Chapter 532

At this time, the atmosphere in the operating room was once depressed!

Ji Qu, director of emergency department, Yang Zhiming, director of hepatobiliary surgery, and Qi Xiao, director of general surgery gathered in the operating room. They stared at the situation in the abdominal cavity meticulously and dared not be careless!

At this moment, Shen Xiuyuan realized how hasty his behavior was

Looking back carefully, I was afraid of my Caesarean section just now. Cold sweat exuded and soaked the clothes inside.

If I had moved a little more, the situation might be out of control now

However, the laparotomy has been opened. Although the sharp wooden fork can be seen stabbing into the abdominal cavity, the people dare not move rashly.

Even the sound of breathing in the operating room began to become noisy.

Ji Qu, director of the emergency department, frowned tightly. Through the projection of the shadowless lamp, you can clearly see that the sharp wood stabbed into the intestinal tract. Although the fecal secretion did not spread at this time, it was entirely because the sharp wood stabbed into it blocked the intestinal wound!

Intraperitoneal exploration should continue, so we can't stop the pace of surgery.

Ji Qu said in a deep voice, "no bile like liquid was found in the abdomen!"

"No major vascular injury was found."

"The liver has obvious penetrating wounds, and the bleeding is not obvious."

……

The exploration was carried out step by step and carefully. At this time, Yang Ziming, director of hepatobiliary surgery, suddenly said, "don't move, old plan!"

One sentence stunned Jiqu. Even Qi Xiao, director of general surgery, looked at Yang Ziming.

Yang Ziming swallowed his saliva: "there are broken branches and residues in the common hepatic artery, and there are obvious stabs into the wound near the hepatic vein. Now you move around and it's easy to cause massive bleeding!"

In a word, Jiqu couldn't help stopping the operation in his hand.

A moment later, Jiqu couldn't help asking, "is it OK to stop bleeding and hemostasis? If we don't deal with it now, when the intestinal tract is completely ruptured and feces spread out, the whole abdominal infection can't be controlled at all."

Indeed, reason is such a truth. After all, feces have strong infectivity. At this time, foreign bodies have entered the abdominal cavity. If intestinal contents leak out, abdominal infection is very troublesome!

Generally speaking, visceral injury can not be saved. It can be carried out slowly according to the principle of "hemostasis first and then repair".

Yang Ziming said sternly, "if you are infected, you can resist infection, but the near hepatic vein is about to break. No one here can save him!"

The voice was not loud, but it was like thunder in the ears of the people!

The injury of proximal hepatic vein is not a vein, but refers to the injury of main hepatic vein and retrohepatic inferior vena cava.

Due to the special anatomical location of the retrohepatic region and difficult treatment, the injury of the proximal hepatic vein is still one of the most difficult problems in the field of liver surgery.

Yang Ziming was not appalling, but took a deep breath and said solemnly, "let's say, the mortality of near hepatic vein injury is as high as 83%, and it's the mortality in the operating room. Do you understand?"

Ji Qu was stunned. He could understand that the mortality rate of 80% was very high, but... He was stunned by the mortality rate in the operating room!

After all, it is a highly professional case. Ji Qu, even the director of emergency surgery, doesn't know very well.

"Can't you...?"

Yang Ziming blushed and laughed at himself: "don't talk about me. There are no more than three people in Dongyang, and... It's just that you can do it, not necessarily."

"I'm not kidding. Injury to the near hepatic veins can cause fatal bleeding. The walls of these veins are thin, and some of them are surrounded by liver tissue, so... Surgery and repair are very difficult!

Moreover, the most important thing is that its anatomical position is behind the liver, which is not easy to expose. If it is operated under direct vision, it will lead to more severe bleeding and the risk of air embolism;

And... If you stop bleeding blindly, it can aggravate the injury! "

Yang Ziming finished with a sigh and said slowly, "do you say it's dangerous or not?"

A word made everyone silent!

Never dare to probe down again.

Yang Ziming glanced at Shen Xiuyuan and asked, "did you sign the critical illness notice?"

Shen Xiuyuan nodded: "signed!"

Yang Ziming said, "if the condition changes, go and sign another one. In addition, the condition notification letter tells the patient the risk..."

"By the way, you go yourself."

The critical illness notice is not signed only once, but if other new and more dangerous diseases are found, they have to sign and inform!

Shen Xiuyuan quickly took off his gloves, picked up the medical record, tore two signature books outside, wrote a few words, and hurried outside!

At this time, Chen Cang and his party sat at the door of the operating room and kept comforting Lao he's wife. A critical notice just now really frightened the woman.

Chen Cang comforted: "aunt, any risky operation in the hospital will let you sign the consent form. You know that the operation itself is risky. This is the process. Don't worry. It's all right!"

But no matter how Chen Cang comforted her, she couldn't help shaking with fear.

At this time, the door of the operating room was opened again. Shen Xiuyuan hurried out and said to Lao he's wife, "Hello, the patient's condition has changed. It was found that there is a wood bifurcation in the near hepatic vein. Now the patient's situation is very dangerous and needs your signature."

In a word, she was instantly out of her mind when she was already shaking. In a very dangerous sentence, she defeated the woman's psychological defense line.

A few days after the good day, my son and daughter just got married. It was not easy for such a thing to happen when the good day began.

The woman was at a loss for a moment.

Shen Xiuyuan was helpless. Looking at the woman, he was persuaded again.

Chen Cang was stunned and asked, "can the hospital do this operation?"

Shen Xiuyuan thought of Chen Cang, the suspected doctor, and shook his head: "we may not be able to guarantee, but... If you don't trust..."

At this time, Yang Ziming came out in person and said to Lao he's wife, "well, the patient's situation is very dangerous. Although safety can be guaranteed now, there may be accidents at any time. Our hospital does not have the ability of this kind of operation."

"If you transfer to another hospital, I'm worried that the patient's condition may not be tolerable, and there may be accidents in the car, so it's best to invite outside experts."

Lao he's wife took a deep breath and made herself want to calm down: "doctor, you must save our family. Lao he, i... as a farmer, I don't know any experts."

Yang Ziming sighed: "our hospital has always been in contact with the hepatobiliary surgery department of the second East University Hospital in ammonium Yang. We can invite the other party for surgery, but... You may need to pay expert fees because of this situation..."