Recovery time after liver resection

[Rock_Robster]

Hi all, I had my liver resection last week (open surgery, 3 segments, about 25% in total), and I feel very lucky that I could and that it all went really well. My next step is long course chemoradiation on my primary tumour, but I understand I need to heal first.

So for those of you that have had liver surgery, how long until you could recommence therapy?

My Google-fu is failing me here and I can’t see much research around this. I’m keen to get back on the horse ASAP, but also don’t want to jeopardise healing.

Thanks!

[AmyG]

How is your recovery going thus far?

I'm supposed to be having an open resection as well after 6 cycles and have no idea what to expect other than a 5-7 day hospital stay. I've only had the one surgery ever to remove my primary tumor but that was laparoscopic.

Care to share all the details?

[Rock_Robster]

Hi Amy, so far it’s been much better than I expected. I went in last Wednesday and walked out yesterday, day 5. I had a fair bit of pain on waking up, but they hit that hard and has been manageable ever since. I did have some minor lung deflation and fluid build-up on the right side, which apparently happens during longer surgeries (esp after chemo), but breathing and coughing exercises have stayed on top of that. It’s really important to take enough painkillers so you can breathe properly and do your rehab exercises, otherwise you can end up with other un-fun complications. My hospital had a good ERAS program, and I also borrowed some tips from MSK’s website.

I was quite interested in the research around avoiding surgery-induced metastasis, so I’ve been doing what I can to prioritise painkillers which aren’t immunosuppressive, and a few other things. That has meant some interesting discussions with anaesthetists, but we got there!

The wound is large but quite tidy; I’ve got a check with GP tomorrow then with surgeon in 2 weeks. Appetite-wise I’ve had to adjust to smaller, frequent meals, with lots of protein to support liver regeneration and avoid losing much muscle mass. Now I’m just focusing on eating, resting and keeping moving to try to keep any issues at bay and get back to treatment!

Let me know if anything else specific I can tell you about.

[martd]

I resumed folfox about two and a half weeks after my first resection. That surgery was laparoscopic. Removed 3 Mets then 3 days later PVE surgery.

[Rock_Robster]

Thanks martd - that sounds fast! I think someone mentioned a 4-6 week recovery but perhaps I can restart treatment somewhere during that window as well.

[Milk Tea]

A few weeks after the surgery, my husband’s big L shape incision opened up in two places and I had to pack in fresh gauze in those two open wounds twice daily to help healing. Both open wounds closed up nicely after a few weeks. Because of that, it was almost 10 weeks after his open liver surgery, he started first mop up chemo. It was originally scheduled for 6 weeks after surgery.

[Rock_Robster]

Thanks Milk Tea, that’s very helpful. Glad it all worked out ok with the wound.

[Pyro]

I had multiple open liver surgeries, as I recall it was about 6 weeks after surgery I resumed chemo/rad. The open ones definitely take longer to heal. I was in the hospital for about u days each liver surgery, the surgeries were a breeze compared to my colon surgery, but that was done fully open as well.

[Rock_Robster]

Thanks Pyro, makes sense

[Gravelyguy]

I started mop up chemo 6 weeks after my Combo liver and rectal resection. I had done short course radiation just before surgery so not sure if they might wait longer to do post surgery radiation. Glad it went well and you are home!

Dave

[Butt]

Chemo started 4 weeks after the surgery. You need a lot of protein in recovery. I was permitted to drive after I stopped narcotics. A month later I could do a full day at work, buy groceries after work and do laundry upon arriving home. So it was a month after my energy got back. Please feel free to ask if there are any questions. Butt.

[Rock_Robster]

Thanks all - it’s 4 weeks to the day today and I’m feeling pretty good. Off painkillers, eating lots, driving and back in the gym today. Still have some abdominal and residual shoulder pain, which is annoying but manageable. Definitely have some tired days, but nothing compared to FOLFOX! Radiation due to start in next 1-2 weeks. Thanks all for the info!

[kandj]

Still have some abdominal and residual shoulder pain, which is annoying but manageable.

Keep an eye on that. Referred shoulder pain can be due to fluid in the abdomen or other issues. If it is not getting better, ask for imaging. DH had shoulder pain pop up about 2 weeks post liver resection and blew it off. It did not get better and came to a head about 3 weeks after the resection. It was a liver abscess that could have killed him. Probably not that for you, but keep an eye on it.

[Rock_Robster]

Thanks kandj, indeed that is my worry too - they mentioned on a recent CT that I still had a bit of fluid & gas in my abdomen which is unusual this far out, and I guess could be related. The strange thing is it’s very transient - 80% of the time I have no pain, then occasionally it will ramp up to something fairly severe, then fade away again. Seems to be worse after eating or sometimes exercise (I guess all things that could irritate the area a bit). It’s also on the opposite shoulder so a bit unusual for liver injury. I have my surgeon’s mobile now and was told to call if it gets bad again, so I’ll be doing that!

[kandj]

DH's wasn't bad all the time either. It was pain at night, when he would lay down. Went on for about a week like that. Even flew home like that. He spiked a fever a few days later and the rest is history. It probably is residual fluid irritating nerves for you. Just make sure to call if it gets worse. Every day should be a little better than the day before.