{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:08:37Z","timestamp":1790723317749,"version":"4.1.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Blood flow factors, such as congestion or ischemia after hepatectomy, have a significant impact on liver regeneration, but with the popularization of precise hepatectomy technology, segmental hepatectomy without congestion or ischemia has become the preferred treatment. Our aim is to investigate the factors affecting liver regeneration after hepatectomy without blood flow changes, and to provide clinical evidence for surgeons on the timing of second hepatectomy for cirrhosis patients with hepatocellular carcinoma (HCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study retrospectively analyzed data from patients who underwent right hepatectomy without middle hepatic vein (MHV) in West China Hospital between January 2016 and January 2018. Eighteen living-donors without MHV as normal group and 45 HCC patients, further classified into 3 subgroups based on the severity of fibrosis using the Scheure system. Demographic data, pre- and postoperative liver function indexes, and remnant liver volume (RLV) were retrospectively compared. We also analyzed the remnant liver regeneration rate (RLRR) post-operatively in each group. The significant indexes in univariate analysis were further analyzed using both receiver operating characteristic (ROC) analysis and multivariate regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Liver regeneration occurred in both living-donor and HCC groups after hepatectomy; the RLRRs at 1 month were 59.46\u200a\u00b1\u200a10.39% and 57.27\u200a\u00b1\u200a4.77% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a=\u200a.509), respectively. Regeneration in the cirrhosis group occurred more slowly and less completely compared with that in other groups. The regeneration rate in the first 6 months showed rapid increase and the RLRR reached above 70% in cirrhosis group. Multivariate and ROC analyses revealed that Alb and the hepatic fibrosis grade in the early postoperative period were significant predictors of remnant liver regeneration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The liver regenerated in all HCC patients; however, regeneration was significantly slower and less complete compared with the normal liver, especially in the patients with cirrhosis. Therefore, it can be concluded that the degree of liver fibrosis is a major predictor of liver regeneration. Furthermore, the optimal time for second resection in recurrent HCC patients with cirrhosis was 6 months after the first operation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000020003","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T15:24:48Z","timestamp":1590679488000},"page":"e20003","source":"Crossref","is-referenced-by-count":22,"title":["Liver fibrosis is a major risk factor for liver regeneration"],"prefix":"10.1097","volume":"99","author":[{"given":"Yiliyaer","family":"Aierken","sequence":"first","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Xiang","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi-Jiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Yin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Liver Surgery and Liver Transplantation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"R1-20240308","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.soc.2008.02.002","article-title":"Liver resection for hepatocellular carcinoma","volume":"17","author":"Bryant","year":"2008","journal-title":"Surg Oncol Clin N Am"},{"key":"R2-20240308","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.bpg.2014.08.007","article-title":"Hepatocellular carcinoma epidemiology","volume":"28","author":"Bosetti","year":"2014","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"R3-20240308","doi-asserted-by":"crossref","first-page":"13074","DOI":"10.1038\/s41598-018-31351-3","article-title":"A novel, non-invasive model for diagnosing liver fibrosis stage in patients with hepatocellular carcinoma","volume":"8","author":"Ouyang","year":"2018","journal-title":"Sci Rep"},{"key":"R4-20240308","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/hep.1840180114","article-title":"Dynamics of normal and injured human liver regeneration after hepatectomy as assessed on the basis of computed tomography and liver function","volume":"18","author":"Yamanaka","year":"1993","journal-title":"Hepatology"},{"key":"R5-20240308","doi-asserted-by":"crossref","first-page":"5986","DOI":"10.12659\/MSM.908136","article-title":"Factors affecting liver regeneration in living donors after hepatectomy","volume":"23","author":"Ibis","year":"2017","journal-title":"Med Sci Monit"},{"key":"R6-20240308","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jhep.2018.10.011","article-title":"Clinical Practice Guidelines of the European Association for the study of the Liver - Advancing methodology but preserving practicability","volume":"70","author":"Cornberg","year":"2019","journal-title":"J Hepatol"},{"key":"R7-20240308","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.2214\/AJR.14.13343","article-title":"Chemoembolization of recurrent hepatoma after curative resection: prognostic factors","volume":"204","author":"Zu","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"R8-20240308","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/j.jhep.2018.08.027","article-title":"Development of pre and post-operative models to predict early recurrence of hepatocellular carcinoma after surgical resection","volume":"69","author":"Chan","year":"2018","journal-title":"J Hepatol"},{"key":"R9-20240308","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1111\/j.1600-6143.2009.02626.x","article-title":"Liver graft regeneration in right lobe adult living donor liver transplantation","volume":"9","author":"Cheng","year":"2009","journal-title":"Am J Transplant"},{"key":"R10-20240308","first-page":"521","article-title":"Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report","volume":"107","author":"Makuuchi","year":"1990","journal-title":"Surgery"},{"key":"R11-20240308","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1016\/0016-5085(85)90005-8","article-title":"In vivo hepatic volume determination using sonography and computed tomography. 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