Ischaemic preconditioning in liver resections studied with microdialysis

INTERVENTION: All patients will receive intrahepatic microdialysis catheters intra‐operatively. Pringle manoeuvre means closure of the portal pedicle. The treatment arm will begin surgery with 10 minutes of Pringle and then 10 minutes of reperfusion (i.e. ischaemic preconditioning) will be allowed before regular 15 minutes of ischaemia and 5 minutes of reperfusion in cycles until the transsection is finished. The control arm will not have preconditioning, otherwise Pringle will be used in the same manner. Both arms are followed for 5 days post‐operatively with microdialysis and laboratory testing and then a follow‐up visit is held at the outpatient clinic about 30‐days post‐operatively where complications and pathological diagnosis is documented. CONDITION: Liver tumour ; Cancer ; Malignant neoplasm of the liver PRIMARY OUTCOME: 1. Changes in metabolism (anaerobic/aerobic), studied with microdialysis; 2. Ischaemia‐reperfusion injury (histology, myeloperoxidase [MPO], etc); ; Results of the microdialysis samples are recorded continuously for 5 days post‐operatively (and blood samples daily for 5 days), but data are not compiled and analysed until the last study participant has completed the 30‐day follow‐up time. SECONDARY OUTCOME: Extent of the resected liver volume, recorded continuously and the volume of resection will be recorded immediately after the operation. Data are not compiled and analysed until the last study participant has completed the 30‐day follow‐up time. INCLUSION CRITERIA: 1. Aged greater than 17 years of age (either sex) 2. Suspected malignant tumour in the liver 3. Assigned to curative liver resection of more than one liver segment