This is a prospective controlled trial, conducted between January 2005 and December 2007. Three centres specialized in hepatobiliary surgery (Cochin hospital (Paris, France), BEAUJON hospital (Clichy, France) and PONTCHAILLOU Hospital (Rennes, France)) participated to this study, which has been initiated by the department of hepatobiliary surgery and liver transplantation of the Cochin hospital. The protocol was approved by ethics committees of each participating centres and an informed consent was obtained from each patients before they were enrolled. Eighty seven patients were randomized to either receive ischemic preconditioning prior to liver resection under intermittent pedicular clamping or not. Ischemic preconditioning was performed through a sequence of 10 minutes vascular inflow occlusion and 10 minutes of reperfusion prior to intermittent pedicular clamping. Intermittent pedicular clamping was conducted through a sequence of 15 minutes of vascular inflow occlusion and 5 minutes of reperfusion. The randomization process which was centralized was held in the operating room after inclusion criteria had been check and exclusion criteria ruled out. Inclusion criteria were: patients' age (≥ 18 years old), liver resection of 3 segments (as described by Couinaud) or more, posterior lesionectomy (segment VI and VII), liver resection only or associated with a primary digestive or biliary tumor. Exclusion criteria : Patients with cirrhosis, synchronous radiofrequency or cryotherapy ablation, undergoing segmentectomy, left lateral lesionectomy or laparoscopic liver resection were excluded from further analysis as well as pregnant women.