Chapter 776: Intraoperative cholangiography + capillary bile duct anastomosis

"Boss, slow down, look at the halo." Su Yun stood on the right side of Zheng Ren, subconsciously sighed and said.
"Fortunately, not too fast." Zheng Ren removed the left liver, and a pathological specimen appeared on the left hand side.
The left liver, which is full of hydatid, is placed in the basin, and patients with intensive phobias will become ill only with one glance.
The Xie Yi people greeted the visiting nurses, carefully throwing the left liver into the yellow garbage bag to avoid contaminating the sterile area.
The Xie Yi talents breathed a sigh of relief until the left liver, which was full of hydatid, disappeared.
It’s scary to take this liver...
At the same time, Zheng Ren quickly removed the uw solution from the portal vein after removing the diseased liver.
Uw liquid is a liquid used to preserve donor organs during organ transplantation. It mainly contains lactobionic acid, which is a major non-permeable anion with a relatively large molecular weight.
It reduces the swelling of cells during cold storage and contains cotton candy, hydroxyethyl starch and adenosine.
On the other side, portal resection and artificial pipe repair have also begun.
Zheng Ren gave half of his energy to stare at the operation of vascular surgery. Seeing that the block was cut, cut, and sutured smoothly, he was relieved.
After all, Su Yun is a doctor who has done a heart transplant. This is not a joke.
The heart transplant of a mouse is definitely more difficult than a human heart transplant. Because the diameter of the blood vessel is fine, the suture requires a microscope.
The portal vein segment containing the hydatid embolization was removed, and the portal vein was replaced by an artificial blood vessel. The difficulty of suturing was not comparable to that of a heart transplant. The hardness of the portal vein is relatively high and it is less difficult to suture.
Zheng Ren knows that Su Yun can do it. In the system operating room, the relevant steps are not detailed.
Originally he wanted to be a substitute himself, just to prevent it. However, Su Yun did not give him this opportunity. He and the package director were particularly smooth.
The liver invaded by the liver hydatid was cut off, and the remaining liver of the patient was small and poor.
"It will be a long time after liver failure." The doctor at the stands could not help but ask.
"The liver volume is 1/3 of the original, and there is a high probability of liver failure."
"What is the significance of this operation?"
Yes, what is the significance of this operation? After stepping down, liver failure will inevitably occur, and the chance of survival of the patient is less than 5%.
Is it necessary to have surgery?
Even a normal person, cut off such a large volume of liver tissue, afraid that it can not stand. What's more, this patient has a right kidney segment, a segment of the lung, a partial resection of the pericardium, and a resection of the superior vena cava and a diversion...
This series of operations, traumatic blows are very huge.
Plus preoperative patients have septic shock...
Even in 912, many surgical professors faced such a situation, and they were all half-cooled.
Professor Yang’s colleagues in the heart and behind the whispers are an idea, but he can’t stop.
The opposite assistant is as calm as ai, and he can't keep up with his concentration, let alone discuss the postoperative problems with others.
The most important thing is that although the surgery has gone through a few hours, it has not yet reached the most critical steps.
Autologous liver transplantation can solve the problems of colleagues. However, autologous liver transplantation is the hardest!
If it is not considered rejection, only the difficulty of surgery, the difficulty of autologous liver transplantation far exceeds that of ordinary liver transplantation.
Ordinary liver transplantation can be done with a large blood vessel and a liver tube. The difficulty of surgery is actually very large. But when Professor Yang had a liver transplant, he could get it.
When the patient was sent, his first consideration was liver transplantation. Who can think that the patient has an ruptured cyst wall in the emergency department, leading to septic shock.
It is too late to wait for the liver source, only autologous liver transplantation.
When thinking about autologous liver transplantation, Professor Yang was desperate.
Large and small hepatic ducts, blood vessels...
Professor Yang has also tried this difficult operation. Although successful, he is not satisfied with his performance. Originally, I planned to hone my skills and then hit the last barrier of the hepatobiliary surgery again. I didn't expect a case of surgery falling in the sky and forced him to the operating table.
"Mr. Yang, cut the liver eight paragraphs, how do you see?" Zheng Ren gave Su Yun a handle, and took advantage of the intermittent period, the guest said.
Professor Yang’s hand is hemp.
Cutting the liver eight segments is indeed the best choice now. Judging from the condition, the eight segments of liver are intact but not the most important liver. If you can successfully do autologous transplantation and become the left lobe of the liver, surgery can be said to be a great success.
however……
Because the liver is running low, liver function is severely impaired, and the operation time must be controlled within 2 hours.
This is not the same as ordinary autologous liver transplantation, which is more difficult than that, and unimaginable.
Professor Yang took a chance and sighed and asked: "Zheng boss, are you sure? Actually, I have no grasp at all."
Hearing Professor Yang said that the operating room was silent again.
The difficulty of surgery, everyone is watching, no one will say that Professor Yang is not enough. The patient is too sick and the manpower is always exhausted.
Can you sigh only once?
Such a wonderful operation, if it did not succeed in the end, it was too disappointing.
"80% of the grasp." Zheng Ren saw Su Yun that side has begun to block the superior vena cava, to be removed and re-sewed, it is faint.
80%... Is this high?
Professor Yang is somewhat puzzled.
He looked up ~EbookFREE.me~ The cervical vertebrae made a squeaky noise because of the long-term posture.
Without taking a look at the cervical vertebrae, Professor Yang looked at Zheng Ren’s eyes and wanted to see if this was a joke.
"After doing intraoperative cholangiography, it is no problem to follow the bile duct. The fine bile duct can also be anastomosed." Zheng Ren said in a word, Professor Yang completely fainted.
In general, autologous liver transplantation is anastomosed to the bile duct, just a thick bile duct, and the remaining capillary bile duct will self-close. Drainage should be performed after surgery to avoid complications such as infection.
But what did you hear?
Intraoperative cholangiography? Then have to match the capillary tube? !
This...This kind of surgery has been heard by Professor Yang, but only the class-level characters will do it once they prove that they can do it.
In theory, it works. But in this case, can someone do it?
"Zheng... Zheng boss, you are not kidding." Professor Yang began to stutter.
In his opinion, this is a joke.
"Cut the liver eight segments, ready to transplant, the patient's vital signs are not very stable, we have no time." Zheng Ren glanced at the ECG monitoring, said.
"You come to me?" Professor Yang said this again.
"You come first, after a angiography, I will assist you with an autologous liver transplant." Zheng Ren's eyes blinked and seemed to be smiling.
On the operating table, it was a shame to be robbed of the position of the surgeon!
However, Professor Yang listened to Zheng Ren and said that his heart suddenly disappeared.
He dares to say that the possibility of doing it will be great. If it is an ordinary young doctor, Professor Yang has already blasted him.
However, the opposite side of the station is the nominee doctor, the aura of the Nobel Prize is shrouded, and facing this situation, Professor Yang can only choose to believe.
"Good!" Professor Yang said with a grin.