Abstract
Hepatobiliary surgery is undergoing a digital transformation guided by the principles of precision medicine. Artificial intelligence (AI) can be applied to predict postoperative complications, recurrence risk, and survival outcomes, thereby reshaping surgical planning and decision-making paradigms. Three-dimensional visualization and augmented reality technologies enable real-time navigation of anatomical structures, improving the precision and safety of complex surgical procedures. Big data analytics facilitate multicenter, long-term prognostic studies, providing evidence-based guidance for optimizing treatment strategies. Precision medicine integrates genomic features with anatomical factors to guide individualized determination of surgical extent and adjuvant therapy selection. Advances in xenogeneic liver transplantation have expanded the donor pool; however, the risks of cross-species infection and immune rejection require mitigation through gene-editing technologies and robust ethical oversight. AI-driven intraoperative navigation and robotic surgery challenge the traditional role of surgeons, while the “digital divide”, insufficient data standardization, and lack of regulatory frameworks continue to hinder widespread implementation. Future research should rely on high-quality clinical trials to validate the efficacy of emerging technologies, establish standardized data-sharing frameworks across institutions, and, while promoting technological innovation, uphold the core humanistic values of surgery—including clinical judgment and patient safety—to ensure that digital transformation ultimately maximizes improvements in patient outcomes.
Key words
hepatobiliary surgery /
precision medicine /
artificial intelligence /
digital transformation /
surgical decision-making optimization
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References
［1］ Fang C，Zhang P，Qi X.Digital and intelligent liver surgery in the new era: Prospects and dilemmas［J］.EBioMedicine，2019，41:693-701.DOI:10.1016/j.ebiom.2019.02.017.
［2］ Cai L，Wang MD，Yang T.Navigating the future of liver disease research: A roadmap for iLIVER［J］.iLIVER，2024，3（1）:100084.DOI:10.1016/j.iliver.2024.100084.
［3］ Cipriani F，Ratti F，Aldrighetti L.Laparoscopic liver resections at the gates of 2020:A stand-alone field of hepatobiliary surgery［J］.Hepatobiliary Surg Nutr，2020，9（3）:371-373.DOI:10.21037/hbsn.2019.11.07.
［4］ Wang XH，Chen FF，Pan J，et al.Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery［J］.World J Gastrointest Surg，2024，16（10）:3155-3162.DOI:10.4240/wjgs.v16.i10.3155.
［5］ Tao KS，Yang ZX，Zhang X，et al.Gene-modified pig-to-human liver xenotransplantation［J］.Nature，2025，641（8064）:1029-1036.DOI:10.1038/s41586-025-08799-1.
［6］ Hashimoto DA，Rosman G，Rus D，et al.Artificial intelligence in surgery: Promises and perils［J］.Ann Surg，2018，268（1）:70-76.DOI:10.1097/SLA.0000000000002693.
［7］ Varghese C，Harrison EM，O'Grady G，et al.Artificial intelligence in surgery［J］.Nat Med，2024，30(5):1257-1268.
［8］ Li H，Han Z，Wu H，et al.Artificial intelligence in surgery: Evolution，trends， and future directions［J］.Int J Surg，2025，111（2）:2101-2111.DOI:10.1097/JS9.0000000000002159.
［9］ 耿小平.人工智能时代肝胆胰外科微创技术与开放手术之争［J］.中国实用外科杂志，2022，42(8):845-848.DOI:10.19538/j.cjps.issn1005-2208.2022.08.02.
［10］ Chen WY，Li C，Liu ZP，et al.Novel online calculator to predict reduced risk of early recurrence from adjuvant transarterial chemoembolisation for patients with hepatocellular carcinoma［J］.eGastroenterology，2023，1（1）:e100008.DOI:10.1136/egastro-2023-100008.
［11］ Cai W，He BC，Hu M，et al.A radiomics-based nomogram for the preoperative prediction of posthepatectomy liver failure in patients with hepatocellular carcinoma［J］.Surg Oncol，2019，28:78-85.DOI:10.1016/j.suronc.2018.11.013.
［12］ Bari H，Wadhwani S，Dasari BVM.Role of artificial intelligence in hepatobiliary and pancreatic surgery［J］.World J Gastrointest Surg，2021，13（1）:7-18.DOI:10.4240/wjgs.v13.i1.7.
［13］ Soto F，Wang J，Ahmed R，et al.Medical micro/nanorobots in precision medicine［J］.Adv Sci(Weinh)，2020，7（21）:2002203.DOI:10.1002/advs.202002203.
［14］ Tang SC，Zeng YY，Yang T.Surgical decision-making considerations in hepatocellular carcinoma resection: Safety and efficacy［J］.Ann Surg Oncol，2024，31（3）:1844-1845.DOI:10.1245/s10434-023-14721-8.
［15］ Jovic TH，Combellack EJ，Jessop ZM，et al.3D bioprinting and the future of surgery［J］.Front Surg，2020，7:609836.DOI:10.3389/fsurg.2020.609836.
［16］ Zhang W，Zhu W，Yang J，et al.Augmented reality navigation for stereoscopic laparoscopic anatomical hepatectomy of primary liver cancer: Preliminary experience［J］.Front Oncol，2021，11:663236.DOI:10.3389/fonc.2021.663236.
［17］ Wang Y，Cao D，Chen SL，et al.Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery［J］.World J Gastrointest Surg，2021，13（9）:904-922.DOI:10.4240/wjgs.v13.i9.904.
［18］ Tang R，Ma L， Xiang C，et al.Augmented reality navigation in open surgery for hilar cholangiocarcinoma resection with hemihepatectomy using video-based in situ three-dimensional anatomical modeling: A case report［J］.Medicine(Baltimore)，2017，96（37）:e8083.DOI:10.1097/MD.0000000000008083.
［19］ Balci D，Kirimker EO，Raptis DA，et al.Uses of a dedicated 3D reconstruction software with augmented and mixed reality in planning and performing advanced liver surgery and living donor liver transplantation(with videos)［J］.Hepatobiliary Pancreat Dis Int，2022，21（5）:455-461.DOI:10.1016/j.hbpd.2022.09.001.
［20］ Wang L，Alexander CA.Big data analytics in medical engineering and healthcare: Methods，advances and challenges［J］.J Med Eng Technol，2020，44（6）:267-283.DOI:10.1080/03091902.2020.1769758.
［21］ 卢实春，顾万清.肝胆肿瘤外科治疗精准医学概要［J］.中华肝胆外科杂志，2019，25(1):1-4.DOI:10.3760/cma.j.issn.1007-8118.2019.01.001.
［22］ Wang MD，Diao YK，Yao LQ，et al.Emerging role of molecular diagnosis and personalized therapy for hepatocellular carcinoma［J］.iLIVER，2024，3（1）:100083.DOI:10.1016/j.iliver.2024.100083.
［23］ Liu H，Diao YK，Wei F，et al.Stratifying risk of failure to achieve textbook outcomes among patients undergoing hepatectomy for hepatocellular carcinoma: A multicenter score validation study［J］.Eur J Surg Oncol，2024，50（9）:108477.DOI:10.1016/j.ejso.2024.108477.
［24］ Liu ZP，Yao LQ，Diao YK，et al.Association of preoperative body mass index with surgical textbook outcomes following hepatectomy for hepatocellular carcinoma: A multicenter study of 1206 patients［J］.Ann Surg Oncol，2022，29:4278-4286.DOI:10.1245/s10434-022-11721-y.
［25］ Yang T，Lau WY，Shen F.Creating favorable conditions for increased quantity of high-quality clinical studies in surgery［J］.Hepatobiliary Surg Nutr，2020，9（3）:330-332.DOI:10.21037/hbsn.2020.04.04.
［26］ Arabi TZ，Sabbah BN，Lerman A，et al.Xenotransplantation: Current challenges and emerging solutions［J］.Cell Transplant，2023，32:9636897221148771.DOI:10.1177/09636897221148771.
