|
Interventional Radiology Clinic |
|
Liver
Embolization Post Op The contents of this web page are provided for informational purposes only. This material is not to be used for diagnosis or treatment without the active participation of a medical doctor. |
|
Post Procedure Information for Patients After Hepatic Artery Embolization Chemoembolization patients and SIR-Sphere Internal Radiation Therapy (SIRT) patients. Immediately After the Procedure Some patients will spend at least one night in the observation unit. This is still considered an outpatient procedure if your total time in the hospital is less than 24 hours. Most patients with very mild post embolization syndrome will go home the same day. The primary symptoms of post embolization syndrome that will limit ability to do well at home are pain and nausea and vomiting. Initially we will use intravenous narcotics and anti-nausea medications. We will also start you on oral pain medications. Once your symptoms are controlled with oral medications, your liver shows no signs of severe damage and you are able to drink well enough to maintain a good urine output, you can go home. What To Expect At Home After the Procedure Most patients will experience, to varying degrees, some form of post-embolization syndrome. The most commonly reported symptom of the syndrome is pain, which persists for a minimum of 2-3 days and may be present for as long as a week or two after the procedure. Post-embolization syndrome also causes other symptoms that are generally described as flu-like (fever, malaise). Like post-operative pain, it is most severe in the hours and days immediately following the procedure and diminishes with time. It is generally well controlled by the use of oral medications. Unlike post-operative pain it will not limit your activity. Limitations on exercise or work will not be imposed after the first 2 days. You may do whatever you feel up to doing. The size of the tumors will diminish slowly with time with the maximum effect seen within the first 6 months, and, typically, within 2-3 months. The first six hours are generally spent in bed to allow the artery in your leg to recover from the procedure. At that point in time you may get up and move around but I still prefer that you keep your activity level minimal. After the first 24 hours, you may move about your normal everyday activities provided that they are not too active and you avoiding lifting or carrying objects greater than 10 pounds in weight. You can go to the store and buy groceries but don't go spend the day at the mall. By 48 hours you can resume all of your usual activities and do anything you feel like doing. You will take anti-nausea and pain medications as needed after the procedure. Internal radiation patients will take a Medrol Dosepak, 7 days of antibiotic and a stomach acid suppression medication (protonix 40 mg each day or equivalent) for several weeks post embolization. Risks of the Procedure -or- When to call. On the day of the procedure, the risks involved relate primarily to the fact that you are undergoing an arteriogram with delivery of particles that are designed to block blood flow. The most common complication that occurs after an angiogram is to have a hematoma or collection of blood form around the entry site into the artery. Less commonly, the arterial puncture sites may not heal normally and you can develop a pseudoaneurysm or arterial-venous fistula. Damage to the artery supplying the leg can also affect function of the leg and can cause pain, particularly in the foot. In general, these complications occur in only 1-2% of patients and even the worse complications are generally readily fixable with simple non-surgical and surgical procedures. Call: If your leg hurts or feels weak; If you develop a knot or swelling in your groin or a particularly large bruise; If you aren't sure. A simple ultrasound will answer any questions. Non-target embolization is also another complication that could occur. This occurs when the particles that are intended for the liver tumor(s) end up in some other part of the body. For this procedure, the worse area that these could end up in would be in an organ next to the liver such as your gallbladder, stomach or intestine and pancreas. However, since superselective catheters are being used, non-target embolization is generally limited to the liver, if it occurs at all, where generally there are no sequelae. Non-target embolization can cause pain or loss of function or tissue death in areas other than the liver, if it occurs. This complication is uncommon but can be severe requiring surgery or prolonged hospitalization. Patients can also have allergic reactions to medications given during the procedure, such as antibiotics, sedatives, pain medications or the contrast material used. Call: If you have worsening pain/nausea or develop blood in your vomitus or stools; If you develop a rash; if you develop symptoms that are new or are getting worse. Delayed complications arising from this procedure would be more likely related to tissue cell death within the liver or the tumor(s) (or elsewhere in the case of non-target emboli). This could lead to the formation of localized areas of infection (abscess) that could require drainage tube placement or even surgery to treat. Symptoms of infection generally don't develop until 7-10 days post procedure but can develop earlier when the pancreas, gallbladder or bile ducts are damaged and particularly can develop earlier with internal radiation therapy. Generally most patients feel noticeably better by post procedure day 3 and really feel great by around day 14-21. Call: If you are not following this general pattern of improvement; If you have high, persistent fevers (101.5 F); If your pain is getting worse; If you are feeling worse. Initial follow-up usually occurs at one to two weeks in the office to monitor for problems or complications. Chemoembolization patients will usually average three treatments one month apart with performance of additional treatments as indicated. SIR-Sphere internal radiation therapy patients generally undergo two treatments one month apart. Repeat imaging usually occurs between one and three months after completion of therapy.. Contact: Interventional Radiology Clinic (210) 616-7780 fax: (210) 616-7789 General Administrative Office (210) 616-7796 (8-5:00, M-F) |