Medical road

The next day, in the operating room, Zhang Fan led the operation, Zhao Quanping first aid, Zhao Jun second aid, and Di Dahepatobiliary tumor professor Li Jingjin on the platform of the operating room.He didn't have much confidence in the eradication of this kind of tumor. Although he was the invited consultation expert, he was not very optimistic that Zhang Fan could do it, but he didn't say it, so let's do it first!Lao Chang also came. Although both are systematic experts and professors, he and Li Jingjin have a bad relationship. They are both experts of the same level, and they are still in the same area. There are only a few hospitals that go to the acupuncture point. If you have more, he will have less. One point, so it’s not wrong to say that colleagues are enemies.

The two of them didn’t feel embarrassed either. They stood on both sides of the operating table. Although they didn’t communicate much, neither of them was optimistic that Zhang Fan would be able to perform the operation. Such a young doctor also performed such a large operation and such a high-end operation. Kind of joking.

They all come to the consultation, as long as they have not undergone surgery, they are not responsible. Anyway, they are not afraid of big things. The city hospital must insist on doing it, and Lao Li will not insist on it!

At the beginning of the operation, Zhang Fan chose a conventional incision. This kind of operation would rather have a larger opening than a small one.The small incision feels as if the damage is small, but the vision is not clear and the internal organs are more damaged.A sharp knife cut across the skin, and the fat layer cracked the skin.The electrosurgical knife stops the bleeding, and the smoke is faint!

Entering the abdomen, Zhang Fan began to explore the size and extent of the tumor to understand whether the tumor tissue really invaded the hepatic hilum and large blood vessels.The tumor is really not small. It occupies a large space in the middle lobe of the liver. Standing on both sides, Li Jingjin and Lao Chang also saw the size of the tumor. At the same time, they shook their heads. It was too big.Maybe it has violated the great blood vessels!One carelessness, liver failure can't escape!

Zhang Fan gently probed his hand and touched it lightly. The tumor tissue grew rapidly and domineering. Zhang Fang's claws caused great damage to the body and tissues. There was a thin film on the surface, which would rupture if accidentally.This patient's tumor has invaded the large blood vessels, and if it moves a little too far, it may rupture and hemorrhage.

Zhang Fan slowly separated the liver and kidney ligaments and cut off the triangular ligaments.This operation is much more difficult than ordinary liver operations. If the action is too large, it will cause ulceration and hemorrhage. Therefore, every action must be careful and careful!"Gauze wrap." Zhang Fan said simply.Zhao Jun immediately wrapped the liver with gauze and supported the liver with his hands. The last ligament, the coronary ligament, was separated and severed.The ligaments that fix the liver are all free, and the assistant must bend over to support the liver to ensure that the liver cannot move.

Zhao Jun bends down, he is now the chief physician, and he is an assistant to a resident, doing hospital work.But he didn't complain at all. This is the team, this is the doctor, this is the characteristic of the technical post, and there are only technical heroes.

Gently slide the round scalpel through the liver capsule, and use the large curved hemostatic forceps on the anterior edge of the liver to slowly enter the liver tissue to separate and clamp into the liver a little bit.At this time, it is very important. It must be accurate. You must be particularly familiar with the anatomy. Otherwise, a blood vessel will be missed. In this case, it is difficult to stop the bleeding.

The vena cava and short hepatic vein are ligated one by one to stop bleeding. The liver has a double blood supply system, which is particularly complicated.However, the veins and arteries leading to other liver lobes cannot be ligated, otherwise the other liver lobes will be avascular and necrotic after the operation is completed.After confirming that the blood vessel was successfully ligated, Zhang Fan gently let go of the hemostatic forceps. The left and right livers, which were already a little gray and white, recovered their blood, indicating that the blood vessels of the left and right liver lobes were unobstructed.

The position of the middle lobe of the liver is too critical. The hilum is close to the inferior vena cava, and the three veins of the liver pass through the middle lobe. The wound at this position has too much bleeding, the blood supply is rich, and the organization is complicated, which has increased exponentially. The difficulty of the operation.

Which artery or vein needs to be ligated, and which artery or vein leads to other liver lobes, must be distinguished.After the liver is cut, it is really impossible to distinguish them without decades of experience in liver surgery.Surgery is so difficult. Without a teacher, it is really too difficult.This is why it is difficult to perform surgery for tumors in the middle lobe of the liver.Without a large number of disease sources, it is impossible to mature.A good teacher is indispensable for a large number of diseases.

Zhang Fan ligated, stopped the bleeding, released the hemostatic forceps, and the left and right liver lobes returned to color. Both Li Jingjin and Lao Chang found it incredible. They were already proficient at this level at a young age. Both of them are experts. Take a look at Zhang Fan's technique. I know that this young man is very powerful.

Little by little time passed, four hours had passed, and the last step was left to the preparations for tumor removal. After the liver wound was covered with a hot saline bag, the liver cancer tissue was removed.Liver cancer grows too fast, and the cancer cells on the outside are not yet mature. The liver cancer tissue inside has been necrotic due to lack of nutrition. The normal nutrition of the human body cannot satisfy the growth of cancer cells. There are too many ways to erode, infiltrate, and plant the cancer cells. It's really terrible.

Five centimeters of cancer tissue was completely peeled off.Compress the wound tissue to bleed, and then inject chemotherapy drugs from the omental vein to kill cancer cells that have entered the blood.Finally, free the omentum to cover the edge of the liver, ligate and fix it.

The operation was considered a success, because the tissues surrounding the liver cancer were cleaned up. When the liver cancer was removed and placed in the tissue tray, Lao Li exclaimed, “Accurate liver resection! Great! I have been taught!”

After seeing Zhang Fan completely resecting the cancer tissue, there was no major bleeding and the patient's vital signs were particularly stable, so he quietly left the operating room. He had no face for consultation fees and air tickets!He made up his mind and decided not to come to the tea market in the future!It's too ridiculous, just a little doctor can do this kind of surgery, it's really ridiculous!

No one cares about Chang's departure. The expert team outside the operation is still on standby, watching the dingy Chang Chang's departure, as if ignoring the retribution!

The operation continued. After Zhang Fan left the drainage tube, the instrument nurse checked the gauze, and after the instrument was completed, the abdomen was closed.After more than six hours, the operation was over, and Zhang Fan began to give an oral doctor's order, "Fasting for three days after the operation, supplementing with plasma and albumin, and inhaling low-flow oxygen."

After listening to Zhang Fan's instructions, the general surgeon said: "Received!" The patient was sent to the ICU by the anesthesiologist and itinerant nurse. A group of nurses in the operating room hurried forward to help the three surgeons take off their surgical gowns.

Tired?Not tired is a fake, more than six hours, fixed stance, not tired is the robot.Zhang Fan, who had just taken off his surgical gown and gloves, was held by Professor Li from the University of California, “Director Zhang, great! The precise liver resection is too precise and powerful!”

It is really not easy to make a provincial surgeon call the director.

"You are polite! Please give me more advice!" Zhang Fan was very polite, and he respected others.

It is not time to rest, in the rest room of the operating room.The support expert group and Zhang Fan and Lao Li began to discuss postoperative care and special care for special diseases. A strict and scientific care plan must be formulated, otherwise the operation is successful, and the patient will die from infection!

Ouyang personally took the chair, and the directors of the various departments discussed together. The plan was quickly approved and sent to the nursing department, which was in charge of the chief nurse.

When Ouyang and several surgical directors, Zhang Fan, and Professor Li of Di Da Li were left, Professor Li said with emotion: "Dean Ouyang, it's really amazing. Your liver and gallbladder tumors have come to the front of us. It's gratifying. "

"The development of regional hospitals is not easy, so I need Professor Li's support in the future!" Ouyang's face was red!Although I always left, the operation is successful now!Ouyang thought of the old and sullen figure, and was very happy. If it wasn't for the wrong occasion, she really wanted to laugh three times!

"Dean Ouyang, I have a suggestion, I don't know it should be said!" Old Li looked at Ouyang who was happy and said.

Who is Ouyang, Lao Li just opened her mouth and she knew what Lao Li wanted to say, and immediately said: "There is nothing that can't be said. You are a professor at a higher-level hospital. If you have any suggestions for our lower-level hospitals, please feel free to let me know. .It is really too difficult for us to train a mature doctor. The remote area cannot retain talents. It is really difficult~! I have protested at the municipal party committee meetings several times. The siphon phenomenon in the higher-level hospital puts too much pressure on us. "

What Lao Li wants to say, I can't say it!Ouyang's meaning is very clear, and all suggestions can be raised. If you want to dig someone out loud, I'm sorry.Ouyang even moved out of the municipal party committee!

"Haha, yes, yes, it's really not easy for the frontier hospital to develop. In fact, it is the same for us. The siphon phenomenon in big cities puts more pressure on us. Many doctors who graduated with Ph.D. went to the south directly. I have no other meaning. , I just want to ask Director Zhang to go to our hospital for several operations and give us lessons. His precise liver resection is too powerful. I can say that, in the area of ​​precise liver resection, Director Zhang is the first in the frontier!"

"You are too polite. How could he be too young to kill him! Dr. Zhang is still a resident doctor. It would be a joke to go to a provincial hospital to give lectures. We are not cherishing ourselves, so let's Professor Li, have this special You can bring the patients to our hospital. We make progress together. Regional hospitals are too difficult, lack of doctors, and lack of typical patients. Provincial hospitals have many patients and high-quality doctors. We can form a helping hospital, even if it helps If the hospital is not good, it can also form a department to help. How about, as long as there are suitable patients, our hospital will absolutely cooperate with you. What equipment is needed? You said, the city hospital does not have one, I will apply now!" Ouyang even canceled He rejected Professor Li's proposal.

"What a joke! Want to dig in my hands!" Ouyang looked at Lao Li triumphantly, Professor Li shook his head with a wry smile, and turned to look at Zhang Fan.

"It's a pity!" There was a voice in his heart.

"Dr. Zhang or a resident?" He was unwilling.

"Well, Professor Li. It didn't take long for me to get the license."

"Dean Ouyang's suggestion is very good. But I have an opinion. I can't be the master of hospital-level assistance, but I can still be the master of the interaction between the departments. The operation can be done in Chasu City, but the assistant They must all be members of our department. We develop together, you say, Dean Ouyang." Old Li turned his head immediately and prepared to train his own doctor if he failed to make a plan.

When the doctor in his own department went to the mainland for further studies, he was worried that the meat buns and dogs would go or not, but he was relieved when he came to Chasu City!