After cancer surgery to remove part of your liver

After a big operation, you may wake up in the intensive care unit or a high dependency unit. You usually move back to the ward within a day or so.

This information is for people who are having part of their liver removed. Your doctor might call this a liver resection or a lobectomy. We have separate information if you are having a liver transplant for liver cancer. 

In intensive care you have one to one nursing care. In the high dependency unit you have very close nursing care. Your surgeon and anaesthetist review you regularly and watch your progress closely.

These units are busy and often noisy places that some people find strange and disorientating. You'll feel drowsy because of the anaesthetic and painkillers.

Tubes and drains

When you wake up, you have several tubes in you. This can be frightening, so it helps to know what they’re for.

You might have:

• drips to give you blood transfusions and fluids usually through a vein in your neck

• wound drains to drain any blood, bile or fluid from around the operation site

• a tube down your nose into your stomach (nasogastric tube) to drain bile and stop you from feeling sick

• a tube into your bladder (catheter) to measure how much urine you pass

• a small tube into a vein or artery to check your blood pressure

• a fine tube in your back that goes into your spinal fluid (epidural) that you have painkillers through

You may also have an oxygen mask on.

Electronic pumps may control any medicines you have through your drip.

Your wound

You have a dressing over your wound when you wake up. Your nurse normally takes the dressing off after a couple of days. You may not need another dressing on if the wound is clean and dry.

The wound drains stay in until they stop draining fluid. Your nurse measures the amount of fluid in the drains. The drains usually stay in for about a week, but it might be longer. 

You have the wound stitches or clips taken out after about 10 days. Some wounds are closed with stitches that dissolve and don't need to be removed.

Painkillers

It’s normal to have pain for the first week or so. You have painkillers to help.

Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Analgesia is another word for painkillers. 

Or you might have painkillers through a small thin tube that is put into your back. This tube connects to a pump that gives you a constant dose of painkillers. This is called an epidural.

You get painkillers to take home. Your nurse will talk to you about:

• how often to take them
• when to take them
• what side effects you may get 

Contact your doctor if you still have pain or if it gets worse.

Eating and drinking

You will be able to drink as soon as you wake up and feel able to. Most people start to eat the day after their operation but it depends on how you feel. Your nurse or dietitian might give you nutrition drinks to help until you are able to eat normally.

You might have a tube down your nose and into your stomach called a nasogastric tube. This drains fluid from your stomach and helps to stop you feeling sick. Your nurse will remove the tube once you are eating and drinking normally.

Getting up

Your nurses and physiotherapists will help you to move around as soon as possible. They'll check you're doing your breathing and leg exercises. This helps you recover. 

You might be sitting in a chair within 12 hours of your operation. The day after, you might be walking around your bed. And within a few days you'll be able to walk along the hospital corridor. 

Making progress

During the first few days after your operation, you’ll start to feel better. The drips and drains will come out, you’ll start eating and can move about better.

You’ll begin to feel like you’re making progress.

Going home

How long you stay in hospital depends on the type of surgery you have. You might be in hospital from one week to a couple of weeks.

You’re likely to feel very tired for several weeks and sometimes months after your surgery. It helps to do a bit more every day.

Try:

• sitting for less time each day
• walking around the house a bit more each day
• building up to walking outside

What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing.

Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about.

Follow up appointments

You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.