After your operation for bile duct cancer
This page has information about what to expect after your operation for bile duct cancer (cholangiocarcinoma). You can find the following information
Immediately after your operation
How you will feel after your operation depends on the type and amount of surgery you’ve had. If you had very major surgery to remove your cancer, you will spend the first couple of days in intensive care or a high dependency unit.
When you first wake up, you are likely to have several tubes in place to give you fluids and painkillers, drain the wound, drain your urine, and drain fluid from your stomach to stop you feeling sick.
It is important to tell your doctor or nurse as soon as you feel any pain. You can help them to find the right type and dose of painkiller for you.
After surgery to any part of the digestive system, the bowel usually stops working for a while. Until it starts working again, you will not be able to eat or drink anything. Once your bowel starts working, you will be able to try sips of fluids. Gradually the amount you can drink will increase. And soon you will be able to try other fluids and then start eating slowly.
Getting up and going home
Your nurse will help you to get up a day or so after your operation. It will be difficult at first but gradually gets easier. Most people stay in hospital for a week or so. But it depends on the surgery you have had. Most people feel tired for at least a few weeks. If you have had major surgery it will take longer to recover. Your nurse will give you an appointment to go back to the hospital for a check up.
You can view and print the quick guides for all the pages in the treating bile duct cancer section.
How you will feel after your operation depends on the type and amount of surgery you had.
If you had very major surgery to try to cure your cancer, you will probably wake up in intensive care or a high dependency unit. This is normal for this type of surgery. It means that you will have one to one nursing care. Your surgeon and anaesthetist will keep a close eye on your progress. As soon as you have recovered enough you will move back to the main surgical ward. This usually takes a few days.
Before your operation your doctor will have told you how long you are likely to be in hospital. Some people go home a few days after their operation. Other people have to stay in for longer. Depending on the type of surgery you have had, it will take from a few days to a few weeks to start to feel better.
When you wake up, you will have several different tubes in place. This can be a bit frightening. But it can help if you know what they are all for. The tubes you have depend on the type of operation you had. They may include some or all of the following
- Drips (intravenous infusions) to give you blood transfusions and fluids until you are eating and drinking again
- Tubes into your neck and arms to measure your blood pressure
- One or more tubes coming out of your abdomen near your wound – these wound drains stop blood, bile and tissue fluid collecting around the operation site
- A tube down your nose into your stomach (nasogastric tube) to drain bile and stop you feeling sick
- A tube into your bladder (catheter) to collect urine
- A fine tube into your back that goes into your spinal fluid (epidural) to help relieve pain
You may also have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse. Keeping your blood pressure stable is very important after surgery. So, your nurses will measure your blood pressure very often for the first week or so. At first, they can check it through the tubes that go into your neck and arms. These go directly into your main blood vessels and give a more accurate measurement than a blood pressure cuff on your arm. Your nurses will also check how much urine you are passing because it can help to show if you have too much fluid in your body or are getting dehydrated.
You may have a couple of electronic pumps attached to your drips. The pumps give you a constant, measured dose of painkillers or other drugs through your drip.
You will almost certainly have some pain for the first week or so. Your doctors and nurses will give you painkillers by drip or injection immediately after your operation. If you have a pump for the painkiller, you will have a hand control. You can press the button on the pump to give yourself extra painkillers if you need them. This is called PCA or patient controlled analgesia. Do use the button whenever you need to. You can't overdose because the machine is set to prevent that. But tell your nurse if you need to press the button very often. You may need a higher dose of painkiller in the pump.
Some hospitals give painkillers into the fluid around the spinal cord (a spinal anaesthetic) for the first few days after surgery. This usually controls pain very well. You will have a very fine tube taped to your back. This connects to a pump, which gives you a continuous dose of painkiller into your spine. Tell your nurse if you still have pain and they can increase the dose.
Once you are able to eat and drink you can take painkillers as tablets. It is important that your pain is well controlled. It will make you more comfortable and will also mean you can get up and about more quickly. You will also be able to breathe properly and sleep better. All of this will help your recovery. So do tell your nurses if you don’t think your painkillers are working well enough.
You will have a dressing over your wound when you wake up. The dressing stays in place for a couple of days. Then your nurse will clean the wound and put a new dressing on. The wound drains stay in until they stop draining fluid. Your nurse will change the bottles attached to them every day. The drains usually stay in for about a week. They may have to stay in longer if there is any fluid leakage from the operation area. You will have the stitches in for about 2 weeks.
After surgery to any part of the digestive system, the bowel often stops working for a while. Until it starts up again, you will not be able to eat or drink.
We know from research that you may recover more quickly and be less likely to get an infection if you start eating and drinking after 24 hours. You usually start with sips of water and gradually increase fluids until you are able to eat a light diet. Your surgical team will tell you when you can start eating and drinking again. Once you are able to drink without feeling sick, your nurse will take out your drip and nasogastric tube.
This might seem almost impossible at first. Your nurses and physiotherapist will get you moving as soon as possible. You will start gradually and they will help you. They will show you breathing and leg exercises and help and encourage you to do them from the day of your surgery. Moving about helps you get better.
Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.
Or you can read a transcript of the video (opens in new window)
Your nurse or physiotherapist will help you to get out of bed, usually 1 or 2 days after your surgery. At first you will need help with moving because of the drips and tubes. As the drips and tubes are taken out over the next few days it will get easier to move around.
Most people are able to go home within a week or two but it depends on the surgery you have had. If you had very major surgery it will take a bit longer. You may still be tired and it will take a few weeks to fully recover. If you need to have stitches or clips taken out, your nurse will arrange this as part of your discharge plan. You will have an appointment to see your surgeon in the outpatient department, usually about 6 weeks after your operation.
After a major operation it takes most people about 6 months to get their fitness and strength back.
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