There are things you can do and things you need to know when you are going to have surgery.
Getting ready for going in to hospital
You may not have very much notice of your operation. Your surgeon will want to remove your cancer as soon as possible. If you’re having a transplant, you’ll know you’re on the list, but are likely to be called in quite suddenly if a liver becomes available.
While you’re waiting, it’s best to take whatever steps you can to make sure you’re as well as you can be. That means eating as healthily as possible, and taking as much exercise as you can. Don’t worry if you’re not feeling well enough to do very much. Every little helps.
If you smoke, do try to stop at least a few weeks before your surgery. You’ll be at lower risk of complications afterwards if you do. If you can’t stop, at least cut down.
Tests you may have
It’s usual for doctors to arrange some tests before any major surgery. These are to make sure you’re well enough to have the anaesthetic and make a good recovery after your operation. You may have
- blood tests to check your general health, especially kidney and liver tests
- tests to make sure your heart is healthy, for example an ECG or echocardiogram
- tests to check your breathing, called lung function tests
- a chest X-ray
- exercise tests to measure your general fitness
The pre-assessment clinic
You are likely to have an out patient appointment around a week before your operation is scheduled. Who you’ll see varies, but may include:
- a specialist liver surgery nurse
- your anaesthetist
- your surgeon
- a physiotherapist
Sometimes if they’re busy in theatre, you won’t see your surgeon or anaesthetist until the day of your operation. Your surgeon will explain the surgery to you, including all the possible risks and complications. This can be a bit scary, listening to a list of everything that could go wrong. Remind yourself that these are very unlikely to happen! Your surgeon is obliged to tell you so that you can give your informed consent to having the treatment. You can ask any questions you have – it may help to bring a list with you. Once you’re satisfied that you have all the information you need, you sign the consent form.
You may also meet your physio at the clinic. They will teach you breathing and leg exercises to do after your operation. Deep breathing and getting moving can help to lower the risk of chest infection and blood clots after an operation.
Enhanced recovery programmes
Many hospitals now run ‘enhanced recovery programmes’ for people having surgery. Taking part in this is likely to shorten the length of time you’ll be in hospital. You may be introduced to this programme at the pre-assessment clinic or earlier, when the decision to operate is taken.
You’ll have advice on diet and exercise before surgery. The healthier you are beforehand, the quicker you are likely to recover. You may have high calorie drinks that you can have until 2 hours before your operation. This does vary, so follow the advice of your surgeon and anaesthetist, who will tell you exactly when to stop eating and drinking on the day.
During the operation, your surgeon will minimise the number of surgical drains so that it’s easier for you to get moving afterwards. They’ll want you to be up and eating and drinking as soon as possible. They may ask you to keep a recovery diary when you go home.
Arrangements you need to make
Any operation on your liver is major and you’ll need to make plans for managing while you get over it.
Firstly, you’ll need someone to take you home. They’ll have to be on stand-by, as you usually won’t know you’re being discharged until the day.
If you live alone, you’ll need to have someone to stay for a while. It’s difficult to know how long you’ll need help for, as everyone recovers at their own pace and it depends what you’ve had done. But you should aim for at least a couple of weeks.
If you know when you’re going in to hospital, it’s a good idea to get as much sorted at home as you can, so you don’t come home to piles of washing or housework. If you cook, you could batch cook some meals and put them in the freezer. Or you could buy some good quality ready meals and freeze those. It’s also sensible to make sure you’ve got enough of your regular prescription medicines.
On the day
You’ll need to stop eating and drinking for a number of hours before your operation is planned to take place. The length of time varies, so follow the instructions of your surgeon and anaesthetist. It’s often 6 hours, but with enhanced recovery programmes, you can often keep drinking until 2 hours before surgery.
Check with the hospital that you know which medicines you should and shouldn’t take on the day of your surgery. Although you’ll be nil by mouth, you may be able to take some of your tablets with a small amount of water.
If you live with diabetes, you should have clear instructions for the day of your surgery on eating and drinking, and on your insulin or tablets.
Have a shower or bath before you leave home. Avoid using lotions and perfumes. Remove any nail varnish from fingers and toes. Looking at your nailbeds is one of the many checks on your oxygen levels that anaesthetists make during an operation.
Content last reviewed: October 2022
Next review date: October 2025