Clinical Trial of Standard Versus Goal-Directed Perioperative Fluid Management (GDT) for Patients Undergoing Liver Resection

Inclusion Criteria: * Adults (18 years old or greater) who are able to provide informed consent. * Patients who undergo an open, elective liver resection. Including those initially approached laparoscopically but converted to an open resection and those undergoing additional procedures. Exclusion Criteria: * Active coronary disease. * Patients with a history of coronary disease will be eligible if they have had a cardiac stress study showing no reversible ischemia and normal LV function within 3 months of operation. * Active symptomatic cerebrovascular disease. * Active congestive heart failure and ejection fraction \<35%. * Active severe restrictive or obstructive pulmonary disease and resting SpO2 \<90%. * Active renal dysfunction (Cr \>1.8) * Abnormal coagulation parameters (INR \> 1.8 not on Coumadin, or platelet count \< 100,000 per mcL) * Presence of active infection including HIV * Patients with active atrial fibrillation or flutter. * Preoperative hypoalbuminemia (Albumin \< 2g/dl). * Female patients who are pregnant (female patients of child-bearing potential must have a negative serum pregnancy test ≤ 14 days prior to surgery or 15 to 30 days prior to surgery with a negative urine pregnancy test the morning of surgery). * Presence of ascites. * BMI \> 45 or \<17