Hepatectomies are performed for the treatment of hepatic tumors and livingdonor liver
transplantation. The success of liver resection relies on the remnant liver's ability to
regenerate after major tissue loss. Despite appropriate liver remnant volume after resection
ensures the liver's ability to regenerate, regeneration progresses at variable ratesin
patients.
Many researches have established a relationship between the gut microbiome and patients with
liver disease such as liver cirrhosis, alcoholic liver disease and obesity related liver
diseases. These liver disorders are associated with bacterial overgrowth, dysbiosis, and
increased intestinal permeability. However, the relationship between hepatectomy and
microbiota has not been fully investigated.
The measurement of small-molecule metabolites has been an integral part of clinical practice
including the familiar clinical standards like glucose and creatinine. Metabolomics, however,
is able to measure all the metabolites at once. It is possible to get a far more
comprehensive picture of what is happening to a patient's physiology or metabolism. Although
gut microbiota has been shown to be related to liver disease and liver regeneration.
Obtaining a more comprehensive analysis by identifying not only the microbial composition but
also the metabolites will be more insightful.
Many routine perioperative aspects of surgical care can impact the state of the microbiome
and therefore can impact clinical outcomes, like bowel preparation and antibiotics. Potential
factors affecting the gut microbiota also include perioperative manipulation, stress released
hormones, and opioids. Maintenance of proper anesthetic depth is beneficial to attenuate
surgical stress. General anesthesia including volatile anesthetics and opioids, is associated
with altered gut microbiota which might in turn affect liver regeneration. In this regard,
perioperative care such as anesthesia, is one of the key points for the success of a liver
resection. However, which anesthetic method is preferable regarding postoperative outcome or
recovery is controversial.
In this study, the study population will include liver tumor resection and living donor
hepatectomy. We aimed to 1) identify the relationship of hepatectomy and changes of gut
microbiota and metabolomics. 2) investigate the impact of different anesthetic methods on the
interaction of gut microbiota and metabolomics.