Chapter 417 Split Liver

"The liver is squeezed out. It's at least a grade III trauma." After Huo Congjun opened his abdomen, he saw a surge of blood in the abdomen. Two little doctors tried desperately to suck it out, barely exposing it.

Zuo Liangcai stretched out his head, and said, "It's a blunt liver trauma, with irregular ruptures, and the inferior vena cava was also ruptured."

"The duodenum is also ruptured." Huo Congjun looked all the way down, frowning tightly.

"Blood loss is rapid." The anesthesiologist reported.

Huo Congjun said "En", and said again: "The gallbladder is also ruptured, it has to be cut off."

"It can only be cut off." Zuo Liang agreed.

Huo Congjun looked through the situation in the abdominal cavity quickly and lightly, and while repairing the inferior vena cava, he said: "The right lobe is seriously damaged, what do you think should be done?"

"Block the hilum of the liver, bluntly split the liver tissue with vascular forceps, ligate and cut off the blood vessels and bile ducts, and then perform a right trilobite resection." Zuo Liang was the quickest answer.

However, after hearing what he said, all the doctors present smiled knowingly, including the other little attending who was waiting beside Sansuke, who didn't even touch Sansuke.

Everyone's smiles are naturally not an encouragement to Zuo Liangcai. For Zuo Liangcai, who likes to read inspirational books and always fights for every opportunity, most middle and low-level doctors don't particularly have a good impression of him.

Everyone's smiles at this moment are the same as the reason why everyone dislikes Zuo Liangcai - this gentleman is too careful.

It was as if he intentionally or unintentionally omitted the fingering method in his answer to Huo Congjun.

Blunt splitting of liver tissue can be handled by finger pinching. When blocking the portal of the liver, the finger pinching method can also be used to solve the problem.

As for the reason why Zuo Liang didn't talk about the pinching method, everyone can easily think that Ling Ran's technique of hemostasis with bare hands is so famous that he has published papers. power will be greatly increased.

However, the reason why small thoughts are small thoughts is that small thoughts are always useless.

Only then did Zuo Liang think of hiding the fingering method, and everyone could see through him, so that doctors who didn't think the fingering method was better had to think deeply about the advantages of the fingering method...

Huo Congjun would not forget about Ling Ran's skills just because Zuo Liang didn't mention it.

In fact, Huo Congjun thought deeper.

"According to this method, it will be a regular liver resection." Huo Congjun summed up Zuo Liangcai's words at once, then turned to Ling Ran, and asked, "What do you think? Are you going to have a regular liver resection?"

"Debridement is more suitable." Ling Ran replied.

Zuo Liangcai curled his lips: Huo Congjun asked this question, and the answer is naturally obvious. Where do you need to answer again.

"Doctor Zuo, please tell me the advantages and disadvantages of regular liver resection and debridement resection." Huo Congjun called Zuo Liangcai's name fiercely.

This question is a little bit difficult. People who have not read the book cannot answer it, but those who have read the book can easily answer it.

Zuo Liangcai got a little more balanced in his mind, and said: "Regular resection is performed according to anatomical divisions. The overall resection area is relatively large. If the patient does not tolerate it, postoperative complications and even death are likely to occur. Debridement The resection is irregular, which does not conform to the distribution of liver segments or lobes. During the operation, the blood vessels and biliary tract must be ligated continuously, but the liver tissue can be preserved to the greatest extent. However, the degree of involvement of different functional areas of the liver has put forward a test... ..."

"Another point is that regular liver resection requires high technology. If one is not good, it is easy to make mistakes." Huo Congjun paused, and said: "We need to hurry up, so we use debridement resection. Ling Of course, you will be my assistant, Doctor Zuo, and you will deal with the duodenum."

"yes."

The junior doctors responded quickly, but some had normal expressions, while others were unwilling.

Ling Ran stood opposite Huo Congjun and acted as a help.

Huo Congjun looked at the monitor and said to the anesthesiologist, "Pay close attention to the acid level."

"Yes. It's currently 6." The anesthesiologist said.

"Pay attention to supplementing sodium bicarbonate." Huo Congjun said, then bowed his head and said: "Emergency liver resection, let's hurry up."

"yes."

"Electric knife." Huo Congjun slashed in the direction of the split liver, lowered his head and said, "I'm going to remove the bloodless liver tissue now, Ling Ran, do you know what to do?"

"Ligate the severed blood vessels and bile ducts." As Ling Ran spoke, he started to do it.

For a contestant who had done hundreds of finger replantations, suturing blood vessels was as easy as eating and sleeping, and the doctors next to him also had incomparable trust in Ling Ran.

Everyone has seen those patients who come and go with severed fingers replanted. Now when we talk about Yunhua Hand Surgery, everyone will naturally add the emergency department of Yunhua Hospital, and even mention it by name. To Ling Ran.

That is to say, for ordinary people, the frequency of emergencies for replanted severed fingers is too low, otherwise, Ling Ran's reputation would not be limited to industrial areas.

But for doctors, it is their own ability to judge another doctor's skill.

The operation time, the effect of the operation, the difficulty of the operation, the prognosis and so on are all taken into consideration by the doctors. In addition, the number is also a very important benchmark. Nowadays, even if Ling Ran is young, no one will question his level in replanting severed fingers or suturing tangs.

Not to mention blood vessels.

Huo Congjun also gave Ling Ran great trust, he did the incision himself, and let Ling Ran complete the more important work of ligation of blood vessels.

Ling Ran's fingers fluttered up and down.

He didn't need extra assistants, he just sewed and ligated his own hands, as fast as Huo Congjun.

Huo Congjun only thought that he was racing against time, so he nodded secretly in his heart.

Emergency liver resection, the most important thing is to be fast.

Because once the incision is made, the wound will become more severe. With the rich blood supply of the liver, the blood loss will be thousands of milliliters every minute.

At this time, the speed of stitching is very critical.

On the contrary, it is the place where the suture is not good enough. You can go back to double ligation after a while, and the effect will not be great.

"I'll make another cut, and then we'll go back and check." Huo Congjun also moved quickly, reminding Ling Ran by the way.

Ling Ran nodded, still flying his fingers, and quickly ligated the exposed blood vessels and bile ducts.

The spirits of both of them entered a state of tension, making the room silent for a while.

"You can't just rely on speed for the sake of speed." Zuo Liangcai muttered again. He couldn't see what was going on in the abdominal cavity, he could only see that Ling Ran and Huo Congjun were moving very fast, and he felt that Ling Ran seemed rough and rotten.

Huo Congjun didn't object to this, he nodded and said, "The ligation of large blood vessels still needs to ensure the quality."

"Yes." Ling Ran answered back and forth, without any change in movement or speed.

As the saying goes, you say what you want, and I do mine. For Ling Ran, if he always followed other people's advice, his life would have been messed up long ago. There are too many people willing and wanting to give him advice.

Huo Congjun didn't say any more, it was also very energy-consuming to complete the resection itself while preserving the liver tissue as much as possible.

After everything was cut, Huo Congjun dropped the scalpel and began to re-examine the blood vessels and bile ducts that Ling Ran had ligated from front to back.

"All the small blood vessels are ligated?" Huo Congjun was surprised.

"To avoid repetition." Ling Ran said.

"This... I'll take a look again..." Huo Congjun felt like he was a painter, Ling Ran was like a painter, the painter went forward to paint, and the painter followed behind, refilling the painting It's over.

The most amazing thing is that the details of the artist's paintings are almost perfect.

"You liver debridement, you're ready to go." Huo Congjun couldn't help sighing after seeing all the ligated blood vessels.

"It's slightly different from the blood vessels of the limbs, just get used to it." Ling Ran summed up his experience.

This time, Huo Congjun laughed out loud.

It is said that the vascular anastomosis is very close, but if it is done so quickly, can the characteristics of the liver be ignored? Can you not understand the anatomy?

"Practiced by yourself?" Huo Congjun asked.

Ling Ran said, "I understand."

"Hmm..." Huo Congjun didn't want to ask any more questions, seeing that the bleeding had stopped, he simply said, "I'll leave the rest to you."

"Yes." Ling Ran didn't even say a word of modesty, and started to deal with the wound after taking over.

What Zuo Liang saw was jealousy. He never had such an opportunity.

"Doctor Zuo is also here to help." Director Huo pulled Zuo Liangcai back to the position of the second assistant with one sentence.

"Yes..." Zuo Liangcai nestled into the operation area without the ability to resist.

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