Having your operation for liver cancer

Before your surgery, you will need

• Blood tests to check your general health and particularly your liver function
• A chest X-ray to check your lungs are healthy
• An ECG to check your heart is healthy
• To learn breathing and leg exercises
• A detailed explanation of what to expect

You may have had some of these tests while your cancer was being diagnosed. If so, you may not need to have them repeated. The tests are done to make sure you are fit enough to make a good recovery from your surgery.

Your nurse or physiotherapist will teach you some breathing and leg exercises. You can help yourself to get over your operation by doing these exercises regularly after your surgery. You should do them as often as you are told you need to. Breathing exercises will stop you from getting a chest infection. And leg exercises will help to stop blood clots forming in your legs. Both of these complications of surgery can happen because you are not moving around as much as you normally would be. Your nurses will encourage you to get up and about as soon as possible after your operation. But this is major surgery, and you will be in bed for a few days at least.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.

View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window)

When you go into hospital for your operation, your surgeon, anaesthetist, physiotherapist and nurse will all come to talk to you about what will happen. Your surgeon will explain what they will do and what to expect when you come round from the anaesthetic. Do ask as many questions as you need to. It may help to make a list of your questions before you go into hospital for your operation. There are some suggestions for questions at the end of this section. The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Just speak to your nurses or doctor again.

At first, you will probably be in a 'high dependency unit'. Or you may be in intensive care. Don't worry about this. These are hospital wards where there are a higher number of nurses per patient, so that they can keep a close eye on you for the first few days. There is always a risk of bleeding after liver surgery and it is best for you to be looked after in a ward where you have your own nurse taking care of you. So any complications will be picked up straight away.

When you wake up, you will have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You will have

• A drip (intravenous infusion) into your arm to give you fluids until you are eating and drinking again
• One or more tubes coming out from under your dressing to drain extra fluid away from the wound
• A small tube called a catheter going into your bladder to drain away your urine.

You may also have a tube down your nose into your stomach (nasogastric tube) to drain fluid and stop you from feeling sick.

These will all be removed within a few days. You will be transferred to a ward to recover before you are able to go home.

There are very effective painkillers available for use after surgery. After a liver resection, most patients have an epidural for pain control. With an epidural, you have a very fine plastic tube going into your back. Your anaesthetist uses the tube to give painkillers directly into your spinal fluid. This usually controls pain very well. You will probably have it in place for a few days after your operation.

You may have painkillers into your bloodstream instead of into your spinal fluid. If you do, you will probably have an electronic pump with painkillers in it attached to your drip. You may have a hand control with a button to press to give yourself extra painkillers, as you need them. This is called PCA or patient controlled analgesia. Do use this whenever you need to. You can’t overdose - the machine is set to prevent that. Do tell your nurse if you need to press the button very often. You may need a higher dose in the pump.

Once you are eating and drinking, you can have your painkillers as tablets or liquids that you swallow. There are many different types of painkilling drugs. It is important to tell your doctor or nurse as soon as you feel any pain. They can help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Gradually, your nurses will help you to get up and about and do more for yourself. You will feel much better once you have got rid of your drips and drains. Depending on the type and extent of surgery you had, you may be in hospital from one week to a few weeks.

Once at home, you will need to take things easy until you have fully recovered. This will take a few weeks at least.