To study the efficacy of preoperative immunonutrition in reducing postoperative morbidity after liver resection for cancer.

Perioperative immunonutrition has been developed to improve the immuno metabolic host response and outcome in postoperative period and has been proven to be beneficial in reducing significantly postoperative infectious complications and length of hospital stay in patients undergoing elective gastrointestinal surgery for tumors. To date, the effects of preoperative oral immunonutrition (ORAL IMPACT) in non cirrhotic patients undergoing liver resection for cancer are unknown. The purpose of this study is to determine whether the administration of a short-term preoperative oral immunonutrition can reduce postoperative morbidity in non-cirrhotic patients undergoing liver resection for malignant tumours.

Inclusion Criteria:

• Age > 18 years
• Non cirrhotic patient
• Elective liver surgery for cancer (primary or secondary malignant tumours)
• Hepatectomy including at least 1 segment or 3 wedge resections

Exclusion Criteria:

• Liver resection for benign lesions
• Liver resection associated with biliary tract surgery
• Liver resection associated with gastro-intestinal surgery
• Cirrhosis, defined by transient elastography (Fibroscan®) or by liver biopsy
• Renal failure
• Pregnancy or nursing women
• History of hypersensitivity or allergy to arginine, omega-3 fatty acids, or nucleotides
• Inability to take oral nutrition
• Mental condition rendering the subject unable to understand the nature, end-points and consequences of the trial