Timely liver function recovery (LFR) is crucial for postoperative hepatocellular carcinoma (HCC) patients. Here, we established the significance of LFR on patient long-term survival through retrospective and prospective cohorts and identified a key gut microbe, Bifidobacterium longum, depleted in patients with delayed recovery. Fecal microbiota transfer from HCC patients with delayed recovery to mice similarly impacted recovery time post hepatectomy. However, oral gavage of B. longum improved liver function and repair in these mice. In a clinical trial of HCC patients, orally administering a probiotic bacteria cocktail containing B. longum reduced the rates of delayed recovery, shortened hospital stays, and improved overall 1-year survival. These benefits, attributed to diminished liver inflammation, reduced liver fibrosis, and hepatocyte proliferation, were associated with changes in key metabolic pathways, including 5-hydroxytryptamine, secondary bile acids, and short-chain fatty acids. Our findings propose that gut microbiota modulation can enhance LFR, thereby improving postoperative outcomes for HCC patients.

及时的肝功能恢复（LFR）对于术后肝细胞癌（HCC）患者至关重要。在这里，我们通过回顾性和前瞻性队列确定了 LFR 对患者长期生存的重要性，并确定了延迟恢复患者体内的一种关键肠道微生物——长双歧杆菌。从恢复延迟的 HCC 患者到小鼠的粪便微生物群转移同样影响了肝切除术后的恢复时间。然而，口服长双歧杆菌可以改善这些小鼠的肝功能和修复。在一项针对 HCC 患者的临床试验中，口服含有长双歧杆菌的益生菌混合物可降低延迟康复率、缩短住院时间并提高总体 1 年生存率。这些益处归因于肝脏炎症减轻、肝纤维化和肝细胞增殖减少，与关键代谢途径的变化有关，包括 5-羟色胺、次级胆汁酸和短链脂肪酸。我们的研究结果表明，肠道微生物群调节可以增强 LFR，从而改善 HCC 患者的术后结果。