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Summary Keywords postoperative delirium, gut microbiota, gut-brain axis, gut-liver axis, liver disease, anesthesia, perioperative intervention Citation Han R, Song Y, Wang Y, Liu Y, Zhang X, Deng Z, Xia L and Zhong M-L (2026) Gut microbiota and postoperative delirium: mechanistic integration of the gut-liver-anesthesia axis in the context of liver disease and perioperative intervention strategies