Chapter 1008: : New ideas

After Chen Cang was ready, Ford and others also went to the operating room.
Several doctors and assistants came, but stood in the distance and looked at the operating table without talking.
Ford looked at the operating room, and suddenly caught Chen Cang's eyes, suddenly stunned.
What does this look mean?
Kind of like ... encourage?
Ford was a little bit confused. It seemed that when he first entered the hospital, the teacher looked at him comfortably and said, "Learn hard!"
At this point, Ford's nurses took the equipment in, and it seemed ... ready to take over the operation at any time.
Although pancreaticoduodenectomy is a more effective treatment for tumors such as pancreatic cancer, its efficacy is still not satisfactory.
Especially pancreatic head cancer is the worst!
Several other types of cancer are slightly better, but the total surgical resection rate is only 30, and the surgical mortality and cure rate after five years of resection are only about 10.
Therefore, this requires a high degree of precision of the operation, and every link should be done well.
Again, this is where the confidence of Ford and others lies. They have sufficient clinical experience and coping strategies!
Even in the field of digestive tract reconstruction, there have been considerable developments.
Ford looked at Chen Cang and saw that he looked calm and calm, which made him a little more curious.
The young man seemed not nervous at all, did he not know the difficulty of pancreaticoduodenectomy?
Perhaps ... the ignorant are fearless!
Ford believes that he can discover many of Chen Cang's deficiencies and errors during the operation, and he will even write a paper specifically for publication in the journal of the American Medical Association.
Surgery is about to begin!
The anesthesiologist is the director of the anesthesiology department, and has had enough communication before to perform laparotomy.
The choice is continuous epidural anesthesia, which maintains for a long time, the response is small, the abdominal muscles relax well, and it is easy to reveal.
Seeing this scene, Ford almost couldn't help laughing. Are you all ready to open an abdomen for a pancreaticoduodenectomy?
Now this operation, Mayo is basically all endoscopic surgery!
Ford suddenly felt a sense of dimensionality reduction ...
"Dr. Chen, are you going to have an abdomen?" Ford couldn't help asking.
Chen Cang did not look back, but looked at the nurse on the side and said "scalpel!"
Seeing this, Ford blushed suddenly.
Chen Cang had already discussed this matter with the anesthesiologist. Choosing laparotomy is a necessary step to decide whether it can be removed!
Because the old man was very early, and did not even have much transfer, so Chen Cang's initial plan was to retain some tissue and remove some tissue.
This is also a surgical plan he has been researching and exploring recently.
If traditional pancreaticoduodenectomy is used, according to the physical fitness of the elderly, plus long-term diabetes, Chen Cang dares to guarantee that the survival period will not be too long.
Even a perfect pancreaticoduodenectomy is useless!
This is a flaw in the operation itself.
This is also the reason why Chen Cang fights for surgery, because he knows that if Ford does it, it must be completely removed. This is not much different from ordinary people. The only difference is that Ford can do when the digestive tract is reconstructed. It is relatively better.
This is the gap between Ford and Chen Cang.
When Chen Cang's pancreaticoduodenectomy was perfect, with the quasi-perfect biliary and intestinal anastomosis ... perfect gastrointestinal anastomosis, etc., this made Chen Cang aware of one thing.
That is the incompleteness of the operation itself.
The more in-depth research, the more Chen Cang found the incompleteness of the operation.
There is no perfect operation, but it is the dwarf who pulls the general. When it is absolutely necessary, he can perform the operation better, and the relative probability of complications is a little lower.
Therefore, Chen Cang didn't pay any attention to Ford, and he needed a surgery.
After taking the scalpel, Chen Cang made an incision in the middle of the old man's right upper abdomen.
The incision is not large, but this position is just convenient for up, down, and extension, revealing the entire digestive tract.
After the abdominal cavity was exposed, Chen Cang began to check it.
The size of the gallbladder is normal, which is a good thing. The cancer of the head of the pancreas will not oppress the bile ducts and cause gallbladder lesions.
When Chen Cang touched the pancreatic head with both hands, he clearly felt a burst of information.
[Pancreatic head cancer is very early, it is recommended to remove it! 】
After feeling the mass of the pancreatic head, the next thing Chen Cang had to do was to open the duodenum to clearly identify the development of pancreatic head cancer.
This operation is dangerous, it is easy to spread the tumor or intestinal bacteria into the abdominal cavity, and it should be avoided if not necessary.
Sun Guangyu looked at Chen Cang nervously, and the atmosphere did not dare to sip.
Although he had talked about the operation plan, he was still a little nervous.
Ford is also dumbfounded!
Chen Cang is dancing on the tip of the needle!
After seeing the internal structure clearly, he was finally relieved.
The next thing to decide is whether to remove it, which can be radically removed.
Check whether the cancer itself has crossed the gland and invaded the portal vein, superior mesenteric artery and vein, abdominal aorta, inferior vena cava and other important blood vessels.
At this time, Chen Cang directly incised the posterior peritoneum outside the duodenum and turned the duodenum and pancreatic head inward!
Then, carefully use your left finger to explore the gap between the dorsal side of the pancreas head and the ventral side of the aorta and inferior vena cava.
It is easy to extend the finger into this gap, indicating that the cancer is still confined to the pancreas and has not metastasized.
Luckily, there is no transfer!
This process requires three steps to check, but Chen Cang has done a dozen steps, he has taken into account all the places he can consider.
This ... is something endoscopic surgery can never do.
Refinement and precision.
Time went by one minute and one second, and Chen Cang checked it carefully.
Finally, the inspection is finished!
Chen Cang looked at the abdominal cavity, and the four-dimensional model began to simulate continuously. After two minutes, Chen Cang began to move!
Next, fully separate the organs to be removed.
And in such a critical link, Chen Cang suddenly did not separate the stomach, but began to free up the gallbladder!
Then ... Under the hemostatic forceps, he took the lead in cutting the Y-shape under the common bile duct and the pancreas with a knife.
Then a clever separation was carried out, at this time, the pancreas was suddenly free!
This inexplicable operation dumbfounded everyone!
At this time ~ EbookFREE.me ~ The head of the pancreas cannot be touched, and no matter whether it is duodenum, stomach or even bile duct surgery, it needs to be ligated before excision to prevent the spread of tumor cells.
But Chen Cang now separates the bile duct directly from the pancreas, so that the bile ducts are free!
This operation directly dumbfounded Ford behind him!
How is this going?
Chen Cang took a deep breath, just this step, he was cautious, afraid of causing adverse consequences, his eyes opened long ago!
Put yourself into it!
All he has to do is not to remove the bile duct, but to skillfully use separation to achieve a resection effect.
At present, the effect is good!
At least for a while, the anastomosis of the gall bladder is less difficult.
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