After surgery

Surgery for liver cancer is a major operation and it’s understandable to be a little nervous. It helps to know what to expect.

When you come round

When you come round from the anaesthetic, you’ll be in the recovery room. You may not remember much about this later as you’ll still be groggy from the anaesthetic. You may have a mask on, or tubes in your nostrils, giving you oxygen. You’ll have a drip (intravenous infusion) to give you fluids until you can drink. You’ll have a clip on your finger to monitor your pulse and a cuff on your arm to check your blood pressure. Every few minutes, a nurse will check these and your dressing.

Once you’re fully awake, you’ll be moved. Where you’ll go depends on the type of surgery you’ve had. For most liver surgery, you will go to a high dependency unit, or ITU (intensive care) if you’ve had a transplant. Going to high dependency or ITU is nothing to worry about. It’s normal after some liver surgery. The nurses in these units have fewer patients to look after, so they can spend more time with you.

If you have any pain or feel sick, tell your nurse. They’ll be able to give you medicine to help. It’s quite normal to feel sick after an anaesthetic. You may also have a sore throat because you’ll have had a tube down your throat during the operation. You won’t be able to drink at first, but your nurse may give you ice chips to suck or wet your mouth with a swab.

Avoiding complications

The commonest complications after surgery are

• chest infections
• blood clots
• wound infections

The best way to reduce your risk of the first two is to get up and about as soon as possible. Depending on the operation you’ve had, your nurse is likely to want you to get out of bed and into a chair for a short while the day after your surgery.

Blood clots

You’ll probably have elastic stockings on when you come round from the anaesthetic. These help to stop you getting blood clots in your legs (a DVT or deep vein thrombosis). You’ll need to keep these on until you are fully mobile again.

You can also help yourself by doing the leg exercises you’ve been taught. Circling your feet, flexing your feet up and down at the ankle – the sort of thing you may do on a long flight.

You’ll be encouraged to get up and move around. Your nurse or physio will help you if you’ve got drips and drains. They’ll take these out as soon as possible, as the medical team know that you’ll be able to move more easily without them.

You may also have daily anti-clotting injections just under the skin (subcutaneously). These go into the skin of your tummy, but it’s a very short needle.

Wound infection

Your wound will be covered with a dressing. That’ll probably be left in place for at least a couple of days. The dressing will be changed if there’s been any bleeding. Over the next few days, tell your nurse if your wound feels hot or sore as that could be a sign of infection.

You may have had antibiotics at the time of your surgery to make post-op infection less likely.

Leaving the hospital

You may not know you’re going home until a day or so beforehand. You’ll have time to put any arrangements in place, including a lift home. It’s not always easy arranging for someone to pick you up, as you’ll have to wait for any tablets to come up from the pharmacy and won’t know when that’ll be. Let your driver know that there may be some waiting around!

You should have an out patient follow up appointment booked before you leave the ward – do ask if not. It may be sent on in the post, but it’s worth checking with your nurse for peace of mind.

Ask your nurse to explain the follow up plan for you. You may need blood tests or scans to make sure all’s well and check how the treatment has worked. Ask them who you should call if you’re worried about anything after you get home and make sure you’ve got the phone number.

At home

When you first go home, you’ll need someone to help you around the house. How long this will be for depends on the type of surgery you’ve had and how well you’re recovering. There are some precautions you need to take after any abdominal surgery. You shouldn’t lift anything heavy for several weeks, to allow your tummy muscles to heal. So don’t carry children or heavy shopping, or do any heavy housework such as vacuuming. You also won’t be able to drive safely until you can twist round easily, to see behind you.

Keep up with the exercises you’ve been taught and try not to spend too long sitting in one place. If your hospital runs an enhanced recovery programme, you may have a diary to fill in, recording:

• how much you’re moving around
• what you’re eating and drinking
• whether you have any pain or sickness

If you are concerned about anything, call the clinic or ward. Try not to worry about bothering them. They won’t mind a quick phone call to sort out any problems. Do let your doctor know if you have any signs of infection such as:

• a raised temperature
• redness or increased soreness around your wound site
• a new cough, wheezing or shortness of breath

Once you’re up and about, the risk of a blood clot is much lower. But also contact your doctor if you have tenderness, redness or swelling in your legs.