2310 Chapter 2312

The journey from Jinling to Fengxian County was not far or near, hundreds of kilometers, even if it was early in the morning and there was no traffic jam on the road, it was almost noon when Director Xia arrived at the Central Hospital.

Director Xia took a quick bite of the hamburger in the car, and when he arrived, surrounded by the patient's family, he took a look at the patient's film and the patient himself.

As imagined, the patient is already in the advanced stage of cancer and is dying.

Explain the condition to the patient's family again. The risk of operation failure is very high, and even if it is successful, it can only last about one year of life.

This is the point, if the patient's family members have illusions and try to cure, Director Xia turns around and leaves without saying a word.

The family members of the patient expressed their attitude, they just want the old man to receive the highest level of medical treatment within their capabilities, and life and death will be his fate afterward, the family knows this.

If so, go for surgery.

Director Li curled his lips when he heard that, he thought to himself, the best medical treatment is in front of you, but you don't know how to cherish it.

But this has nothing to do with him anymore. Boss Zheng's TIPS operations have been done, and he should be eating at this time, and then return to the imperial capital by high-speed train and plane.

It is really a pity to pass by Boss Zheng, whether it is the patient or himself, this is life.

Sending the patient to the stage, Director Li accompanied Director Xia from Jinling Cancer Hospital, chatting while taking the stage.

Director Li was shocked when he learned that Director Xia was going to perform the operation under laparoscope.

No wonder people dared to take this operation, this Director Xia has real skills.

Anesthetize, brush hands, get dressed and go on stage.

After establishing the pneumoperitoneum, Director Xia fiddled with the laparoscopic forceps twice, and then stood there in a daze.

Director Li could see very clearly that the intra-abdominal adhesions were very heavy, which could not be removed by laparoscopic surgery at all.

There is not even a surgical field, what kind of laparoscopy! (Note)

Then turn to laparotomy, you can't give up the operation if you can't do laparoscopic surgery.

Director Xia is not embarrassed at all. With his illness here, he insisted on doing it with strength.

Take a midline abdominal incision about 20 cm long, and cut into the abdomen layer by layer.

The surface of the liver, small intestine, and pelvis were checked again and no metastatic nodules were found; the gallbladder was about 8×3cm in diameter, and the diameter of the common bile duct was about 0.6cm. The gallbladder was resected retrogradely.

The surgery was done quite well, and the laparoscopic surgery was not seen, but the surgical operation proved that Director Xia's level is quite high.

The uneasiness in Director Li's heart calmed down slightly.

Director Xia opened the gastrocolic ligament along the edge of the colon, opened the peritoneum on the side of the duodenum, lifted the duodenum, and performed bimanual examination. Exploration revealed that the tumor in the uncinate part of the pancreas was 4cm in diameter, hard in texture, unclear in boundary, and fairly mobile.

It's just that as the operation progressed, Director Xia's face became more and more serious.

It's one thing to watch a film, but quite another to actually open it up and watch it.

The current surgery is definitely more difficult than the ones I have done before. The patient had heavy intra-abdominal adhesions, and it was too difficult to successfully remove them for surgery.

To do this, Director Xia tried hard not to think about the failure of the operation.

Continue to dissociate the head of the pancreas and the back of the duodenum, and check that the inferior vena cava is not involved. The root of the transverse mesocolon was probed, and no contracture was found.

But when the superior mesenteric vein was separated, Director Xia was stunned.

He opened the retroperitoneum at the root of the transverse mesentery and dissected along the direction of the superior mesenteric vein to find the vessels.

Then skillfully separate the branch vessels that flow into the superior mesenteric vein, suspend the blocking band, and separate the main trunk of the superior mesenteric vein upward along the vessel.

Macroscopically, the tumor was closely related to the superior mesenteric vein, and the confluence of the downward bifurcation of the superior mesenteric vein was involved.

all...involved...

Looking at the tumor and the superior mesenteric vein that were sticking together, Director Xia took a deep breath, and was about to start dissociation.

Of course, he knew in his heart that it would be too difficult for this kind of adhesion to swim away smoothly. At this moment, he had already begun to regret, why he was so obsessed with ghosts last night, he wanted to come over to change the knife, and he took this operation.

What a fuck!

Director Xia cautiously tried Liao, and subconsciously he realized that he had made a wrong choice. A large amount of adrenaline and dopamine are secreted in the body, the parasympathetic nerve is inhibited, the sympathetic nerve is excited, and directly enters a state of stress.

The sweat glands secrete a large amount of sweat, and the sterile cap is penetrated within 2′22″.

Director Xia turned his head, but this is not his own hospital, and there is no tacit understanding at all. No one understood the intention of his every movement, and he felt that his movement was stupid.

"Wipe your sweat." Director Xia said helplessly.

The itinerant nurse took a piece of gauze, wiped his sweat and asked in a low voice, "Director Xia, may I tie a piece of gauze for you?"

"Okay." Director Xia took this opportunity to relax his already tense sympathetic nerves.

He thought of the tumor and the superior mesenteric vein stuck together in the operation area, feeling helpless.

It's really obsessed, why did I rush to talk about Boss Xiao Zheng! It turned out to be a good thing, the boss Xiao Zheng escaped, but he was put on the fire to roast himself.

This is amazing!

Director Xia has a good temper and rarely swears at others. But the complicated situation made him irritable, maybe it was a side effect of the dormant parasympathetic nerve and the excitement of the sympathetic nerve.

A piece of gauze was tied on the outside of the sterile cap on the head, Director Xia concentrated on continuing the operation.

I hope I can do it,

Hopefully the tumor is less adhered to the superior mesenteric vein than the eye can see.

hope……

Director Xia had too much hope in his heart.

However, after 3 minutes and 12", all hopes were dashed.

The tumor was tightly adhered to the superior mesenteric vein, and the operation could not proceed.

"Do you have vascular surgery?" Director Xia asked in a deep voice.

"Uh..." Director Li hesitated for a moment, feeling a sense of pleasure that shouldn't have appeared in his heart.

But this kind of emotion was suppressed by him, and if the patient couldn't get off the stage, he himself had to take the blame. Although this blame was asked by the patient's family members, it is better not to recite it.

"Director Xia, we have vascular surgery, but the technical level is average." Director Li said bluntly.

Director Xia stopped the operation and looked at the operation area helplessly. The internal organs and blood stains were so dazzling under the shadowless lamp, his hands and feet were a little numb, and he was thinking about how to explain it to the patient's family.

In the quietness of the operating room, Director Li peeked at the electronic timer next to him. He waited for 3 minutes. Seeing that Director Xia hadn't spoken, he suggested in a low voice, "Director Xia, Boss Xiaozheng from the imperial capital hasn't left yet." , do you want to..."

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Note 1: This operation is quoted from a real operation in a top tertiary hospital in China, where laparoscopy was converted to laparotomy. Not all preoperative evaluations can correctly determine the surgical method, which is discussed separately.