Home Page

About your Programme/ Diary

This leaflet is for patients having a laparoscopic hemi- hepatectomy.  This operation is performed for malignant (cancerous) or benign (non cancerous) disease.

This diary has been designed to help prepare and support you and your family/carers during your stay in hospital.

It outlines what should happen on each day.  Sometimes there will be a specific reason why something isn’t done but the team should explain this to you.  If you have any concerns about what has or has not happened on any day, please let a member of the team know.

The diary advises on what you can do each day to help your recovery after surgery and get you home as soon as it is clinically safe. It is a good idea to start planning for when you go home before you come into hospital, so that your discharge is not unnecessarily delayed.

Day of Operation (Day 0)

Before coming to hospital

On the morning of surgery, you must drink water until-

07:00 am if you are coming into hospital at 07:00 am

or

11:00 am if you are coming into hospital at 11:00 am.

You may be given water to drink whilst you are waiting in the hospital depending on the time of your operation.

Coming into Hospital

Please go to the Admission Ward as advised on your admission letter. You will be checked in by a nurse and seen by members of the surgical and anaesthetic team before you are taken to theatre for your operation.

After your operation

After your operation you will be taken to the surgical ward.

Drips, Drains and Tubes

After your operation you will have several drips, drains and tubes in place:

An intravenous (IV) drip is used to give you fluids until you are able to drink normally.

An abdominal drain is a tube inserted near your abdominal (tummy) wound to help drain off fluid and prevent swelling.

A urinary catheter is a tube (catheter) put into the bladder to drain your urine into a collecting bag

Reducing the risk of developing deep vein thrombosis (blood clots) – DVT Prophylaxis

You will wear TED stockings which help to maintain circulation in the leg and reduce the risk of blood clots forming (DVT – deep vein thrombosis). You will wear them for the whole of your hospital stay.  You will also be given a daily injection of a blood thinning medicine (Clexane) which you will need to carry on using for 28 days once discharged from hospital.

Pain Control

It is important that your pain is well controlled so that you can

• walk about

• breathe deeply

• eat, drink and sleep well

• recover more quickly

If at any time you feel your pain is not well controlled, it is important that you tell the nursing team. 

On the first few days after the operation, you will have your pain controlled by patient controlled analgesia (PCA) or an epidural. You will also be given regular paracetamol through a drip.  Once the PCA is stopped, your pain will be controlled by medicine in liquid or tablet form.

Sickness

If you feel sick (nausea) let the doctors or nurses know as there are medicines which can help.

Exercise

Moving around as soon as possible after your operation will reduce your risk of developing a chest infection and blood clots and will help you recover from your operation more quickly. 

• In bed keep the backrest raised at a slight angle

• Every hour you are awake do some gentle breathing and leg exercises as follows:

  • Cough 2 to 3 times

  • Take 2 to 3 slow deep breaths to help keep your lungs clear

  • Flex your ankles by pointing your toes up towards the ceiling and then down towards the floor, then circle your feet in one direction and then the other

• The nurses will assist you to get out of bed and sit in a chair. Try to sit out in the chair for short periods in the morning and afternoon.  Each day you should aim to spend  longer periods of time in a chair than the previous day

• The nurses will assist you to gradually start walking.  Build up the distance and time spent walking each day

• As well as building up your level of activity every day, you also need to have proper rest periods

Eating and Drinking

It is important to eat and drink as your body needs fuel to repair.  You can start eating and drinking as soon as you feel able after your operation. 

Initially you might find it easier to eat little and often. 

You may find that your sense of taste is altered and your appetite is less than normal after your operation.  It can take several weeks for taste to return to normal. 

Personal Care

The nursing team will help you to wash yourself until you can manage on your own. 

Try to wear your day clothes in hospital as this can help you stay more active and be positive about your recovery. 

Review

• A member of the surgical team will see you at least once a day

• If you or your family/carers need additional support or would like to talk to your Liver Cancer Nurse Specialist or the surgeons  please speak to a member of staff

• If your family / carers would like to talk to the surgeons, please let the nurses know.

Daily Care

• The next page outlines the routine for each day and includes things that you should do to improve your post-surgery recovery.

• Sometimes there will be a specific reason why something isn’t done but the team should explain this to you.