The image on the computer showed that MRI
Showed liver growth.
T1, short
The signal was limited. The arterial stage mass was evenly strengthened and quickly emptied. The delayed stage was cystic strengthening.
According to the characteristics of strengthening, it could be preliminarily diagnosed as hepatocellular carcinoma.
The surgery was actually not difficult.
Whether it was hepatobiliary surgery resection of the right lobe of the liver or interventional embolization treatment, they were all indications.
However, the patient's condition was difficult because he drank a lot of alcohol.
"The amount of ascites is too large. It's not suitable for surgery," Zheng Ren said. "It has been used for a long time to reduce the ascites."
"Yes," Professor Yang said. "Boss Zheng, take a look at the patient?"
Zheng Ren nodded, stood up, and followed Professor Yang out.
He seemed to have completely forgotten his purpose before coming — to work together with the Department of Hepatobiliary and Pancreatic Surgery to do a project.
When he arrived at the ward, the first thing he saw was a bulging stomach.
The weather was already slightly hot, and it was the season to wear clothes randomly.
The patient was wearing a black vest, and his stomach was exposed.
Although the amount of ascites had decreased a lot, it was still very large. It caused his stomach to bulge high, and even his navel was slightly protruding. It looked particularly strange.
"Old Yang, you're here." The patient was lying on the bed in a semi-reclining position, leaning against the blanket.
Seeing Professor Yang come in, he wanted to sit up. However, because his stomach was so swollen, his abdominal muscles contracted, and the pressure increased. The body's natural protective reaction made him unable to get up and lie down again.
Professor Yang was very helpless. He sighed and said, "Lie down properly. Boss Zheng, help me take a look."
The patient was a little surprised to see Professor Yang bring two young doctors in, but out of politeness, he did not say anything.
Zheng Ren first glanced at the System panel. It was the same as his diagnosis just now. There was no discrepancy.
However, the degree of the patient's stomach swelling was much more serious than when he did the MRI scan.
He recalled that the radiographic films were done two days ago.
In just two days, it had developed to this extent? Zheng Ren's first feeling was that the patient was hopeless.
Although he thought so, Zheng Ren still gave the patient a physical examination first.
The percussion examination showed a stomach full of moving dullness. Zheng Ren estimated that there was about 2,000 ml of peritoneal effusion.
With this amount of ascites, he could not even perform minimally invasive surgery like interventional surgery, let alone hepatectomy.
Zheng Ren looked at the patient's bulging navel and felt particularly helpless.
Professor Yang was the same, but he was a classmate with the patient. It was completely different from facing other patients.
His face hardened, and his displeasure was written all over it.
Zheng Ren nodded and looked at Professor Yang for a moment before turning around and leaving.
"Brother Yang, the patient's condition isn't good. We can't even perform a portal vein embolization," Zheng Ren told Professor Yang bluntly after they went out.
Professor Yang naturally knew. He let out a long sigh and said, "I told him to stop drinking and talk to him again. If it doesn't work, then there's nothing I can do. "
Hepatocyte growth factor mainly acts on the portal vein. Hepatocyte hyperplasia can occur after ligation of portal vein.
He was discovered in the first year.
In the past, it was a major surgery to ligate the portal vein.
With interventional surgery, they could directly embolize the branches of the portal vein.
The portal vein branches were embolized to proliferate the opposite lobe of the liver so that the residual liver could compensate for the liver function after lobectomy.
After the portal vein branches were embolized, the hepatocytes could undergo dedifferentiation and clonal proliferation.
If the residual liver is normal, the most that can be removed is
75% of the liver and still keep the patient alive. However, the patient's alcoholic liver … could not be removed so much of the liver. However, the patient did not need to remove 75% of the liver. He only needed to remove the tumor.
However, there were also strict requirements for portal vein embolization. The patient's large amount of ascites was one of the contraindications.
In theory, the benefits of embolization of the portal vein branches on the affected side before partial hepatectomy were not only to make the residual liver hyperplasia and hypertrophy, but also to avoid the sudden increase in portal pressure caused by partial hepatectomy and damage to the residual liver.
There were many benefits. This was also one of the projects that the Department of Hepatobiliary and Pancreatic Surgery and the Department of Interventional Medicine could cooperate on.
"Brother Yang," Su Yun said with a smile behind him, "I saw you being sneaky this morning. Is that it?"
At this point, Professor Yang's footsteps paused for a moment before he smiled and said, "Of course not. Did Department Chief Kong say anything?"
Su Yun despised this thief in his heart.
If he had something to say, he would ask Department Chief Kong if he said anything first. There were more thoughts in his mind.
Zheng Ren did not think anything of it. He smiled and said, "I did."
"Boss Zheng, I won't stand on ceremony with you. What do you think of this matter?" Professor Yang immediately asked.
"Find a place, smoke a cigarette, and tell me in detail," Zheng Ren said.
They came to the duty room.
It was morning. Everyone had gone to perform surgery. The duty room was empty and there was no one.
After closing the door, Su Yun lit a cigarette. Zheng Ren asked directly, "Brother Yang, we're on the same side. There's no need to hide it. Is there anything you need here?"
At the beginning, when he was worshipping everywhere, Professor Yang and Chief Luo from the Department of Digestive Medicine were the first people to support him.
In return, there should be such a question.
Professor Yang was a little bashful, but seeing that Zheng Ren was very serious and serious, he thought for a moment and said, "Isn't it because Deputy Chief Tian of the department is about to retire? I'm thinking about fighting for this position."
Zheng Ren was stunned for a moment. He did not expect this to be the reason.
However, scientific research had nothing to do with the deputy chief. It was not that if the scientific research was done well, the deputy chief would not be able to run.
"The other conditions are not bad. My level … is definitely not comparable to you, Boss Zheng, but compared to the others in the department, I'm not afraid of anyone," Professor Yang said frankly. "Now we lack a momentum."
Zheng Ren and Su Yun did not say anything. They quietly waited for Professor Yang to finish speaking in one breath.
"It's not that I've been communicating more smoothly with the hospital recently … To be honest, I just want to bask in your glory, Boss Zheng," Professor Yang said very frankly, his eyes staring straight at Zheng Ren's eyes.
These words were very honest. Zheng Ren smiled and said, "Brother Yang, in the beginning, you were very supportive of me. If you have any difficulties, I will definitely help."
Professor Yang knew that there would be, but he listened attentively.
"The surgery should be broadcasted live. Can you accept this?" Zheng Ren asked.
"Yes." Professor Yang was overjoyed. "The live broadcast is the best!"
To build momentum, Professor Yang probably had other amazing support, but that had nothing to do with him. Zheng Ren nodded.
"What does Chief Li think?"
"Chief Li supports me," Professor Yang said. "As long as you agree to the project, I'll start accepting patients immediately. The interventional surgery will be done on my bed. After a period of time, we'll remove it. "
"Okay."
The two of them did not have anything to hide about this matter. They each took what they needed.
"Boss Zheng, it won't delay your Nobel Prize project, right?" Professor Yang asked nervously in the end.
This was what he was most worried about. After all, the weight of a chief in the 912 was far less than the Nobel Prize in Medicine.
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