• Factor V at day 3 after surgery [ Time Frame: day 3 ]
  

• Liver regeneration kinetics (bile production at days 1, 3, 5 and 7;factor V, γ-glutathione transferase, α-foetoprotein at days 1, 3, 5, 7, 10 and 30; liver volume at days 10 and 30 [ Time Frame: days 1, 3, 5, 7, 10 and 30 ]
  
• Immunological biomarkers
  
• Infections
  

In patients undergoing hepatic resection for liver cancer (with cirrhosis or fibrosis liver), mortality rate can reach 10% and morbidity (ascites, icteria, infections) 70%. These complications are mainly due to hepatic insufficiency: surgery leaves a reduced parenchyma, with oxidative stress lesions due to reperfusion injury. A good preoperative nutritional state has been shown to reduce complications and mortality. This can be amplified by preoperative nutrition with supplements containing L-arginin, ω3 polyunsaturated fatty acids, and nucleotides which boost immune responses, resistance to infections and liver function recovery. In this context, the study randomly assigns 50 patients who were scheduled to undergo hepatic resection, to receive either an oral immune-enhancing nutritional supplement or a placebo, for the 7 last preoperative and the first 3 postoperative days. The aim of the study is to evaluate the effects of this supplementation on liver function, immunity, and incidence of infections after surgery.

Inclusion Criteria:

• Adult over 18 years
• Hepatectomy of at least 2 segments
• For primary or secondary cancer
• With cirrhosis (Child Pugh <8) or liver fibrosis (fibrosis score of 3)
• Informed written consent

Exclusion Criteria:

• Pregnancy
• Recent weight loss of more than 10% of body weight
• Immunological deficiency
• Portal or hepatic arterial thrombosis
• Biliary duct dilation