Molecular and Translational Anti-Inflammatory Strategies After Abdominal and Liver Surgery: From Immunonutrition to Cell-Based Therapies

Postoperative inflammation influences recovery after abdominal and liver surgery. This narrative review critically synthesizes clinical and translational evidence on inflammation-modulating strategies using a structured search of PubMed, Scopus, Web of Science, and Cochrane Library for publications from 2015 to 2025. Case reports, pediatric studies, and publications lacking clinical or translational relevance were excluded. Immunonutrition and early enteral nutrition are the most established approaches, with benefits for postoperative recovery and infectious complications. Perioperative corticosteroids in liver resection and short-course antibiotics following adequate source control offer procedure- and indication-specific benefits. Emerging interventions, including microbiota modulation, N-acetylcysteine, activation of nuclear factor erythroid 2-related factor 2/heme oxygenase-1 signaling, and cell-based therapies, show biological promise but lack sufficient high-quality clinical evidence for routine implementation. Established strategies should be integrated into Enhanced Recovery After Surgery pathways according to patient risk and surgical context. Personalized management requires prospective validation of emerging therapies and candidate biomarkers, including interleukin-6, C-reactive protein, and heme oxygenase-1, with standardized assays and sampling schedules.