Chapter 447

The liver, no matter where it is in the human body or its function, is a bit of a connecting link between the preceding and the following, left and right. If the brain is a 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, and the stomach is hot pot.

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

On the micro level, what is the liver 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 form hepatic lobules around the central vein. The hepatic lobules are like the floor of an office building, which has many offices.

These offices are hepatocytes, and the fire passage around the office building is the interlobular artery of the liver.

Then the liver building has countless floors of this liver lobule.

Venous blood from the stomach, large intestine, small intestine, pancreas and spleen converges into the liver.

After all kinds of food absorbed by the human body are absorbed in the stomach, small intestine and large intestine, all kinds of substances, including nutrients, enter the liver through blood vessels. The liver is broken down and combined, and then transported out.

How to decompose and combine? Say a very simple and vulgar. Protein, a person ate sweet and sour tenderloin. It is rich in a lot of protein, but it is all the protein that makes up pigs. The liver is like a disassembler. It disassembles the protein into parts and then combines them into the protein that makes up the human body.

If there is no liver, how is this protein eaten and how is it absorbed. This is a bad thing. After eating pork for several years, I find that how can I start to look like a pig?

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

All kinds of venous blood in the digestive tract not only contain nutrients, but also toxins, such as pesticides, such as harmful substances decomposed and absorbed by various substances.

All these will be eliminated by the liver, detoxification and detoxification. Without this connecting prime minister, these harmful substances, not to mention entering other organs, light entering the brain is a very troublesome thing.

For example, after eating an egg, ammonia molecules produced by protein decomposition directly enter the brain. Well, people start talking nonsense, all kinds of weird, and even streaking.

So, the liver is very important. How did the liver tumor come from? To tell you the truth, many have not been studied clearly. However, there are still some clear studies.

For example, a person who likes fat meat or who drinks too much for a long time is much more. 80g Baijiu is more than a day.

Not to mention other related diseases. But for a liver, fatty liver will appear first. In other words, fat people and people who love drinking are prone to fatty liver.

If you are fat and like to drink, you can't run away with fatty liver. Not to mention alcoholic fat and nonalcoholic fatty liver.

Generally speaking, it is also very simple to say what fatty liver is. In this large office building, the liver is stuffed with many fat employees, who are fat particles.

These guys don't work. They don't do any decomposition and combination. They are all masters. If he doesn't work, he will occupy the living space of thin liver cells.

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

If the liver is only at this point, it can be saved. Quit drinking and lose weight, and slowly the fatty liver will recover. It won't take long. As long as you quit drinking, meat and lose weight scientifically, you can recover in six weeks.

As long as six weeks, not 998, not 666. As long as six weeks, these fat people will be slowly decomposed and metabolized by the hepatocytes in the liver. The liver can still return to the original and continue to be his little fresh meat.

If you continue to eat, continue to drink. Well, more and more fat people will enter these writing rooms and directly get tired of the weak liver cells with their fat bodies.

Can hepatocytes be reconciled to being greased to death by fat for no reason? No, so this guy will become fibrotic. It turned out to be small fresh meat.

Because unwilling, the little fresh meat changed after it died. It's just as like as two peas of dried beef jerky.

Then the liver, which has become a fat office building, becomes a piece of hard meat with no channel and no function, greasy outside and fibrosis inside.

At this stage of development, the name of fatty liver has been changed, and the very tall one has become liver cirrhosis.

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

The disease followed, first of all, ascites. The veins in the lower abdomen could not pass through the liver and could not return to the heart. The blood containing a large amount of protein leaked out of the blood vessels, and the human stomach began 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 and waxy yellow, like a wax statue without bleaching.

Men can also have breast (a) room development, women directly have irregular menstruation and can't get pregnant. What bleeding tendency, hypoproteinemia, is directly followed.

Because the liver doesn't work and is not transparent, the related vascular pressure begins to increase, just like pressing and holding the rubber hose at the water outlet.

The most common is esophageal varices. Eat Oreo. Usually crisp Oreo. At this time, the veins of esophageal varices are sharp blades.

With a gentle stroke, it is directly like a fountain. Blood can be ejected from people's mouth, either spit or directly. This is also a common cause of death in patients with liver cirrhosis.

If these diseases have not killed this person, after spending all kinds of advanced surgery, all kinds of advanced drugs and money like water.

This man has survived for seven years. At this time, he has become the liver of dehydrated beef jerky. The boss of the disease, cancer and liver cancer have come.

Therefore, in modern society, with such a high-energy diet, it will not be greedy to eat less meat and drink less wine. Run two more steps. You'll never die if you have nothing to walk.

There are many cancers in the liver. We won't talk about those with unknown causes and can't be prevented. If we don't prevent those that can be prevented, it won't make sense.

The surgical incision for liver cancer is very huge. What appendectomy incision, what gallbladder incision, in front of it are little brothers.

"Enter plasma directly." When Zhang Fan was ready to open, he said to the itinerant nurse.

The itinerant nurse hesitated a little and looked at Professor Zhao Jingjin. Lao Zhao quickly nodded. After all, it is a provincial third-class hospital. The nurses in the operating room are still a little arrogant.

Zhang Fan doesn't care. He starts to do it directly!

Instead of hitting people, start the surgical incision. The old man's skin has turned yellow to bright eyes, and the color of iodophor can't be seen on his skin.

Because the patient was a huge liver central tumor, Zhang Fan made a large incision directly. How big is the incision made along the rib arch from under the xiphoid process?

Pull the lens up and look at the patient's right abdomen from the shadowless lamp, so that Zhang fan can uncover it all. To make a vulgar analogy, just like the pig who was laparotomized in the meat case, the stomach was completely beaten open.

While cutting, hemostasis and ligation, Zhang Fan's technique can't be more skilled. There is no obvious bleeding in the surgical field, such as large and small bleeding points, ligation and electrocoagulation.

In the science and Education Hall, the director who had called Lao Chang recovered a little. Looking at Zhang Fan's technique, he said to another director around him, "it's a little interesting and skilled. It's very rare to be able to do this at this age. What's the origin of this guy? The one surnamed Zhao didn't leak a word? "

"Lao Zhao was afraid that others would take his credit, so he didn't say it at all. He waited for others to jump out when they were helpless. Didn't you see the dean's face at that time? " At this time, the directors believed that Zhang Fan could perform the operation.

We are all engaged in this industry. We know whether we have kung fu and whether we are experts.

Open the abdominal cavity and start exploring. Tumor, that's disgusting. There are too many ways to transfer this thing. It can go to other places from the blood.

From the lymph node can run to other development, but also can be transmitted directly through nearby tissues. And can run around through ascites. Like fruit trees, mature cancer cells can germinate in deep roots where they fall.

For other operations, the operation plan is generally formulated before the operation and can be implemented directly, but cancer surgery is not good. Although modern examination equipment is very advanced, there is still no field investigation.

"No ascites, no metastasis above the greater omentum, mesentery and peritoneum!" After Zhang Fan explored it again, he was a little relaxed. Once transferred, the operation will change accordingly.

"It's saved, otherwise it's hard for such an old man to stick to it if he's expanding the scope of cleaning." Zhao Jingjin also breathed a sigh of relief.

He knew that the operation was successful today, and the things about his experiment in the hospital would disappear. When his experiment was successful, he began to charge for the top of the hospital.

Therefore, the operation can not fail, nor can it be allowed to fail. When he heard Zhang Fan say that there was no ascites, he was really as comfortable as entering the heating room in thirty or nine days.

God help me too!

Liver cancer surgery is not easy to do. Apart from others, the liver has the function of storing blood, which is directly like beef injected with water or sponge soaked in water. If you break any point, there will be blood pouring, not to mention cutting off a large part.

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

"OK, start timing now?" Professor Zhao Jingjin asked Zhang Fan. Although he was an expert, Zhang Fan was the main knife, and Zhang Fan did better than him for this kind of operation.

"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 ligate." Professor Zhao Jingjin reached out and wanted to take the rubber band for ligation. As a result, Zhang Fan directly refused. Once the operation is performed, what Zhang fan can do will never be handed over to others.

Liver ligation is simple. It's really simple. It's OK to ligate the ascending and descending blood vessels with rubber bands. What's it like. In fact, it is like an apple on a branch, connecting the apple with a rope, and tying up the small branches of the tree with a rope.

That's what it means. However, the blood vessel is not a branch. If the ligation is loose, it can't stop the blood. If the ligation is tight, it may break the blood vessel. The blood vessel here is not a small blood vessel, but a very thick inferior vena cava. Once it is broken, it will kill people.

"Tut tut! You see, this guy doesn't even believe Lao Zhao. He won't even let Lao Zhao dry by ligating his blood vessels. " The directors of the Department of science and education gloated and began to laugh at Lao Zhao.

"Yes, let's see what he can do to make the arrogant Lao Zhao obedient."

"Timing!" Zhang Fan gently and forcefully ligated the upper and lower blood vessels, which sounds very contradictory. This is a degree, an appropriate strength.

Without five years of practice, the superior doctors of hepatobiliary surgery will never let the subordinate doctors get started.

Blood vessels cannot be ligated for too long. Once it is too long, liver necrosis will occur. Therefore, the ligation time should not exceed 20 minutes and 15 minutes in patients with obvious liver cirrhosis.

In other words, every 15 minutes of surgery, we must release the ligation of blood vessels and let the blood enter the liver for three or five minutes.

Itinerant nurse, turn on the timer. To Zhang Fan and Zhao Jingjin, "start timing."

In fact, the difficulty of resection is not resection, but free. First, free blood vessels, various nerves and ligaments, and various pipes above the liver.

Surgery is to save people, not to cut, so we should reduce the injury as much as possible. This is the embodiment of a doctor's level.

Regardless of 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 the blood vessels and hepatobiliary channels pass along these ligaments. If you want to remove the tumor, you must first separate these ligament blood vessels and various hepatobiliary channels.

Because it is a central tumor, Zhang Fan directly began to remove the gallbladder after ligating the blood vessels, because after the tumor was removed, the bile duct was damaged, and the gallbladder is useless. It will only be bad to stay.

Therefore, if you want to remove the tumor, you must first clean up the surrounding areas, just like the war of annihilation. You must first clean up the surrounding areas, and then launch a general attack.