After surgery for bile duct cancer
Your recovery after surgery will depend on what operation you have had. It also depends on your general health. Having bile duct cancer removed is major surgery.
Many hospitals follow an Enhanced Recovery Programme (ERP). They encourage people to move around soon after their operation. They may also start eating and drinking not long after surgery. This helps them recover quicker and have less complications.
When you wake up after your operation
After the operation, you wake up in the recovery room. You will have one to one nursing care. The nurse looks after you until you are awake and well enough to go back to the ward.
Everybody is different when they are waking up after an operation. It takes some people longer than others to wake up. Some people remain very sleepy for a while afterwards. You may be in the recovery room for hours before you are ready to go back to the ward.
Back on the ward your doctor will see you regularly. Specialist nurses may visit you. They look after people who have had major surgery but do not need to be in the intensive care or high dependency unit.
Sometimes you may wake up in the
(ICU) or (HDU) after your operation. This is so your doctors can keep a closer eye on you. This may happen if:
- your general health is poor
- the operation took longer than planned
- the operation was more complicated than the doctors thought it would be
In the ICU you have one to one nursing care. In the HDU you have very close nursing care.
The staff in the ICU or HDU will speak to a member of your family or friends about visitors. But, you usually move back to the ward within a day or so.
You might go back to the ward straightaway if you have had a smaller operation.
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.
Painkillers
It’s normal to have pain for the first week or so. You have painkillers to help. Painkillers work best when you take them regularly.
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. So it is important to tell them how well the painkillers are working.
Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Or you might have an epidural. This gives you a constant dose of painkillers.
You may also have a wound catheter. This gives painkillers directly into your wound.
Your team will normally give you painkillers to take home. Follow the instructions they give you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Eating and drinking
Your doctor may want you to build up slowly to eating and drinking after your operation. Sometimes your doctor might be happy for you to start eating and drinking straight away. This depends on what operation you have had.
When you start eating and drinking again, you have sips of water before building up to other drinks then food. Once you’re able to drink without being or feeling sick your nurse takes out your drip. They will also take out the nasogastric tube if you have one.
You normally see a dietitian whilst you are in hospital. This is because you may not absorb as many of the nutrients from your food as you did before the operation. You may also feel full quicker, feel sick (nausea) or have lost your appetite. Your dietitian will talk to you about:
- tips for eating a healthy diet after surgery for bile duct cancer
- any nutritional supplements you may need
- which foods you may want to avoid
- which foods may help your symptoms
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.
Stitches and clips
Your doctor closes the wound with stitches or clips. Your nurse normally takes these out around 10 days after the operation. Some wounds are closed with stitches that dissolve and don't need to be removed
If you go home with the stitches or clips, your nurse will tell you when to get them removed. You may need to make an appointment for the practice nurse at your GP’s surgery to do it.
Sometimes your doctor uses a special glue instead of stitches. This is waterproof and comes off on its own in about 10 days. You don’t normally need a dressing over this.
Wound drain
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.
Some people may go home with the drain still in. Your nurse will tell you:
- who to contact if you have any problems with the drain
- who will change the dressing around the drain and change the drainage bag or bottle - they may arrange for a district nurse to do this, or you may need to go back to the hospital
- who will remove the drain and when
- tips for keeping the drain safe so it doesn't get caught on anything
Moving about
Getting up may seem difficult at first, but moving about helps you get better quicker. It also helps to stop you getting a chest infection or blood clot. And it helps your bowel work as it might be a bit slow after the operation.
If you are well enough, your nurse may encourage you to sit out in a chair shortly after your operation. They will help with all your drains and drips.
You may have an injection every day. This also helps stop you from getting blood clots. Some people need to continue having these injections when they go home.
A physiotherapist normally visits to help you with your breathing and walking around.
When you’re making enough urine and can walk to the toilet, your nurse will take your catheter out.
Once the drips, drains and catheter are out it’s much easier to get around. That’s when you feel you’re beginning to make progress.
Going home
You normally stay in hospital for 1 to 2 weeks after surgery for bile duct cancer. This depends on which operation you had, and how well you are recovering. Some people may need to stay in for longer.
Before you leave hospital, your nurse will give you any medicines you need at home. They will also tell you:
- how to look after your wound
- when you will have a follow up appointment
- who to contact if you have a problem when you are at home
- when you can go back to your normal activities including driving
When you are back home
You’ll need help when you first go home. 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.
Follow up appointments
You’ll have follow up appointments after your operation. This is so your doctor can check on your recovery. They are also your opportunity to speak to your doctor or specialist nurse about any concerns you have.
You should contact them if you are worried whilst waiting for your appointment. They might be able to reassure you over the telephone about your concerns. Or they might want to bring your appointment forward if they think they need to see you sooner.
