"The liver is crushed. It's at least a Level III trauma. " After Huo Congjun opened the abdomen, he saw the raging blood accumulation in the abdomen. Two young doctors sucked the blood desperately, and it was barely exposed.
Zuo Liangcai stretched his head and said, "It's blunt liver trauma. There are irregular ruptures, and the inferior vena cava is also ruptured."
"The duodenum is also ruptured." Huo Congjun looked down and frowned.
"The blood loss is very fast," the anesthetist reported.
Huo Congjun hummed and said, "The gallbladder is also ruptured. It has to be removed."
"It can only be removed," Zuo Liangcai agreed.
Huo Congjun quickly and gently looked at the situation in the abdominal cavity. He patched up the inferior vena cava and said, "The damage to the right lobe is very serious. What do you think we should do?"
"Block the hepatic portal, use vascular forceps to rupture the liver tissue bluntly, ligate the blood vessels and bile duct, and do a right trilobectomy," Zuo Liangcai answered first.
However, after listening to his words, the doctors in the room smiled knowingly, including the other young attending physician who waited by the side and did not even get a chance to be the third assistant.
Their smiles were naturally not to encourage Zuo Liangcai. Zuo Liangcai liked to read motivational books and always fought for all opportunities. Most of the middle-ranked and low-ranked young doctors did not have a good impression of him.
The reason why everyone smiled at this moment was the same as why they did not like Zuo Liangcai — he had too many tricks up his sleeves.
Just like how he intentionally or unintentionally omitted the pinching technique in his answer to Huo Congjun.
Blunt rupture of the liver tissue could be handled with the pinching technique. When blocking the hepatic portal, the problem could also be solved with the pinching technique.
The reason why Zuo Liangcai did not mention the pinching technique was easy for everyone to understand. Ling Ran's barehanded bleeding control was so famous that he even published a research paper on it. If he used the pinching technique at this time, Ling Ran's competitiveness would be greatly increased.
However, the reason why a little trick was a little trick was that little tricks were always useless.
Zuo Liangcai could think of hiding the pinching technique, and everyone could see through him, so the doctors who originally did not think that the pinching technique was better had to think deeply about the advantages of the pinching technique …
Huo Congjun would not forget Ling Ran's skill just because Zuo Liangcai did not mention it.
In fact, Huo Congjun thought even deeper.
"If we do this, it will be a standard hepatectomy." Huo Congjun summarized Zuo Liangcai's words in one go. He then turned to Ling Ran and asked, "What do you think? Are you going to perform standard hepatectomy? "
"Debridement is more suitable," Ling Ran answered.
Zuo Liangcai pursed his lips. 'Since Huo Congjun asked, the answer is naturally obvious.' There's no need for you to answer.
"Doctor Zuo, why don't you talk about the advantages and disadvantages of regular hepatectomy and debridement?" Huo Congjun immediately called Zuo Liangcai's name.
This question was a little difficult. Those who did not read could not answer it, but those who had read could easily answer it.
Zuo Liangcai felt a little better in his heart. He said, "Regular resection is performed according to the anatomical area. The overall area to be resected is relatively large. If the patient can't tolerate it, there will be complications and even death after the surgery. Debridement is irregular, and it does not conform to the distribution of the liver segments or lobes. During the surgery, the blood vessels and bile duct need to be continuously ligated, but it can preserve the liver tissue to the greatest extent. However, the degree of involvement of different functional areas of the liver is a test … "
"There's one more thing. Regular hepatectomy requires high skills. If it's not done well, it's easy to make mistakes." Huo Congjun paused for a moment and said, "We have to hurry, so we will use debridement. Ling Ran, you will be my assistant. Doctor Zuo, you will handle the duodenum. "
"Yes."
The junior doctors answered very quickly. However, some of them looked normal, while some of them were reluctant.
Ling Ran stood in front of Huo Congjun and acted as the first assistant.
Huo Congjun looked at the monitor and said to the anesthetist, "Pay close attention to the level of acid."
"Yes. It's currently at six, "the anesthetist said.
"Pay attention to adding sodium bicarbonate," Huo Congjun said before he lowered his head and said, "Emergency hepatectomy, we have to hurry."
"Yes."
"Endotherm knife." Huo Congjun moved in the direction of the ruptured liver, lowered his head, and said, "I'm going to remove the liver tissue that has no blood supply now. Ling Ran, do you know what to do?"
"Ligate the severed blood vessels and bile duct." As Ling Ran spoke, he started to move.
For a contestant who had performed hundreds of finger replantation surgeries, suturing blood vessels was as easy as eating and sleeping. The doctors beside him also trusted Ling Ran very much.
Everyone had seen the patients who received finger replantation surgeries who came and went. Now, when they talked about Yun Hua Hospital's Hand Surgery Department, everyone would naturally add the Emergency Department of Yun Hua Hospital to it, and they would even mention Ling Ran's name.
For ordinary people, the frequency of emergency finger replantation surgeries was too low. Otherwise, Ling Ran's reputation would not only be limited to the industrial area.
But for doctors, they had the ability to judge another doctor's skills.
The time of the surgery, the effect of the surgery, the difficulty of the surgery, the prognosis, and so on were all observed by the doctors. Besides, the number of surgeries performed was also a very important benchmark. Nowadays, even if Ling Ran was young, no one would question his level in finger replantation surgeries or M-Tang surgery.
It was even more so when it came to connecting the blood vessels.
Huo Congjun also gave Ling Ran a lot of trust. He made the incision himself and let Ling Ran complete the more important blood vessel ligation work.
Ling Ran's fingers moved up and down.
He did not need an additional assistant. He sutured and ligated the blood vessel with his own hands, and his movements were as fast as Huo Congjun's.
Huo Congjun only thought that he was racing against time, and he nodded in his heart.
The most important thing in emergency hepatectomy was speed.
This was because once the incision was made, the wound would tear even more. With the rich blood supply in the liver, one would lose more than one thousand ounces of blood in a minute.
At this time, the speed of the suture was very important.
On the contrary, if the suture was not good enough, it could be returned to double ligation later, and it would not affect much.
"I'll make another incision, and then we'll come back to check." Huo Congjun's movements were also very fast, and he reminded Ling Ran while he was at it.
Ling Ran nodded. His fingers still moved quickly, and he quickly ligated the exposed blood vessels and bile duct.
Both of them entered a state of tension, causing the room to become silent for a moment.
"We can't just do it for the sake of speed," Zuo Liangcai muttered again. He could not see the situation in the abdominal cavity. He could only see that Ling Ran and Huo Congjun's movements were very fast, and he felt that Ling Ran's work was crude.
Huo Congjun did not object to this. He nodded and said, "The quality of the ligation of the large blood vessels must be ensured."
"Yes," Ling Ran answered, but his movements and speed did not change.
If Ling Ran always listened to other people's suggestions, his life would have been a mess a long time ago. There were too many people who were willing and wanted to give him advice.
Huo Congjun did not say anything else. Completing the hepatectomy while preserving the liver tissue as much as possible was also very mentally draining.
Huo Congjun only put down the scalpel after he was done with the incision. He began to check the blood vessels and bile duct that Ling Ran ligated from the back.
"The small blood vessels have all been ligated?" Huo Congjun was very surprised.
"To prevent any recurrence," Ling Ran said.
"This … Let me take another look …" Huo Congjun felt that he was like a painter, and Ling Ran was like a painter. The painter was painting in front of him, and the painter was actually following behind him to finish the painting.
The most amazing thing was that the details of the artist's painting were almost perfect.
"Your liver debridement is really good." Huo Congjun could not help but sigh after he finished looking at all the ligated blood vessels.
"It's slightly different from the blood vessels in the limbs. You'll get used to it." Ling Ran summed up his experience.
This time, Huo Congjun chuckled.
Blood vessel anastomosis was very close, but how could he not consider the characteristics of the liver when he did it so quickly? How could he not understand the anatomical form?
"Have you practiced it yourself?" Huo Congjun asked.
Ling Ran said, "I learned a little."
"Hmm …" Huo Congjun did not want to ask anymore. When he saw that the bleeding had stopped, he simply said, "I'll leave the rest to you."
"Yes." Ling Ran was not humble at all. He took over and started to treat the wound.
Zuo Liangcai was jealous when he saw that. He had never had such an opportunity before.
"Doctor Zuo, come and help too." Department Director Huo's words pulled Zuo Liangcai back to his position as the second assistant.
"Yes …" Zuo Liangcai nestled in the operating theater without any resistance.
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