Liver Resection

WHAT YOU SHOULD KNOW:

Liver Resection (Inpatient Care) Care Guide

Liver resection is surgery to remove part of your liver.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may have an allergic response to the medicines used during and after your surgery. The fluids used during your surgery may build up in your abdomen and lungs and make it hard for you to breathe. Even if the cancer is removed, it may come back, and you may need another liver resection. During surgery, your blood vessels may be damaged, and you may lose large amounts of blood. Air may also enter your blood vessels, which could be life-threatening if it enters your heart.

  • After surgery, bile may leak from your bile ducts into your abdomen. You may get a wound, abdominal, or lung infection. An abscess (pus pocket) may form in your abdomen. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Your lungs and heart may not function as they should, and you may have a heart attack. The remaining area of your liver may fail, which can become life-threatening.

  • Without surgery, your symptoms, such as jaundice and poor nutrition, may worsen. If you have cancer in your liver, the cancer may spread to other areas of your body. Your liver may fail, which can become life-threatening.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Antibiotics: This medicine helps prevent infection from bacteria. You may receive antibiotics before and after your surgery.

  • Pre-op care: You may be given medicine that makes you relaxed and sleepy right before your surgery. You also may be given medicine to dilate (widen) your blood vessels. These medicines can decrease the pressure in your blood vessels to help decrease blood loss during surgery.

  • General anesthesia: This medicine keeps you completely asleep and free from pain during surgery.

  • Monitoring:

    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

    • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

    • Central venous pressure (CVP) line: This is a thin tube put into a vein near your collarbone, or in your neck or groin. The CVP line can monitor the fluid and pressure in your blood vessels. The CVP line also may be used to give medicines or IV fluids.

    • Arterial line: This is a tube placed into an artery (blood vessel), usually in your wrist or groin. An arterial line measures your blood pressure and may be used for taking blood.

    • Rectal temperature: A thermometer may be put into your rectum so caregivers can monitor your temperature during surgery.

  • Foley catheter: This is a tube placed into your bladder to drain your urine into a bag.

  • Nasogastric tube: A nasogastric tube will be put into your nose and down into your stomach. The tube may be attached to a suction machine used to keep your stomach empty.

  • Blood transfusion: You may need a transfusion during surgery if you lose a large amount of blood. During a blood transfusion, you will get whole blood, or parts of blood through an IV. You also may need a blood transfusion after your surgery.

During your surgery:

  • Your caregiver will make an incision in your abdomen just below your ribs. Muscles and other tissues will be moved aside to make your liver easier to see. An ultrasound may be done during surgery to look for unknown areas of disease. If the right side of your liver is being removed, your gallbladder also will be taken out. Lymph nodes will be removed if they look diseased, and sent to a lab for tests. Lymph nodes are small tissue lumps that help your body fight illness and disease. Clamps may be used to stop the blood flow through your liver during surgery. The clamps may be removed for short times during surgery to allow some blood to flow through your liver. The blood vessels attached to the area to be removed will be cut and closed to stop any bleeding.

  • Your caregiver will remove the diseased part of your liver. The clamps will be removed so blood can flow through the remaining part of your liver. Your caregiver may use stitches, glue, or a laser beam to stop any areas of bleeding. Your incision will be closed with stitches or tissue glue and covered with a bandage. The liver tissue that was removed may be sent to a lab for tests.

After your surgery:

You will be taken to a room where you can rest until you are fully awake. Do not get out of bed until your caregiver says it is okay. A caregiver may remove your bandages soon after your surgery to check your wound. When caregivers see that you are not having any problems, you will be taken to your hospital room.

  • Medicines:

    • Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

    • Patient controlled analgesia: You may get pain medicine through an IV or an epidural line attached to a patient controlled analgesia (PCA) pump. Caregivers set the pump to let you give yourself small amounts of pain medicine when you push a button. Your pump may also give you a constant amount of medicine, in addition to the medicine that you give yourself. Let caregivers know if your pain is still bad even with the pain medicine.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • Prevent deep vein thrombosis (DVT): Surgery can increase the risk that blood clots will form in a major vein in your leg or arm. This is a serious condition called deep vein thrombosis. The following can help prevent blood clots:

    • Compression stockings: Your caregiver may have you wear compression stockings. These are tight elastic stockings that put pressure on your legs after your surgery. The pressure is highest in the toe area and decreases as it goes toward your thighs. Pressure stockings help push blood back up to your heart and keeps clots from forming.

    • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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