Mechanistic Study on the Protective and Regenerative Effects of Spirulina in Hepatectomy-Related Liver Injury

Inclusion Criteria: * Diagnosed with cholangiocarcinoma (bile duct cell carcinoma). * Child-Pugh Class A liver function. * Planned to receive neoadjuvant therapy with gemcitabine + oxaliplatin, combined with lenvatinib and a PD-1 inhibitor, followed by anatomical hemihepatectomy (remaining liver volume \> 40%). * Age 18-75 years, male or female. Willing and able to comply with the study protocol, including oral administration of spirulina or placebo for 3 weeks before and 3 weeks after surgery. * Voluntarily agrees to participate and signs written informed consent. * Has had no acute illness or significant symptom worsening within 4 weeks before enrollment. Exclusion Criteria: * Presence of severe comorbidities (e.g., uncontrolled cardiovascular, respiratory, renal, or hematologic diseases). * Known allergy to spirulina or its components. * Concurrent malignant tumors other than the target disease. * History of previous liver resection surgery. * Severe psychiatric disorders that could affect compliance or the ability to provide informed consent.