"Aspirate faster." Ling Ran's order was clear and accurate.
Resection of the right lobe of the liver was definitely a major surgery in any hospital. Everyone in the operating theater was excited and nervous.
Huo Congjun, who was still scrubbing his hands outside the door, was nervous, but he was not excited.
However, his hands were not clean, so it was useless even if he went in. He could only ask loudly, "What's the situation now?"
"I've used the Pringle technique to stop the blood flow," Ling Ran answered.
The Pringle technique was the most commonly used method to stop the blood flow in the liver. It was also the simplest method. The break point was at the hepatic hilum and hepatic pedicle, but it could not completely control the bleeding of the cross-section.
Considering the heat ischemia damage in the liver, the Pringle technique could stop the blood flow for an hour at most. In the county hospital, even if the doctors in the Emergency Department saw the patient continuously losing blood, they did not dare to use this method. Because if there was no follow-up, using the Pringle technique would only cause more damage.
Huo Congjun was also full of doubts.
However, he could not pass his worries to Ling Ran when he was outside the door.
In emergency surgery, sometimes the worst decision was better than not making a decision. Huo Congjun could only shout at the top of his voice to express his worries. "What about now?"
"The amount of bleeding is decreasing." Ling Ran paused for a moment and said, "The condition of the liver is very bad. There's no time for a normal right lobe hepatectomy."
Huo Congjun's heart skipped a beat, and he asked, "How bad is it?"
"Hemoglobin is 16, blood pressure is 45, and it's still decreasing," Ling Ran answered very quickly. He was also thinking as he looked at the monitor.
If a few seconds were used to answer questions, it would be the shortest amount of time possible. But on the operating table, in an emergency surgery, a few seconds was enough for everyone to have doubts in their hearts.
Lu Wenbin, Yu Yuan, and Zuo Cidian looked at Ling Ran at the same time. There was the same question in their eyes. 'What should we do now?'
For them, the chief surgeon was the backbone.
Everyone knew how to suture, make incisions, and use instruments. However, the chief surgeon's guidance was needed on where to suture, where to make incisions, and where to use the instruments.
Ling Ran's brain worked very fast.
He was thinking of one plan after another.
There was no need to consider a normal right lobe hepatectomy. A normal regular hepatectomy would take one and a half hours. This patient might not even be able to wait for fifteen minutes.
Then, what about a simple repair followed by a resection?
Ling Ran looked at the exposed field of vision. He did not think that there was any plan that could be executed in a few minutes.
"How's the situation?" This time, the person who spoke was an attending physician from the Department of Hepatobiliary and Pancreatic Surgery.
"Where's He Yuanzheng?" Huo Congjun asked the department director of the Department of Hepatobiliary and Pancreatic Surgery.
The young attending physician seized the time to scrub his hands and said, "A patient suddenly suffered from biliary tract hemorrhage and was admitted to the palace for the second time. Department Director He went to perform surgery, and the other chief physicians are also performing surgery."
The prognosis of liver surgeries had always been a difficult problem, and it had to be dealt with as soon as possible.
Department Director Huo pursed his lips and glanced at the young attending physician whom he did not know. He felt that Ling Ran would not be as good as him.
"Hemoglobin 14 … 12," Su Jiafu shouted and reminded him.
Ling Ran's expression did not change, but Huo Congjun, who was outside the door, was already extremely anxious. "Why did it drop so quickly?"
"The injury to the liver is very serious. The gauze used to stuff the liver won't work," Ling Ran answered.
"Then, why are you in a hurry to remove the gauze?" The young attending physician's expression changed as well. The number of hemoglobin was so low, and the patient might die if they did not handle it properly.
Huo Congjun glanced at him from the corner of his eyes. "The gauze used to stop the bleeding didn't work. If we don't remove the gauze, the insides of the liver will be blasted open. We're racing against time now. Are you confident that you can handle 11000 ounces of blood loss?"
"Ten thousand?" The young attending physician's hands stopped scrubbing.
"Eleven thousand. I reckon that it's almost twelve thousand ounces of blood loss." Huo Congjun snorted and asked, "Are you confident?"
"Department Director Huo, the whole body has been transfused twice, I …" The young attending physician did not dare to say that he was confident.
"I'm starting to separate the right half of the liver now," Ling Ran shouted. This was a notification. He was now the chief surgeon in the operating theater, and he had the greatest clinical authority. He could not see the situation outside, and the patient's condition inside the operating theater would become worse the longer he waited, and the longer he waited, the lower his survival rate would be.
Huo Congjun did not even put on his surgical gown. He looked at the young attending physician from the Department of Hepatobiliary and Pancreatic Surgery beside him, and he could not help but feel angry. He looked down on such irresponsible doctors the most.
When a doctor stood on the operating table, he was trying to snatch his life back from the gates of hell. What could he do if he was afraid of the wolves in front and the tigers behind?
Huo Congjun recalled the liver surgery that Ling Ran had just performed with him, and he shouted from outside the door, "First determine whether there is any hepatic vein damage, then separate the round ligament and falciform ligament of the liver …"
Ling Ran did not mind Huo Congjun's explanation. If a novice was in the operating theater now, he would probably be very grateful.
Of course, if it were a novice, he might not even be able to find the round ligament and falciform ligament of the liver.
Huo Congjun had taught countless novice surgeons, and he was also worried that Ling Ran would be nervous and commit the novice's mistakes, so he continued, "Look for the falciform ligament of the liver first, then follow the portal vein …"
The young attending physician from the Department of Hepatobiliary and Pancreatic Surgery scrubbed his hands. He was indeed afraid, so when he heard Huo Congjun's words, he did not say anything even though he knew that Huo Congjun wanted Ling Ran, who was inside, to be the chief surgeon.
He was also not willing to have another death under his hands.
At that time, just the discussion of the death would be fatal.
However, the young attending physician from the Department of Hepatobiliary and Pancreatic Surgery was not optimistic about Ling Ran. He knew Ling Ran. Everyone in Yun Hua Hospital probably knew him, but the blood loss of 11000 ounces was not a joke. The current record for blood transfusion in Yun Hua Hospital was a pregnant woman with amniotic fluid embolism. She had transfused more than 18000 ounces of blood, but that was because the department director of the Gynecology Department used all the resources in the department to save the patient. He even used his personal connections to get the blood, and he was only able to complete the feat by a stroke of luck. The other pregnant women with amniotic fluid embolism were not so lucky.
The young attending physician from the Department of Hepatobiliary and Pancreatic Surgery made many malicious guesses. The patient in front of him was sent from another county, and it was probably because the blood bank of the local blood bank was in urgent need …
"The round ligament and the falciform ligament of the liver are disconnected." Ling Ran's voice came from inside the door.
"Disconnected?" The young attending physician was surprised.
Before he could think further, Ling Ran's voice came again, "The perihepatic ligament is disconnected.
"The upper and lower veins are not free.
"The deactivated liver tissue is disconnected."
The voice came from inside, and it had a calming aura.
Huo Congjun finally washed his hands, stepped open the airtight access door, and entered. He saw Ling Ran on the operating table holding the patient's ruptured liver. He used his fingers and the handle of the scalpel to cut off the deactivated liver tissue along the edge of the rupture, which had poor blood supply.
To a layman, such an action was considered rough. However, Huo Congjun and the young attending physician from the Department of Hepatobiliary and Pancreatic Surgery were stunned.
"Do universities nowadays teach this?" The young attending physician was as dumbfounded as a chicken liver.
Genius One Second Remember Site Address: Mobile version:.
You've already exceeded your reading limit for today. If you want to read more, please log in.
Login
Select text and click 'Report' to let us know about any bad translation.
