Problems after resection surgery for liver cancer

About the complications of liver resection

Possible problems after a liver resection include bile leakage, liver failure or fluid build up in your tummy. Other risks include infection, blood clots and bleeding.

Many problems are minor but some can be life threatening. Treating them as soon as possible is important.

Infection

You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. You will have antibiotics to reduce the risk of developing an infection after surgery. Tell your doctor or nurse if you have any symptoms of infection. If you have these symptoms when back at home, call your 24 hour advice line.

They include:

• a change in your temperature – 37.5°C or higher or below 36°C

• shivering

• feeling hot and cold

• feeling generally unwell

• cough

• feeling sick

• swelling or redness around your wound and your wound might feel hot

• a strong smell or liquid oozing from your wound

• loss of appetite

Rarely for an infection in your wound, you may need another operation.

Bleeding

After any operation there is a chance of bleeding. This is particularly the case with liver surgery as a lot of blood passes through the liver. 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. They will check for possible 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 leak

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 into the small bowel. The bile ducts connect the liver and gallbladder to the small bowel.

There is a risk of bile leaking from areas where the liver has been cut, or from any new joins the surgeon makes. This may cause pain, sickness and a high temperature. You might have a drain inserted to collect bile while the leak heals. Rarely, you might need another operation to repair the leak.

Kidney problems

Sometimes 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 might have a build up of fluid in your tummy (abdomen) called ascites.

This can happen for different reasons, including an increase in pressure in one of the main blood vessels of the liver (portal vein). Your doctor can give you medicines to help reduce the fluid. Or in some situations, they may put in a tube into your tummy to drain the fluid.

Read more about ascites and its treatment

Blood clots

Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery. This is 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. This causes a blockage in the lung called a pulmonary embolism. Symptoms include:

• shortness of breath

• chest pain

• coughing up blood

• feeling dizzy or lightheaded

To prevent clots it's important to do the leg exercises that your nurse or physiotherapist taught you. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.

Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.

It's important to continue wearing compression stockings if you have been told to by your doctor.

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. These are the 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 properly after your operation. This is a rare but serious complication and can be life threatening.