The surgeon opens a cheat

Chapter 231 Ups and Downs
scientific research center.

Xiang Jianhua, Ning Hongru, Wu Yan and the others are working hard to help sort out the data of the patients in the first operation, and to make preoperative adjustments for the patients.

Xiang Jianhua said, "Lao Ning, can you help with the liver cancer removal part in Zhang Gu's operation?"

Ning Hongru and Wu Yan glanced at each other: "We both have some experience in the field of liver cancer resection, and we will be able to cover the bottom line when the time comes."

"However, we are all secondary!"

"The most important thing is to ligate and cut off the portal vein, which is the core technology that only Zhang Gu has mastered."

Xiang Jianhua also said: "Yes, it is up to Zhang Gu whether the liver can be rapidly expanded in a short period of time. This is the focus of this project."

Several people still have doubts about whether the liver can grow rapidly after the first operation.

This is the whole subject, the only point they worry about.

Finally, it was time for the first patient's operation.

With the help of the little nurse, Zhang Gu put on the surgical gown and gloves.

Tian Sha said next to him: "Doctor Zhang, the patient's current liver volume is 1373ml. How much do we need to cut in this first operation?"

Zhang Gu said: "The patient weighs 65 kilograms, right?"

Tian Sha nodded repeatedly, admiring Zhang Gu's memory, able to recite everything about the patient clearly.

Zhang Gu: "The CT examination showed that after all the liver cancer was removed, there was still 300ml left in the patient's left liver. According to the body weight ratio, it was 0.44. This value was within the safe range. Therefore, for this first operation, the goal was to remove 1070ml. .”

Tian Sha said oh twice, and quickly wrote it down.

Next to him, Wu Yan, Ning Hongru, and Xiang Jianhua were secretly thinking about this "body quality".

"It seems that Zhang Gu has a formula for evaluating the volume of the resected liver."

"His set of safety standards is definitely higher than our standard for routine liver cancer resection. I don't know where it came from. I will ask him later."

While everyone is guessing.

On the operating table, with the cooperation of Xiao Mao, Zhang Gu has already started the operation.

On the patient under general anesthesia, a "herringbone" incision is made under the costal margin, the right triangle of the liver, coronary ligament, and hepatorenal ligament are dissected, and the first hepatic portal vessel and bile duct are dissected...

Ning Hongru was at the side, watching Zhang Gu's operation, and nodded slightly.

He laughed and said, "In my opinion, we don't have to worry about removing part of the liver cancer."

"You can see that his operation is very standardized, and he has always followed the principle of 'no tumor'. Although the ligament and hepatic portal blood vessels have been freed, he has not freed the retrohepatic inferior vena cava and small short hepatic veins, which shows that he has a good understanding of liver cancer resection. very thorough.”

Wu Yan also secretly praised Zhang Gu's operation, although the operation of the knife is fast and seemingly chaotic, it actually follows a set of principles and is very standardized, and they don't need to point fingers at all. "

As time progressed, the surgery proceeded to ligation of the portal vein.

This is the most critical and core part, which determines the success or failure of this operation.It also determines the success or failure of the subject.

Xiang Jianhua clenched his knuckles.

"Zhang Gu, come on."

Xiang Jianhua knew in his heart that with so much attention from the society and so much attention from the leaders, at this moment, all the pressure was on Zhang Gu alone.

This young man has taken on too much.At this step, none of them can help, and they can only rely on Zhang Gu himself.

I saw that Zhang Gu chose to use 3-0 vascular sutures, and first ligated the small branches of the right anterior and right posterior, as well as the small branches supplying the hepatic artery.The left and right hepatic ducts and the left and right hepatic arteries were freed but not ligated.Then, at the right side of the falciform ligament, the liver was split, and the liver cancer tissue was split with an ultrasonic scalpel.

Wu Yan asked Jianhua and Ning Hongru next to him and said, "Old Wu, how is the ligation of the portal vein going?"

Everyone knows that Wu Yan has done the last project, and he still has some understanding of this portal vein ligation.

Wu Yan said: "Do you still remember that there are three levels of spleen-preserving surgery?"

Everyone nodded.

Wu Yan: "The ligation of the portal vein used by Zhang Gu in this operation was the highest level back then, and it required the most technical skills."

When he said this, everyone became nervous.They all know that its difficulty is very high, currently only Zhang Gu can take it down in Quanyuan City.

In other words, if Zhang Gu had an accident now, there would be no substitute for him.If that kind of situation really happened, Ning Hongru and Xiang Jianhua could only go up and perform conservative salvage surgery.

But in that way, although the patient's life could be saved, the operation failed.

Everyone didn't even dare to speak, and kept their eyes on the operating table.

At this moment, Zhang Gu's hands are extremely fast. In order to reduce the exposure time of the patient's wound, instead of clamping the blood vessel with titanium clips, he uses fast operations to make up for it.

After doing these operations.

Zhang Gu: "Xiao Mao, use color Doppler ultrasonography to check the right hepatic portal vein and right hepatic artery."

After the examination, Xiao Mao said: "There is no blood flow in the right portal vein of the liver, and the blood flow in the right artery is normal."

As soon as he said this, the corners of Zhang Gu's mouth twitched slightly.The initial effect of portal vein ligation has come out.

Xiang Jianhua, Wu Yan, and Ning Hongru who were next to him also breathed a sigh of relief!Although they didn't know the specific process, they all remembered the result.As long as these two phenomena appear, it means that the ligation and dissociation of the portal vein has been successful!

after.Zhang Gu wrapped the dissociated right hemi-liver in a sterile bag to prevent adhesions between the right hemi-liver and its surroundings during the first and second operations.Latex drainage tubes were placed in the liver sector.

The first surgery was declared complete.

While everyone breathed a sigh of relief, they began to worry about new problems.

Does this really make the liver bulkier?
Zhang Gu: "Tian Sha, how much is the remaining liver volume?"

After taking the measurements, Tian Sha quickly said: "1082ml of cancerous liver tissue was removed during the operation, leaving 291ml."

The crowd looked solemn.

There is only so much left!
This basically accounts for only 21% of the volume of a standard liver!
It is clear to everyone that the patient is now facing two problems.

One is whether the patient can survive with only 21% of the liver left.The second is whether such a small amount of liver can rapidly expand by 100% within seven to fourteen days.

After Zhang Gu got off the operating table, everyone surrounded him.

Wu Yan: "Zhang Gu, how is the remaining volume of the liver? Is it safe?"

Xiang Jianhua and Ning Hongru looked over with solemn expressions.When they underwent liver cancer resection before, they had never left such a small part of the liver.

This is really beyond their cognition.

Zhang Gu was not worried at all, and said with a smile: "Don't worry, with the nutritional support of the whole blood supply, the patient will be safe, just wait and see. In the past few days, you can use the color Doppler instrument at any time Monitor at any time to check the growth and changes of the patient's liver volume."

"Tian Sha, you also need to record the detailed change data every day."

Tian Sha nodded quickly.

(End of this chapter)