Chapter 532: : Expert fee ... (Mon./Sat.)

At this time, the atmosphere in the operating room was depressed!
Director of Emergency Department Ji Qu and Director of Hepatobiliary Surgery Yang Zhiming and Director of General Surgery Qi Xiao gathered together in the operating room, eyes meticulously staring at the situation in the abdominal cavity, dare not care at all!
At this moment, Shen Xiuyuan realized how sloppy his behavior was ...
Looking back carefully, I was caesarean. I was afraid after a while, the cold sweat was seeping out, and the clothes inside were soaked.
If you move a little more, you may not be able to control the situation now ...
However, the open abdomen had already been opened. Although sharp wooden forks could be seen penetrating into the abdominal cavity, but everyone did not dare to move rashly.
Even the sound of breathing in the operating room became loud.
The director of the emergency department planned to frown and frown. Through the projection of the shadowless lamp, you can clearly see that sharp wood penetrated the intestine. Although the fecal-like secretion did not spread at this time, it was entirely because the sharp wood penetrated into the bowel Road wound blocked!
Intra-abdominal exploration should be continued, and the pace of surgery cannot be stopped because of this.
Ji Qu Shensheng said: "No bile-like fluid was found in the abdomen!"
"No major vascular injury was found."
"The liver clearly penetrates the wound and the bleeding is less pronounced."
...
The exploration was carried out step by step and carefully, and at this time, Yang Ziming, director of hepatobiliary surgery, suddenly said, "Don't move!"
In a word, Ji Qu was stunned, and even Qi Xiao, the director of general surgery, looked at Yang Ziming.
Yang Ziming swallowed saliva: "There is a broken branch residue in the common hepatic artery, and there is a clear puncture in the wound near the hepatic vein. Now you can easily cause heavy bleeding if you disturb it!"
In a word, Ji Qu could not help but stop the operation in his hand.
After a while, Ji Qu couldn't help but asked, "Is it good to bleed and stop bleeding? Now I don't deal with it, when the intestine is completely ruptured, the feces spread out, and the entire intra-abdominal infection cannot be controlled."
Indeed, the reason is such a reason. After all, feces have a strong infectious power. At this time, the abdominal cavity has already entered because of foreign bodies. If the contents of the intestinal tract are leaked out, the abdominal infection is very troublesome!
In general, visceral damage is not impossible to save, and it should be carried out slowly according to the principle of "stop bleeding and repair later."
Yang Ziming said sharply: "Infected, it can fight the infection, but the hepatic vein is about to break, and no one can save him here!"
The sound was not loud, but it sounded like thunder in the ears of everyone!
Proximal hepatic vein injury is not a vein, but refers to the injury of the main hepatic vein and the posterior hepatic inferior vena cava.
Due to the special anatomy of the posterior hepatic region and the difficulty in handling, near hepatic vein injury is still one of the most difficult problems in the field of liver surgery.
Yang Ziming was not appalling, but took a deep breath and said solemnly: "Let's say, the average mortality rate of near hepatic vein injury is 83%, and it is the operating room mortality rate, do you understand?"
For a moment, he understands that the 80% mortality rate is very high, but ... the operating room mortality rate is a little daunting!
After all, it is a highly professional case, and Ji Qu is not very familiar with even the director of emergency surgery.
"Can't you ... do it?"
Yang Ziming blushed and laughed at himself: "Don't talk about me. There are no more than three people in Dongyang who can do it, and ... this can only be done, not necessarily."
"I'm not kidding. Injuries near the hepatic veins can cause fatal bleeding. The walls of these large veins are thin and some are surrounded by liver tissue, so ... both surgery and repair are difficult!
And the most important thing is that its anatomical position is not easy to reveal behind the liver. If the surgical operation under direct vision results in more severe bleeding and the risk of air embolism;
And ... if you stop bleeding blindly, you can aggravate the damage! "
Yang Ziming finished speaking, sighed, and slowly said, "Did you say that it is dangerous?"
One word silenced everyone!
Never dare to explore further.
Yang Ziming glanced at Shen Xiuyuan and asked, "Did you get a bookmark for the critical notice?"
Shen Xiuyuan nodded: "Signed!"
Yang Ziming said, "If the condition changes, go to sign another one. Also, the condition notification letter, tell the patient the risk ..."
"Yes, you go in person."
The critical illness notice is not only signed once, but if you find other new and more dangerous diseases, you must sign and inform!
Shen Xiuyuan quickly took off his gloves, picked up his medical record, tore two signatures outside, and after writing a few words, he hurriedly went outside!
At this point, Chen Cang and his team sat at the door of the operating room and comforted Lao He's wife. A critical notice just now really scared the woman.
Chen Cang calmed down: "Well, any risky operation in the hospital will let you sign the consent form. You must know that the operation itself is risky. This is the process. Don't worry, it's okay!"
But no matter how calm Chen Cang was, she couldn't help frightening.
At this time, the door of the operating room opened again, and Shen Xiuyuan hurried out and said to Lao He's wife, "Hello, the patient's condition has changed, and I found that there is a wooden bifurcation near the hepatic vein. The situation is dangerous and requires your signature. "
In a word, she was so frightened that she lost her heart instantly. One sentence was very dangerous and broke the woman's psychological defense.
It's only been a few days since the good days have just passed since the son and daughter got married.
The woman was at a loss for a moment.
But Shen Xiuyuan was helpless, looking at the woman, and was persuaded again.
Chen Cang Yiyi ~ EbookFREE.me ~ asked: "Can the hospital perform this operation?"
Shen Xiuyuan then thought of this doctor-like Chen Cang and shook his head: "We may not be able to guarantee it, but ... if you are not assured ..."
At this time, Yang Ziming came out personally and said to Lao He's wife: "Yes, the patient's condition is very dangerous. Although it can still be safe now, there may be accidents at any time. Our hospital does not have this. Capability for surgery. "
"If I am transferred, I am worried that the patient's condition may not be tolerated, and accidents may occur in the car, so it is best to invite an outside expert."
Lao He's wife took a deep breath and made herself want to calm down: "Doctor, you must save our family, Lao He, I ... what do I know as a farmer?"
Yang Ziming sighed: "Our hospital has always been in contact with the Department of Hepatobiliary Surgery of the Second Affiliated Hospital of Dongda University in Ammonium. We can ask the other party to perform the operation, but ... you may need to pay expert fees because of this situation ..."
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