Chapter 1461

The image on the computer showed that MRI showed long T1 and short T2 signals in the liver with limited diffusion. The mass in arterial phase was uniformly enhanced and rapidly emptied, and cystic enhancement in delayed phase.

According to the enhancement characteristics, it can be preliminarily diagnosed as hepatocellular carcinoma.

Surgery, in fact, is not difficult.

Both hepatobiliary surgical resection of the right lobe of the liver and interventional embolization are indications.

But the patient's situation is difficult in his heavy drinking.

"The amount of ascites is too large for surgery." Zheng Ren said, "it's been a long time to reduce ascites."

"Yes." Professor Yang said, "boss Zheng, look at the patient?"

Zheng Ren nodded, stood up and followed Professor Yang out.

He seems to have completely forgotten his purpose before coming - to work with hepatobiliary surgery.

When I came to the ward, the first thing I saw was a bulging stomach.

It's getting a little hot. It's the season to dress disorderly.

The patient was wearing a black vest with his stomach exposed.

Although the amount of ascites has decreased a lot, it is still very large. It leads to the high bulge of the stomach, and even the navel is slightly protruded. It looks very strange.

"Lao Yang, here you are." The patient is in a semi reclining position, lying on the bed against the quilt.

When Professor Yang came in, he wanted to sit up. But because of the severe swelling of the stomach, contraction of abdominal muscles, increased pressure and the natural protective response of the body, he didn't get up and lay down again.

Professor Yang was very helpless and sighed: "you lie down, boss Zheng, give me a hand."

The patient was surprised to see Professor Yang coming in with two young doctors, but he didn't speak out of politeness.

Zheng Ren glanced at the system panel first. Like his diagnosis just now, there was no difference.

It's just that the swelling degree of the patient's stomach is much more serious than that when doing an MRI.

Remember, the film was made two days ago.

Has it developed to this extent in only two days? Zheng Ren's first feeling was that the patient was hopeless.

Although he thought so, Zheng Ren gave the patient a physical examination first.

After percussion, there was a moving voiced sound in the stomach. Zheng Ren estimated that there was about 2000ml of peritoneal effusion.

This amount of ascites, let alone cutting the liver, can't be done even if it is involved in this minimally invasive operation.

Zheng Ren looked at the patient's raised navel, especially helpless.

Professor Yang is the same, but he is a classmate with the patient and is completely different from other patients.

His face was stiff and full of unhappiness.

Zheng Ren nodded, looked at Professor Yang's eyes, and turned out.

"Brother Yang, the patient's condition is not good. Portal vein embolization can't be done." After going out, Zheng Ren bluntly told Professor Yang.

Professor Yang naturally knew. He sighed and said, "I told him to stop drinking and talk to him again. If it didn't work, I couldn't help it."

Hepatocyte growth factor mainly acts on portal vein. Portal vein ligation can make hepatocytes proliferate, which has been found since 1920.

Once upon a time, portal vein ligation was a major operation.

After interventional surgery, direct embolization of portal vein branches is OK.

Embolizing the branches of portal vein to proliferate the contralateral lobe of liver, so that the residual liver can compensate for the liver function after hepatectomy.

After portal vein branches are embolized, hepatocytes can undergo dedifferentiation and clonal proliferation.

If the residual liver is normal, up to 75% of the liver can be removed and the patient can still survive. But the patient's alcoholic liver... Can't remove so many livers. However, patients do not need to remove 75% of the liver, just remove the tumor.

However, there are strict requirements for portal vein embolization. A large amount of ascites is one of the contraindications.

Theoretically speaking, the benefit of portal vein branch embolization on the affected side before partial hepatectomy is not only to make the residual liver hyperplasia and hypertrophy, but also to avoid the damage to the residual liver caused by the sudden increase of portal vein pressure caused by partial hepatectomy.

There are many benefits. This is also one of the projects that hepatobiliary surgery and interventional department can cooperate with.

"Brother Yang." Su Yun smiled behind his back and said, "I saw you sneaking in the morning. That's all?"

At this point, Professor Yang's footsteps paused and then smiled, "how can I? Did director Kong say it?"

Su Yun despised the chicken thief.

If you have something to say, ask director Kong first whether he said it or not. There is more careful thinking inside.

Zheng Ren didn't feel anything and said with a smile, "I said."

"Boss Zheng, I'm not polite to you. What do you think of this?" Professor Yang asked immediately.

"Find a place, smoke a cigarette and say in detail." Zheng Rendao.

Come to the duty room.

It was in the morning that they all went for surgery. The duty room was empty and there was no one.

After closing the door, Su Yun smoked. Zheng Ren directly asked, "brother Yang, we are our own people. We don't hide and tuck in. Do you need anything here?"

At the beginning, Professor Yang and director Luo of the Department of Gastroenterology were the first to support themselves.

In return for your kindness, there should be such a question.

Professor Yang was a little nervous, but when he saw that Zheng Ren was very serious and serious, he thought and said, "this is not Deputy Director Tian of Corey. I'm going to quit. I'm thinking about competing for this position."

Zheng renleng for a moment. Unexpectedly, this is the reason.

But scientific research has nothing to do with the deputy director. It doesn't mean that if scientific research is done well, the deputy director doesn't run away.

"Other conditions are not bad, level... You must be unable to compare with boss Zheng, but compared with other people in Corey, we are not afraid of anyone." Professor Yang said frankly: "there is a lack of momentum."

Zheng Ren and Su Yun didn't speak. They quietly waited for Professor Yang to finish in one breath.

"It's not that I saw you recently. I communicated with you quite smoothly in the hospital... To be honest, I just want to get your light from boss Zheng." Professor Yang said frankly, staring straight into Zheng Ren's eyes.

This is very true. Zheng Ren smiled and said, "brother Yang, at first, you have great support for me. If you have difficulties, I will certainly help."

Professor Yang knew there would be, but he listened attentively.

"The operation should be broadcast live. Can you accept this?" Zheng Ren asked.

"Yes." Professor Yang beamed, "live broadcasting is the best!"

It is estimated that Professor Yang has other Olympic aid, but it has nothing to do with himself. Zheng Ren nodded.

"What does director Li think?"

"Director Li supports me." Professor Yang said: "as long as you agree with boss Zheng, I will start to collect the patient immediately. Interventional surgery will be performed on my hospital bed and resected after a period of time."

"OK."

There's nothing they can hide about this. They take what they need.

"Boss Zheng, won't you delay your Nobel Prize project?" Professor Yang finally asked uneasily.

This is what he is most worried about. After all, 912 a director is far behind the Nobel Prize in medicine.