When a doctor opened a plug-in

After Chen Cang was ready, Ford and others also went to the operating room.

Several doctors and assistants came, but stood far away, looking at the operating table, without speaking.

Ford took a look at the operating room, and suddenly met Chen Cang's gaze, and he was taken aback.

What does this look mean?

Kind of like...encouragement?

Ford was a little confused. It seemed that when he first entered the hospital, the teacher looked at him with satisfaction and said: "Study hard!"

At this moment, Ford's nurses all brought in the equipment, as if... ready to take over the operation at any time.

Although pancreaticoduodenectomy is a relatively effective treatment for pancreatic cancer, its efficacy is still not satisfactory.

Especially pancreatic head cancer is the worst!

The other types of cancer are slightly better, but the total surgical resection rate is only 30%, the surgical mortality rate and the five-year cure rate after resection are both only about 10%.

Therefore, this requires a high degree of precision in the operation, and every link must be done well.

Similarly, this is where the confidence of Ford and others lies, they have enough clinical experience and coping strategies!

Even in the field of gastrointestinal reconstruction, there has been considerable development.

Ford looked at Chen Cang, and saw that his expression was happy, which made him more curious.

This young man doesn't seem to be nervous at all. Doesn't he know the difficulty of pancreaticoduodenectomy?

Perhaps...the ignorant are fearless!

Ford believed that he could discover many deficiencies and mistakes of Chen Cang during the operation, and he would even write a paper specifically for publication in the journal of the American Medical Association.

The operation is about to begin!

The anesthesiologist is the director of the anesthesiology department, and he has communicated enough before, open surgery.

The choice is continuous epidural anesthesia, so that the maintenance time is long, the response is small, and the abdominal muscles are relaxed and easy to be exposed.

Seeing this scene, Ford almost couldn't hold back a smile: Could it be...Are you going to open an abdomen for a pancreaticoduodenectomy?

Now this kind of surgery, Mayo is basically all laparoscopic surgery!

Ford suddenly felt a sense of dimensionality reduction...

"Doctor Chen, do you want to open your stomach?" Ford still couldn't help but asked.

Chen Cang didn't look back, but looked at the nurse on the side and said, "Scalpel!"

Seeing this, Ford blushed.

Chen Cang has discussed this matter with the anesthesiologist a long time ago. Choosing open abdominal exploration is a necessary step in deciding whether to remove it!

Because the old man was very early and didn't even transfer too much, Chen Cang's initial plan was to keep some tissues and remove some tissues.

This is also a surgical plan that he has been studying and exploring recently.

If the traditional pancreaticoduodenectomy is used, according to the physical fitness of the elderly, plus long-term diabetes, Chen Cang can guarantee that the survival period will not be too long.

Even a perfect pancreaticoduodenectomy is useless!

This is a flaw in the operation itself.

This is also the reason why Chen Cang strives for surgery because he knows that if Ford does it, it must be completely removed. This is not much different from ordinary people. The only difference is that Ford can do it when the digestive tract is reconstructed. Relatively better.

This is where the gap between Ford and Chen Cang lies.

When Chen Cang's pancreaticoduodenectomy was perfect, with those quasi-perfect biliary-enteric anastomosis...perfect gastrointestinal anastomosis, etc., Chen Cang had already realized one thing.

That is the disability of the operation itself.

The more he studied, the more Chen Cang discovered the deficiencies of the operation.

There is no perfect operation, but the general is drawn from the short man. When it is absolutely necessary, he can operate better, and the relative probability of complications is lower.

Therefore, Chen Cang ignored Ford at all and needed an operation next.

After taking the scalpel, Chen Cang made an incision near the middle of the old man's right upper abdomen.

The incision is not large, but this position is just convenient for up, down, and extension, revealing the entire digestive tract.

After the abdominal cavity was exposed, Chen Cang began to check.

The size of the gallbladder is normal, which is a good thing. The pancreatic head cancer will not compress the bile duct and cause gallbladder lesions.

When Chen Cang touched the head of the pancreas with both hands, he clearly felt a burst of information.

[Pancreatic head cancer: very early, it is recommended to remove!

After feeling the lumps in the head of the pancreas, what Chen Cang would do next was to open the duodenum and examine the development of cancer of the head of the pancreas.

This operation is dangerous, and it is easy to spread the tumor or spread the intestinal bacteria into the abdominal cavity. It should be avoided when it is not specially necessary.

Sun Guangyu looked at Chen Cang nervously, not daring to take a mouthful.

Although he had talked about the surgery plan, he was still a little nervous.

Ford was equally dumbfounded!

Chen Cang is dancing on the tip of the needle!

After seeing the internal structure clearly, I finally breathed a sigh of relief.

The next thing to decide is whether to remove it, and it can be used for radical resection.

Check whether the cancer itself has gone beyond the gland and invaded important blood vessels such as the portal vein, superior mesenteric artery and vein, abdominal aorta, and inferior vena cava.

At this time, Chen Cang directly incised the posterior peritoneum on the outside of the duodenum, turning the duodenum and the head of the pancreas inward!

Then, carefully explore the space between the dorsal side of the pancreatic head and the ventral side of the aorta and IVC with the left hand index finger.

It is easy to put the finger into this gap, indicating that the cancer is still confined to the pancreas and has no metastasis.

Luckily, no transfer!

This process requires three steps to check, but Chen Cang has done more than a dozen steps, and he counts all the places he can consider.

This... is never done by endoscopic surgery.

Refinement and precision.

As time passed by, Chen Cang checked very carefully.

Finally, the inspection is over!

Chen Cang looked at the abdominal cavity, and the four-dimensional model began to simulate continuously. After two minutes, Chen Cang began to move!

Next, the organs to be removed must be fully separated.

And at such a critical link, Chen Cang suddenly did not separate the stomach, but began to free the bile duct!

Then...under the hemostat, he took the lead in making a Y-shaped incision under the common bile duct and the pancreas.

Then a clever separation was performed. At this time, the pancreas suddenly became free!

This inexplicable operation stunned everyone!

At this time, the head of the pancreas cannot be touched, and whether it is the duodenum, gastric body, or even bile duct surgery, it needs to be ligated before removal to prevent the spread of tumor cells.

But now Chen Cang has separated the bile duct directly from the pancreas, so that the bile duct is free!

This operation stunned Ford behind him!

How is this going?

Chen Cang took a deep breath. At this step, he was cautious, fearing that it would cause bad consequences, his eyes were opened long ago!

Fully invested in it!

What he has to do is not to remove the bile duct, but cleverly use separation to achieve a resection effect.

So far, it looks good!

At least for a while the biliary anastomosis became less difficult.