394 http://dx.doi.org/10.21037/hbsn-20-394 .

Murtha-Lemekhova A ， Fuchs J ， Ghamarnejad O ， et al . Influence of cytokines，circulating markers and growth factors on liver regeneration and post-hepatectomy liver failure：a systematic review and meta-analysis ［J］. Sci Rep ， 2021 ， 11 （ 1 ）： 13739 . doi： 10.1038/s41598-021-92888-4 http://dx.doi.org/10.1038/s41598-021-92888-4 .

安琪，齐光照，韩超 . 麦冬皂苷B调节Shh/Gli1通路对肝细胞癌上皮间质转化及耐药性的影响［J］. 世界临床药物， 2024 ， 45 （ 3 ）： 285 - 293 . doi： 10.13683/j.wph.2024.03.008 http://dx.doi.org/10.13683/j.wph.2024.03.008 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Expression of miR-1231 and miR-146b in ovarian cancer and their relationship with patient prognosis

Influence factors for the prognosis of patients with hydrocephalus after hypertensive intracerebral hemorrhage

Analysis of related factors and prognosis of postoperative recurrence of benign meningioma

Risk factors of the peri-operative hidden blood loss in artificial femoral head replacement

Clinical study on neglected perforation of glove during spinal surgery

Related Author

MIAO Jing

GAO Li-feng

SUN Meng-xiong

LIU Nan

ZHANG Hong-qing

WANG Zhi-hua

CHEN Qiang

HUANG Jing

Related Institution

Department of Gynaecology and Obstetrics,Zhangjiakou First Hospital

Department of Clinical Laboratory,Zhangjiakou First Hospital

Department of Pathology,Zhangjiakou First Hospital

Department of Neurosurgery,Lianyungang Hospital Affiliated to Xuzhou Medical University

Graduate School of Xuzhou Medical University

⁰