Regardless of whether it was liver hydatid or a malignant tumor, once it invaded the portal vein, there was a high probability that the difficulty of the surgery would increase exponentially.
"The Thoracic Department has opened four operating theaters in the operating theater. They're acting weird tonight. The Thoracic Department can't even bring anyone over," Dong Jia complained. "Chief Zhao said that if there's anything, he'll be responsible for it. I haven't called you yet and you're already here. "
As he spoke, a figure rushed in quickly, panting. His throat seemed to be pulled by a wind box. The roar made him feel that his breathing was not smooth.
"Professor Yang!" Dong Jia hurriedly shouted.
"How's the resuscitation?" The person was out of breath. He had probably run up.
"It's stable for now, but …"
"I'll go change my clothes." Professor Yang did not even look at Zheng Ren and Su Yun. He probably thought that the two of them were passersby.
"Do you have radiographic films?" Zheng Ren asked.
"Yes, I did a CT scan in the afternoon. I have it in the chest and abdomen." Dong Jia immediately turned around, took out a bag of radiographic films under the patient's bed, and handed it to Su Yun.
"You guys take a look first. I'll go take care of the patient. Don't let anything happen later." Dong Jia did not forget to be polite at the end.
Su Yun carried the bag of radiographic films and did not say anything. He turned around and went straight to the doctor's office.
When the radiographic films were inserted into the radiographic film viewer, Su Yun was stunned.
Two layers of CT images were directly reflected in his eyes. On one layer, a small snake appeared in his field of vision. The snake was not big, less than 10 centimeters, but its shape was lifelike. On the other layer was a ball of gauze.
What the f * ck. Was this put in for an experiment?
Zheng Ren was still in his usual posture. He rested his chin on his right hand and looked at the radiographic films seriously.
No matter how talented Su Yun was, he was not from the General Surgery Department after all. He did not know much about liver hydatid disease, a rare disease in the Imperial Capital.
Seeing that Zheng Ren was focused on looking at the radiographic films, he took out the chest CT scan.
The imaging showed that it was a ghastly sight.
Liver hydatid disease had a wide range of erosion, involving four abdominal and thoracic organs and important blood vessels.
Looking at the images, it was really similar to cancer.
It was also very appropriate to say that it was worm cancer.
The hydatid disease had eroded about 65% of the liver, forming a huge and hard mass, and had also eroded down to the right of the liver.
It eroded upwards and penetrated a large area of the diaphragm, then invaded the thoracic cavity and right lower lung, all the way to the pericardium.
The hydatid worm invaded the largest venous blood vessel and its branches in the abdomen, causing the 17cm vena cava to be completely occluded from the right renal vein to the level of the right atrium. The four groups of blood vessels that entered and exited the liver at the same time, including the hepatic artery, portal vein, hepatic vein, and bile duct, were all severely damaged.
It was similar to Budd-chiari syndrome, but the range of portal vein erosion was simply too wide. It could not be treated by interventional surgery at all.
Judging from the erosion of the thoracic cavity, the wall of the vesicle was relatively thin. Zheng Ren estimated that the right side of the thoracic cavity had ruptured, causing septic shock.
However, this surgery …
It was a little too complicated.
If they were to do it, the chances of the patient leaving the stage alive were not high. At most, there was a 30% chance.
That was not all. Even if he managed to leave the stage alive, the chance of him surviving the critical period was less than 20%.
The probability of the patient recovering and leaving the hospital after surgery was only 5-6%.
This was simply dancing on the tip of a knife!
"Boss, this surgery can't be done." Su Yun looked at the radiographic films for two minutes and finally came to a conclusion.
Zheng Ren knew what Su Yun meant. In fact, he thought so too.
For this kind of patient who would die if he did not do it, most doctors would choose to give up if there was still a 5% chance of survival.
It had nothing to do with him if he did not go on stage. If he went on stage, he would be affected.
Who would be confident in such a complicated surgery?
Moreover, the family members were not around? If the surgery was successful, it would definitely not appear. If it failed … In Sea City General Hospital, Zheng Ren performed a surgery to stop the bleeding of a pregnant woman. The surgery was successful, but the patient's family still took the patient away and prepared to sue Zheng Ren and the obstetrician.
However, since the medical administration division had already filed the case, it meant that the hospital would take responsibility. Zheng Ren looked at the radiographic films and was already thinking about how to perform the surgery.
Watch the patient die in front of him? Zheng Ren really could not do it.
It was fine for a disease like triple-negative breast cancer. Even if Zheng Ren used up all the surgery time, he would not be able to solve it.
However, although this patient looked serious, there was still a glimmer of hope.
Although Zheng Ren had left Sea City General Hospital for a few months, he had first carried out a mission and then went to earthquake relief. He had not adapted to the situation of only performing interventional surgery.
The first thing he did was habitually put himself in the position of the emergency department's chief resident.
No matter what, he had to be saved, even if there would be endless trouble in the future.
He would give it a try. Even if he had surgical training time, Zheng Ren was still not confident.
This kind of surgery was simply too f * cking difficult.
"You are …" Zheng Ren was pondering when Professor Yang's voice came over. He had not recovered yet. He was panting. He had just changed into a white coat, and his chest was drenched in sweat.
"Hello, Professor Yang. I'm Zheng Ren from the Department of Interventional Medicine."
Professor Yang, who was leading the group, saw that Zheng Ren and Su Yun were looking at the radiographic films and casually asked. However, Professor Yang quickly recalled what Zheng Ren had just said.
"You're Zheng Ren from the Department of Interventional Medicine?"
"Yes." Zheng Ren nodded without a smile. He was thinking about how to perform the surgery.
Even if he went to the operating theater to train for surgery, he still had to have a train of thought.
However, this patient's surgery … was a mess. How could he have a train of thought?
"Boss Zheng, who was nominated for the Nobel Prize?" Professor Yang asked in a low voice.
"Yes." Zheng Ren hummed again.
"Nice to meet you." Professor Yang reached out and shook Zheng Ren's hand. Then, he asked, "Can interventional surgery solve the problem of the portal vein?"
"If we're waiting for the liver, we can give it a try. But now, the patient is in an acute shock period. If we operate, we'll need the vascular department to perform reconstructive surgery, "Zheng Ren answered straightforwardly.
Professor Yang was obviously disappointed.
He knew about the patient's condition a long time ago. He originally wanted to delay it as much as possible and carry out the slow-motion liver transplant with the authorization of the hospital. He did not expect the cyst to rupture at night.
He had thought that the Nobel Prize candidate would have some good tricks up his sleeve … Although Zheng Ren was telling the truth, Professor Yang could not help but sigh.
"Boss, what's going on with this little snake?" Su Yun looked at the radiographic films and suddenly asked.
"This is the image of liver hydatid. It's the same as the gauze below. It's not real.
Year and
Two articles published in the European Journal of Radiology in 2005 gave a classic description of the characteristic images: the snake-like sign and the spinning sign, which have diagnostic significance for acute abdomen with hepatic cyst rupture, "Zheng Ren said.
"Hiss …" Su Yun took a deep breath, feeling extremely awkward.
Determining the gauze and the small snake was not important. What was important was the surgery.
"Sigh." Professor Yang sighed and picked up his phone. As he contacted people, he asked Dong Jia to prepare to send the patient to the stage.
This was a hot potato, but if he did not perform the surgery, the patient would die.
No matter what, he had to report it and then go on stage to give it a try.
As for the troublesome matters in the future … Let's talk about it in the future.
"Boss, you can't perform this surgery. You're new here, so don't let anyone catch you. Let's not talk about Professor Zhao. The department chiefs and group professors of the various departments are here. Don't show off, "Su Yun shook his head and reminded Zheng Ren again.
"Can you do the chest?" Zheng Ren suddenly asked.
"I can definitely do the chest, but the abdomen …" As he said that, Su Yun pointed at the portal vein and right kidney on the radiographic films and said, "I'm afraid you can't do these either."
..
..
At this time, Professor Zhao of the Intervention Department was at home. He was sitting in the study and reading a foreign language journal.
"Who did you call just now?" Professor Zhao's wife asked.
"The newcomer, Zheng Ren."
"The junior doctor who asked for a bed from you?" Professor Zhao's wife raised her eyebrows. When she heard Zheng Ren's name, a murderous intent soared into the sky.
Cutting off a person's path to wealth was like killing his parents. This sentence really made sense.
"What junior doctor? He's Department Chief Kong's treasure and a candidate for the Nobel Prize," Professor Zhao said with a smile.
"Just pretend. Why did you call him for no reason?"
"Isn't this the afternoon consultation of the whole hospital? There's a patient with liver hydatid disease. All the departments have gone to see him."
"Does it have anything to do with you?"
"No. If you want to say that there is, it can be done. When we do the autogenous liver transplant in the end, it will be faster to do an image. "
"Then why did you call Zheng Ren?"
"I can't do anything, but that doesn't mean that Boss Zheng can't do anything." Professor Zhao leaned against the chair and closed his eyes, as if he was deep in thought.
"He …"
"When I did scientific research last time, I heard that he graduated from general surgery."
"Then why did you let him go? Are you giving him a chance to show his face in front of others? "Professor Zhao's wife did not understand.
"Chance? I'm just afraid that he won't dare to do it. "Professor Zhao smiled and said," He's from Sea City. I don't know why Department Chief Kong took a fancy to him. He's the chief resident of the emergency department in Sea City. I'm looking forward to him performing the surgery. Tell me, no matter who it is, can we let him perform the surgery? Which department's surgery needs an interventional doctor to perform? This isn't showing his face. "
"You're the only one who thinks too much."
"If he dares to request to perform the surgery, he won't be able to gain a foothold in the 912 in the future." Professor Zhao smiled and said, "If that's the case, it would really save us a lot of trouble."
"Department Chief Kong is the same. He's just a junior doctor. Is there a need for him to snatch the bed from you?"
"He's a candidate for the Nobel Prize. If I were Department Chief Kong, I would do the same. He's going to retire anyway, so it doesn't matter. It's a pity. If I had fought for the position of chief two years later and met him again, how good would that have been? "
"He's that capable?" Professor Zhao's wife was surprised.
"I can't compare to him in surgery, especially in TIPS surgery. His technique is so smooth. However, he's young and impetuous. He has such great ability at this age, so his ambition must be high. I don't know what's going on over there today. If he really doesn't know his limits and wants to go on stage, it'll be fun to watch. "
"Don't tell me he really went up to be the chief surgeon."
"How is that possible! Emergency treatment? Was it a joke? Besides, is Yang Lei, who stayed at home in the Department of Hepatobiliary and Pancreatic Surgery, someone who is easy to deal with? In all these years, he had never seen him submit to anyone. A few years ago, he even had a huge argument with Lin Guodong. In the end, he forcefully pushed Lin Guodong away. What right does a junior doctor who is less than thirty years old in the Department of Interventional Medicine have to steal Yang Lei's stage? In that case, I'm really looking forward to it. "
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