Background/Objectives: Liver-on-a-chip (LiOC) technology is increasingly recognized as a transformative platform for modeling liver biology, disease mechanisms, drug metabolism, and toxicity screening. Traditional two-dimensional (2D) in vitro models lack the complexity needed to replicate the liver’s unique microenvironment. This review aims to summarize recent advancements in LiOC systems, emphasizing their potential in biomedical research and translational applications. Methods: This narrative review synthesizes findings from key studies on the development and application of LiOC platforms. We explored innovations in material science and bioengineering, including microfluidic design, 3D printing, stem cell– and tissue-derived liver organoid integration, and co-culture strategies. Commercially available LiOC systems and their regulatory relevance were also evaluated. Results: LiOC systems have evolved from simple PDMS-based chips to complex, multicellular constructs incorporating hepatocytes, endothelial cells, Kupffer cells, and hepatic stellate cells. Recent studies demonstrate their superior ability to replicate liver-specific architecture and functions. Applications span cancer research, drug toxicity assessment (e.g., drug-induced liver injury prediction with >85% sensitivity), disease modeling, and regenerative medicine. Several platforms have gained FDA recognition and are in active use for preclinical drug testing. Conclusions: LiOC technology offers a more physiologically relevant alternative to traditional models and holds promise for reducing reliance on animal studies. While challenges remain, such as vascularization and long-term function, ongoing advancements are paving the way toward clinical and pharmaceutical integration. The technology is poised to play a key role in personalized medicine and next-generation therapeutic development.

Background: Open surgery is gradually replaced by minimally invasive surgery, but few studies have reported the feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with vascular resection and reconstruction. The present study compared the efficacy of LPD with open pancreaticoduodenectomy (OPD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic cancer. Methods: The clinical data of patients who underwent PD combined with PV/SMV resection and reconstruction from March 2016 to August 2022 at our institution were retrospectively analyzed. The perioperative outcomes and survival outcomes were compared after propensity score matching (PSM). Results: The original cohort included 64 patients. Sixteen pairs of patients were obtained by 1:1 PSM. The intraoperative blood loss was greater in the OPD group than in the LPD group (550 vs. 200 mL, P=0.04), and the PV clamp time was longer in the LPD group than in the OPD group (29.4 vs. 18.8 min, P0.05). Conclusions: LPD combined with PV/SMV resection and reconstruction is safe and feasible in selected patients and results in similar perioperative outcomes and prognosis as open surgery.

Purpose There are few studies on the reconstruction of the middle hepatic vein (MHV) tributaries in split liver transplantation (SLT) using right lobe grafts. This study aimed to compare the outcomes of patients undergoing combined reconstruction of MHV tributaries and the right hepatic vein (RHV) versus those undergoing separate reconstruction. Methods Clinical data of 114 patients who underwent SLT from March 2021 to December 2023 were retrospectively collected. We analyzed and compared the postoperative outcomes and reconstructed MHV patency between different modalities of MHV tributaries reconstruction in the right lobe SLT. Results Forty-five right lobe grafts were reconstructed with the MHV tributaries and were divided into two groups according to the type of reconstruction. Group 1 (n = 19) received separate reconstruction, while Group 2 (n = 26) received combined reconstruction. The duration of warm ischemia in Group 2 was significantly less than that in Group 1 (47.9 ± 7.8 vs. 59.7 ± 15.6 min, P = 0.002), and the ICU hospitalization time was significantly less in Group 2 than in Group 1 (2 vs. 3 days, P = 0.022). The complete patency rate of the reconstructed MHV at 30 days postoperatively was higher in Group 2 than in Group 1 (96.2% vs. 68.4%, P = 0.031). The rates of postoperative complications were comparable between the two groups. Conclusion Combined reconstruction of the MHV tributaries and RHV in SLT improves the rate of complete patency of the reconstructed MHV, reduces warm ischemia time, and shortens the length of ICU stay.