Chapter 166

The next day, in the operating room, Zhang Fan, Zhao Quanping, Zhao Jun, and Li Jingjin, Professor of hepatobiliary tumor of Dida, were on the platform of the operating room. He didn't have much confidence in the eradication of this tumor. Although he was a consulting expert invited, he wasn't very optimistic that Zhang Fan could do it, but he didn't say it. Let's do it first! Lao Chang also came. Although he is a systematic expert Professor, he has a bad relationship with Li Jingjin. He is an expert at the same level, and he is still in a region. There are so many acupoint hospitals. If you have more, he will be less. Therefore, his peers are friends and are right at all.

They didn't feel embarrassed. They stood on both sides of the operating table. Although there was no communication, they were not optimistic about Zhang Fan's operation. Such a young doctor still did such a big operation and such a high-end operation. It was really a bit of a joke.

They all come for consultation. They have no responsibility as long as they don't have surgery. Anyway, they are not afraid of big things. The municipal hospital should insist on doing it, and Lao Li doesn't insist either!

At the beginning of the operation, Zhang Fan chose a conventional incision, which would rather have a larger opening than a smaller one. Small incision, it seems that the damage is small. In fact, the visual field is not clear, and the damage to the internal organs is greater. When the sharp knife cuts through the skin, the fat layer breaks the skin. Electric knife hemostasis, light smoke!

After entering the abdomen, Zhang Fan began to explore the size and scope of the tumor to understand whether the tumor tissue really invaded the hilar and large blood vessels. The tumor is really not small. It occupies a large space in the middle lobe of the liver. Li Jingjin and Lao Chang stood on both sides and saw the size of the tumor. At the same time, they shook their heads. It's too big. What you said may have invaded the great blood vessels! One careless, liver failure can't run away!

Zhang Fan gently touches the tumor tissue. The tumor tissue grows rapidly and overbearing. It is particularly harmful to the body and tissue. There is a thin film on the surface, which will break if you are not careful. The patient's tumor has invaded large blood vessels. If it moves a little too far, it may break and bleed.

Zhang Fan slowly separated the liver and kidney ligaments and cut off the triangular ligament. This operation is much more difficult than ordinary liver operation. If the action is too large, it will break and bleed. Therefore, each action is careful and careful“ Wrapped in gauze. " Zhang Fan said simply. Zhao Jun immediately wrapped the liver with gauze and held the liver with both hands. The last ligament, the coronary ligament, was separated and broken. When the ligaments that fix the liver are free, the assistant should bend down and hold it to ensure that the liver cannot move.

Zhao Jun stooped down. He was a chief physician. He worked as an assistant to a resident and did the work of hospitalization. But he didn't complain at all. This is the team, this is the doctor, and this is the characteristic of the technical post. Only the technical hero.

Gently slide the round scalpel over the liver capsule, and slowly enter the liver with large curved hemostatic forceps at the front edge of the liver to separate and clamp the liver tissue a little. At this time, it is very important to be accurate and be particularly familiar with anatomy, otherwise a blood vessel will be missed, which is difficult to stop bleeding.

The vena cava and short hepatic veins are ligated one by one to stop bleeding. The liver has a double blood supply system, which is particularly complex. However, the veins and arteries leading to other liver lobes cannot also be ligated, otherwise the other liver lobes will be ischemic and necrotic after the operation. After confirming the successful ligation of blood vessels, Zhang Fan gently released the hemostatic forceps, and the left and right livers were a little gray, and the blood color was restored, indicating that the vascular tissue of the left and right hepatic lobes was unobstructed.

The position of the middle hepatic lobe is too dangerous. The hepatic portal is close to the inferior vena cava and the three veins of the liver pass through the middle hepatic lobe. The wound at this position has too much bleeding, rich blood supply and complex tissue, which doubled 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. When the liver is cut, it is really impossible to identify them without decades of liver surgery. Surgery is so difficult. It's really too difficult without a teacher. This is why it is difficult to operate on middle lobe tumors. It is impossible to mature without a lot of disease source support. Good teachers are indispensable for a large number of diseases.

Zhang Fan ligated, stopped bleeding, let go of the hemostatic forceps, and the color of the left and right liver lobes recovered. Li Jingjin and Lao Chang thought it was incredible that they were so skilled at a young age. They were both experts. When they saw Zhang Fan's technique, they knew that this young man was very powerful.

As time goes by, four hours have passed, and there is only the last step before removing the tumor. After pressing the liver wound with a hot saline bag, the liver cancer tissue is removed. Liver cancer grows too fast, the outside cancer cells are not mature, and the internal liver cancer tissue has died due to lack of nutrition. The normal nutrition of the human body can not meet the growth of cancer cells at all. There are too many ways for cancer cells to spread, which is really terrible.

Five centimeters of cancer tissue was completely stripped off. Compress the wound tissue to bleed, and then inject chemotherapeutic drugs from omental vein to kill the cancer cells entering the blood. Finally, the greater omentum was covered at the edge of the liver, ligated and fixed.

The operation was successful because the tissues around the liver cancer were treated very clean. When the liver cancer was removed and put into the tissue plate, Lao Li exclaimed: "accurate liver resection! fierce! Taught! "

Lao Chang left the operating room quietly when he saw Zhang Fan's complete removal of cancer tissue without massive bleeding and the patient's vital signs were particularly stable. He had no face for any consultation fee or air ticket! He made up his mind that he would never come to the tea vegetable market in the future! It's ridiculous. Just jump out of a small doctor and you can do this operation. It's really ridiculous!

No one cares about Lao Chang's departure. The expert group outside the operation is still on standby. Looking at Lao Chang's departure, it's like ignoring it. Retribution comes too fast!

The operation continued. After Zhang Fan retained the drainage tube, the instrument nurse counted the gauze and instruments, and began to close the abdomen. After more than six hours of operation, Zhang Fan began to give oral medical advice, "fasting for three days after operation, supplementing plasma and albumin, and low flow oxygen inhalation."

After listening to Zhang Fan's medical advice, the chief physician of general surgery said, "received!" The patient was sent to the ICU by the anesthesiologist and itinerant nurses. A group of nurses in the operating room hurried forward to help the three operators take off their surgical clothes.

exhausted or not? Not tired is false, more than six hours, fixed standing posture, not tired is the robot. Zhang Fan, who had just taken off his surgical clothes and gloves, was held by Professor Li of Dida. "Director Zhang, great! Accurate hepatectomy, the technique is too accurate, too powerful! "

It's really not easy for a provincial surgeon to call the director.

"You're welcome! Please give me more advice! " Zhang Fan is very polite. People respect three feet. He respects one foot.

Now is not the time to rest, the rest room in the operating room. The support expert group and Zhang Fan and Lao Li began to discuss postoperative nursing and special nursing for special diseases. We must formulate a strict and scientific nursing plan, otherwise the operation will succeed and the patient will die of infection!

Ouyang personally presided over the meeting. The directors of all departments discussed it together. The plan was soon passed and distributed to the nursing department, which was in the charge of the chief nurse.

When Ouyang and several surgical directors, Zhang Fan and Professor Li of Di University were left, Professor Li said with emotion: "President Ouyang, it's really powerful. Your hepatobiliary tumors have come in front of us. Congratulations."

"The development of regional hospitals is not easy. In the future, Professor Li needs more support!" Ouyang blushes! Although Lao Chang left, the operation is successful now! Ouyang was very happy when she thought of Lao Chang's gloomy figure. If it wasn't for the wrong occasion, she really wanted to laugh three times!

"President Ouyang, I have a proposal. I don't know what to say!" Lao Li looked at the happy Ouyang and said.

As soon as Lao Li opened her mouth, she knew what Lao Li wanted to say and immediately said, "there's nothing you can't say. You're a professor and expert in a superior hospital. Please don't hesitate to give us any suggestions for our subordinate hospitals. It's really difficult for us to train a mature doctor. It's really difficult to keep talents in remote areas ~! I protested at the municipal Party committee meeting several times. The siphon phenomenon in the superior hospital puts too much pressure on us. "

Lao Li can't say what he wants to say! Ouyang's meaning is very clear. You can put forward any suggestions. If you want to dig people up, you'll be sorry. Ouyang even moved out of the municipal Party committee!

"Oh, yes, yes, the development of Frontier hospitals is really not easy. In fact, we are the same. The siphon phenomenon in big cities puts more pressure on us. Many doctors who graduated from doctors went directly to the south. I have no other meaning. I just want to ask director Zhang to go to our hospital for several operations and give us classes. His precision hepatectomy is too powerful. I can say that director Zhang is the first in the frontier for precision hepatectomy! "

"It's very kind of you. He's too young to win! Dr. Zhang is also a resident doctor. It will make people laugh when he goes to the provincial hospital to give lectures. We don't cherish ourselves. Professor Li, with this special patient, you can bring it to our hospital. We can make progress together. Regional hospitals are too difficult. There are many patients in provincial hospitals, and the quality of doctors is high. We can form a helping hospital, Even if the hospital can't help, it can also form a department to help. What's the matter? As long as there are appropriate patients, our hospital will absolutely cooperate with us. What equipment do you need? You said, if the municipal hospital doesn't have it, I'll apply now! " Ouyang Lian rejected Professor Li's proposal.

"Are you kidding! Want to dig in my hand! " Ouyang looked at Lao Li proudly. Professor Li shook his head with a bitter smile and turned his head to Zhang Fan.

"What a pity!" A voice came out of his heart.

"Doctor Zhang or resident?" He is unwilling.

"Well, yes, Professor Li. It wasn't long before I got my license. "

"I think President Ouyang's suggestion is very good. However, I have a suggestion. I can't be the master of hospital level assistance, but I can still be the master of the interaction between departments. Surgery can be done in tea vegetable City, but the assistants must be all the personnel of our department. We develop together. What do you say, President Ouyang? " When Lao Li failed in his plot, he immediately turned to train his own doctor.

Let the doctors in his department go to the mainland for further study. He is also worried that meat steamed stuffed buns and dogs will never return, but he is very relieved to come to tea vegetable city!