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Problems after surgery

All operations to remove liver cancer are major surgery, and take place in specialist centres.

As with any operation, there is a risk of complications. A complication is anything that happens after surgery that makes your recovery more difficult. Before offering surgery as an option to you, your doctors make sure the benefit of having the operation outweighs the possible risks.

Your doctors will talk to you about the possible complications of the surgery and general anaesthetic before you sign the consent form to have the operation. Your doctors and nurses monitor you very closely after the operation to check for problems, and even when you go home they still see you quite often to make sure you are recovering well.

Some complications can be serious. But they are becoming less common as surgeons get better at deciding who is likely to make a good recovery.

This page is about problems after surgery to remove part of your liver (resection). Liver transplant surgery has some additional risks because there is the possibility of your body rejecting the new liver.

Some of the possible problems after having a liver resection include:

Chest, wound, urine infection

There is a risk of infection after an operation. The wound area might be red and sore. If you have a chest infection you might have a cough or feel short of breath. You might also feel generally unwell and have a temperature.

Let your doctor or nurse know if you have any symptoms. They can give you antibiotics through a drip or as tablets.

Bleeding

After any operation there is a risk of bleeding, particularly with liver surgery as a lot of blood passes through the liver. Also, your liver normally makes substances that help your blood to clot. So any damage to the liver can cause problems with bleeding.

Your doctors and nurses will monitor you closely during and after the operation to check for signs of bleeding. You may need a blood transfusion after your operation. Rarely you may need to go back to theatre for another operation to stop the bleeding.

Bile leakage

Bile is a fluid that helps to digest food by breaking down fat. The liver makes bile which is stored in the gallbladder. Small tubes called bile ducts carry the bile, and connect the liver and gallbladder to the small bowel.

There is a risk of bile leaking from the ducts on the cut surface of the liver. This may cause pain, sickness and a high temperature. Rarely, you might need another operation to repair the leak.

Kidney problems

There is a risk that your kidneys may stop working properly after the operation. Your doctors and nurses will keep a close eye on blood test results and how much urine you make. Your kidneys usually recover over time but some people require kidney support (dialysis) after major surgery.

Build up of fluid in the abdomen (ascites)

You may develop ascites in your tummy (abdomen) after having liver surgery. This can be due to different reasons, including an increase in pressure in one of the main blood vessels of the liver (portal vein). Your doctor can give medicines to help reduce the fluid, or in some cases they may put in a tube to drain the fluid.

Blood clots

Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the body. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.

There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:

  • shortness of breath
  • chest pain
  • coughing up blood
  • feeling dizzy or light headed
If you have any symptoms of a blood clot when you are at home, see your GP or go to your nearest accident and emergency department (A&E).

To try to prevent blood clots you wear compression stockings after surgery. You also have daily injections for several weeks to thin your blood, and your nurses will encourage you to get up as soon as possible or do regular leg exercises. 

Blockage of blood supply to the liver

Although uncommon, there is a risk of a blood clot developing in one of the main blood vessels to and from the liver (hepatic artery, portal vein or hepatic veins). You may have drugs to thin the blood if this happens. In some cases, you may need another operation.

Liver failure

There is a risk that your remaining liver doesn’t work after your operation. This is a rare but very serious complication and can be life threatening.

Last reviewed: 
19 Feb 2019
  • EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
    European Association for the Study of the Liver
    Journal of Hepatology, 2018. Volume 69, Pages 182-236

  • Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    A Vogel and others
    Annals of Oncology, 2018. Volume 29, Supplement 4, Pages 238-255

  • Comprehensive review of post-liver resection surgical complications and a new universal classification and grading system
    I Masayuki and others
    World Journal of Hepatology, 2014. Volume 6, Issue 10, Pages 745 to 751

  • Postoperative management after hepatic resection
    L Wrighton and others
    Journal of Gastrointestinal Oncology, 2012. Volume 3, Issue 1, Pages 41 to 47

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