Medical road

The liver, no matter where it is in the human body or its function, is a bit of a link between ups and downs and a balance between left and right.If the brain is the king, then the liver is the prime minister.

Macroscopically, the liver is like a snail lying next to the stomach, like a snail eating hot pot, the stomach is like a hot pot.

The head of the snail is next to the stomach, this is the left lobe of the liver, and the back of the snail is the right lobe of the liver.In this way, the liver can be roughly divided into two leaves.

On the microscopic level, what does the liver look like, like a honeycomb or a large office building.The central vein of the liver is the elevator in the middle of the office building.

Then various structures surround the central vein to form liver lobules. The liver lobules are like the floors of an office building, with many offices inside.

These offices are liver cells, and the fire escapes around the office buildings are the interlobular arteries of the liver.

Then the liver building has countless floors of liver lobules.

The venous blood from the stomach, large intestine, small intestine, pancreas, and spleen is collected into the liver.

After the various foods absorbed by the human body are absorbed in the stomach, small intestine, and large intestine, various substances including nutrients pass through the blood vessels and enter the liver.The liver breaks down and combines, and then transports it out.

How to decompose the combination? Let me put it very simple and vulgar.Protein, one person ate sweet and sour pork.There is a lot of protein in it, but these are the proteins that make up pigs. The liver is like a disassembler, breaking the protein into parts, and then combining them into the protein that constructs the human body.

If you don’t have a liver, what does this protein look like when you eat it, and when it’s absorbed?This is a bad thing. After eating pork for a few years, why did you realize that it started to look like a pig?

Continue to eat, eat for five or six years, well, become a pig!Although it is a bit exaggerated, this is one of the functions of the liver.

Various venous blood in the digestive tract not only contains nutrients, but also toxins, such as pesticides, such as harmful substances that are decomposed and absorbed by various substances.

All these will be eliminated by the liver, detoxification and detoxification.Without this prime minister, these harmful substances, not to mention entering other organs, would be very troublesome to enter the brain.

For example, if you eat an egg, the ammonia molecules produced by protein decomposition directly enter the brain.Well, people started talking nonsense, all kinds of weird, and even streaking.

Therefore, the liver is very important.How did liver tumors come from?To be honest, many have not been studied.However, the current research is clearer.

For example, a person who loves to eat fatty meat or a person who drinks a lot of alcohol for a long time, how much is too much? 80g of white wine per day is even more.

Let alone other related diseases.But with just one liver, fatty liver will appear first.In other words, fat people and people who love to drink are prone to fatty liver.

If you are a fat man and love to drink, then your fatty liver will not be able to escape.Don't talk about alcoholic fat and non-alcoholic fatty liver.

In general terms, what is fatty liver is actually very simple. In the large office building of the liver, many fat employees are stuffed into by the faint king. These fat people are fat particles.

These guys don't work, and they don't do any decomposition or combination. They are all uncles.If he doesn't work, he has to squeeze the living space of thin liver cells.

More and more fat people are stuffed into the office building.The liver, a large office building, becomes a piece of fat, which is fatty liver.At this time, the liver cells can still work, so there are no obvious symptoms.

If the liver only reaches this step, there is still a rescue.Stop drinking and lose weight, and the fatty liver will gradually recover.It doesn’t take long. As long as you give up alcohol, meat, and lose weight scientifically, you can recover in six weeks.

It only takes six weeks, not ninety-nine-eight or sixty-six, as long as six weeks, these fat people will slowly be catabolized by the liver cells in the liver.The liver can still return to its original state and continue to be his little fresh meat.

If you continue to eat, continue to drink.Well, there will be more and more fat people entering these writing rooms, directly using their fat bodies to make the weak liver cells greasy.

Can the liver cells be reconciled to being fat greasy for no reason?No, so this guy will become fibrotic.It turned out to be small fresh meat.

Because he was not reconciled, after Xiao Xianrou died, his corpse changed.It directly becomes dewatered beef jerky, exactly the same.

Immediately after the liver, the office building that had become fat, it became a hard meaty block with no channels and no function, oily on the outside and fibrous inside.

At this point, fatty liver changed its name, and the very tall one became cirrhosis.

At this time, the disease will also come, and at this point, it is impossible to restore the liver to its original small fresh meat, that is, it can only be delayed but not cured!

Diseases follow, first of all ascites. The veins in the lower abdomen cannot pass through the liver and cannot return to the heart. The blood containing a large amount of protein leaks out of the blood vessels, and the human belly begins to grow.

Because of the strike of the liver, various hormones and poisons in the body cannot be inactivated, and the skin turns yellow directly. The skin is like turmeric in the early years, waxy yellow, like a wax figure without bleaching.

Males can also develop breast (a) room development, while females have irregular menstruation and cannot get pregnant.Any bleeding tendency or hypoalbuminemia immediately followed.

Because the liver is no longer working and not transparent, the related blood vessel pressure begins to increase, just like pressing a rubber hose at the water outlet.

The most common is esophageal varices. Take a mouthful of Oreos. Oreos are usually crispy. At this time, the esophageal varicose veins are sharp blades.

With a light stroke, it is directly like a fountain, and blood can be sprayed from a person's mouth, either directly or directly. This is also a common cause of death in patients with liver cirrhosis.

If these diseases have not killed the person, after all kinds of advanced operations, all kinds of advanced drugs, money is spent like water.

This person has survived for seven years. At this time, the liver has become dehydrated beef jerky. The boss of the disease, cancer, and liver cancer are coming.

Therefore, in modern society, with such a high-energy diet, eating less meat and drinking less alcohol will not be greedy.Run two more steps, walk around without problems, you will not die.

There are many cancers in the liver. Let's not talk about the unexplained and unpreventable cancers. If this kind of preventable cancer is not prevented, it will not be justified.

The surgical incision for liver cancer is very huge.What is the incision of appendix surgery, what is the incision of gallbladder, in front of it is the younger brother.

"Infuse plasma directly." Zhang Fan said to the traveling nurse when he was about to open his stomach.

The itinerant nurse hesitated for a while, looked at Professor Zhao Jingjin, and Zhao nodded hurriedly. After all, it is a provincial-level tertiary hospital, and the nurses in the operating room are somewhat arrogant.

Zhang Fan didn't care about it and just started to do it!

Instead of beating people, I started making surgical incisions.The skin of the elderly has turned yellow to dazzling, and the color of iodophor on the skin is no longer visible.

Because the patient had a huge liver center tumor, Zhang Fan made a large incision directly.Starting from under the xiphoid process, make an incision along the rib arch. How big is it?

Pulling up the lens, looking from the shadowless lamp, the patient's right abdomen was completely uncovered by Zhang Fan.To make a vulgar metaphor, it is like a pig whose belly is completely beaten up in the meat case.

He cut, while hemostasis and ligation, Zhang Fan's technique could not be more skilled, large and small bleeding spots, ligation of ligation, coagulation of electrocoagulation, and no obvious bleeding in the surgical field.

In the Science and Education Department, the director who had called the old Chang had recovered a bit. Looking at Zhang Fan’s technique, he said to another director next to him: “It’s interesting. I have one hand. I can do this at this age. It's very rare. What is the origin of this guy, the surname Zhao didn't miss a word?"

"Old Zhao was afraid that others would take credit for him, so he didn't say anything. He just waited for others to be helpless, and then jumped out again. Didn't you see the face of the dean at that time!" At this time, these directors somewhat believed that Zhang Fan could do it. This operation is out.

Everyone is in this industry. Whether they have any skills or not, everybody knows whether they are experts.

Open the abdominal cavity and start exploring.The thing about tumors is terrible.There are too many ways to transfer this stuff, and it can go to other places to develop from the blood.

It can run from the lymph to other developments, and it can also directly spread through nearby tissues.And also can escape through ascites.Just like a fruit tree, where the mature cancer cells fall, and where the deep roots germinate.

For other operations, the surgical plan is generally prepared before the operation and can be performed directly. However, cancer surgery is not feasible. Although modern inspection equipment is very advanced, it is still not realistic.

"There is no ascites, there is no metastasis on the omentum, mesenteric, or peritoneum!" Zhang Fan felt a little relieved after exploring it.Once transferred, the surgery must be changed accordingly.

"It's saved, otherwise it would be difficult for such an old person to expand the cleaning range." Zhao Jingjin also breathed a sigh of relief.

He knew that the operation was successful today, and all the things in the hospital about his experiment disappeared. Waiting for his experiment to succeed, he began to charge towards the top of the hospital.

Therefore, the operation cannot fail, nor is it allowed to fail.When Zhang Fan said that there was no ascites, he was really as comfortable as if he had entered the heating room for three or nine days.

God helps me too!

Surgery for liver cancer is not easy. Apart from others, the liver has blood storage function, which is directly like beef filled with water or sponge soaked with water.If you break a little bit, it will be bloody, let alone cut a large part of it.

So hemostasis is very important."Although the tumor is not very large, it is too close to the center. Ligation." After the exploration, Zhang Fan said to Zhao Jingjin gently, looking at the tumor protruding from the liver.

"Okay, do you start timing now?" Professor Zhao Jingjin asked Zhang Fan. Although he is an expert, Zhang Fan is the chief surgeon, and Zhang Fan can do this kind of surgery better than him.

"Gloves." Zhang Fan took a pair of unused gloves from the instrument nurse. He cut the gloves and took out the rubber band from the mouth of the gloves.

"I'm ligating." Professor Zhao Jingjin stretched out his hand and originally wanted to take the rubber band for ligation, but Zhang Fan directly refused.Once the operation is performed, Zhang Fan will never leave it to others to do.

Liver ligation is simple. It is really simple to say. It is OK to ligate the ascending and descending blood vessels with rubber bands. What is it like?In fact, it is like an apple on a branch. The small branches of the apple connected to the big tree are tied with a rope.

That's what it means.However, blood vessels are not branches. If the ligation is loose, it will not stop the blood. If the ligation is tight, it may strangle the blood vessel. The blood vessel here is not a small blood vessel, but a very thick inferior vena cava. Once broken, it will kill you. of.

"Tsk tusk! Look, this guy doesn't even believe Lao Zhao directly, and he won't let him dry the blood vessels." The directors in the Science and Education Department began to laugh at Lao Zhao with sorrow.

"Yeah, let's see, what on earth is there to make the arrogant old Zhao bend his head to his ears."

"Time!" Zhang Fan ligated the upper and lower blood vessels gently and vigorously. It sounded contradictory. This is a degree, a proper strength.

The strength of this ligation of blood vessels, without five years of practice, the upper-level doctors of hepatobiliary surgery will never let the lower-level doctors get started.

The blood vessels cannot be ligated for too long. Once too long, the liver will die.Therefore, the ligation time should not exceed 20 minutes, and patients with obvious liver cirrhosis should not exceed 15 minutes.

In other words, for every 15 minutes of surgery, the ligature must be released to allow blood to enter the liver for three to five minutes.

The itinerant nurse, turn on the timer.Said to Zhang Fan and Zhao Jingjin: "Start timing."

For resection, the hard part is not resection, but dissociation.First, we must free blood vessels, various nerves, ligaments, and various channels on the liver.

Surgery is done to save people, not to cut, so it is necessary to have as little injury as possible. This is a manifestation of the level of a doctor.

If you don't care about the injury, it is estimated that a slightly trained person can cut off the tumor, but once the injury is involved, it will be very troublesome.

The liver is suspended in the abdominal cavity. This thing is pulled up by many ligaments, and then blood vessels and hepatobiliary channels pass along these ligaments. If you want to remove the tumor, you must first give these ligament vessels and various hepatobiliary channels. Separate.

Because it is a central tumor, Zhang Fan immediately began to remove the gallbladder after ligating the blood vessels, because after the tumor was removed, the bile duct was damaged, and the gallbladder was no longer useful, leaving it behind would only be bad.

Therefore, if you want to remove the tumor, you must first clean up the surrounding area, just like an annihilation battle. First, you must clean up the surrounding area before you can launch a general attack.