A full discussion will take place in clinic as to what the operation involves and an explanation as to which part of the liver is to be removed. The risks and benefits will be fully discussed at this time. If further scans are required they will be organised for you.
A date for surgery will be made by Professor Karanjia's secretary and a pre-assessment appointment with the pre-assessment nurse (which takes approximately one hour) will be sent to you. Routine blood tests, ECG and also a chest x-ray will be carried out at this time.
If you have any further queries regarding your medication or any worries about the forthcoming operation please mention them to the nurse who will endeavour to help you with these worries.
The anaesthetist will see you on the ward on the day of your operation and will discuss this fully with you.
The liver is a remarkable organ which has the ability to regenerate following surgery. The objective of surgery is to remove all of the abnormality in the liver, whilst leaving sufficient, good quality, liver. It is possible to remove up to 70% of the liver and for a full recovery to be made.
Often the operation will start with a look inside the abdominal cavity with a camera via keyhole surgery (laparoscopy) to ensure there is no additional disease that previous scans were unable to diagnose. Once this is felt to be clear the abdomen will be opened via an incision just below the ribcage on your right. A further scan of the liver using ultrasound is usually performed at this time to further evaluate any abnormality. At this point removal of the diseased liver tissue is performed.
The operation normally takes between 3-4 hours to carry out but this depends on the extent of the abnormality. Following surgery you are likely to have the following:-
After the operation, it is normal for you to be able to start drinking and eating quite soon and nearly always by the following morning.
You will be discharged from hospital around 7-10 days after the operation. This can vary with individuals and will depend on your post-operative progress. The nurses will arrange for the stitches/clips to be removed 12-14 days following surgery.
Everyone's recovery occurs at different rates and is dependent on their illness and surgery. However, when you get home it is important that you keep active and don’t take to your bed. Aim to do a little walking each day, and gradually increase the amount daily so you are back to normal activities 4-6 weeks after your operation. Listen to your body; it will tell you when to rest.
It is advised that you take 4 weeks off work after discharge. The nature of your occupation will determine how soon you can return. Initially, it may be wise to start back at work part-time until you regain your strength. If you need a sick certificate you can obtain this from Professor Karanajia's secretary.
You should wait at least 4 weeks before starting to drive again. It will depend on your ability to perform an emergency stop without it hurting, how comfortable it is to wear a seat belt and how tired you feel. It is advised to notify your insurance company that you have had an operation.
It may be a while before your appetite returns fully. Instead of eating 3 meals a day it may be easier to have small and more frequent meals.
The part of the liver removed is sent to the laboratory for detailed analysis. This usually takes about one week.
You will be given/sent an appointment to be seen in clinic for follow up approximately 4-6 weeks following your surgery when the results will be discussed with you. The results of the laboratory tests will determine whether you will need further treatment.