Chapter 776: Intraoperative Cholangiography and Capillary Bile Duct Anastomosis
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“Boss, slow down. You’ll faint if you look at it,” Su Yun said as he stood on Zheng Ren’s right side and subconsciously breathed out air.
“It’s alright. It wasn’t too fast.” Zheng Ren removed the left liver, and a pathological specimen basin appeared on the left side.
If the left liver filled with hydatid worms was placed in the basin, the patients with phobias would get sick just by looking at it.
Xie Yiren called the circulating nurse and carefully threw the basin and left liver into a yellow garbage bag to avoid contaminating the sterile area.
It was not until the left liver that was full of hydatid worms disappeared that Xie Yiren let out a sigh of relief.
Taking this much liver…was really scary.
At the same time, after Zheng Ren removed the diseased liver, he quickly poured UW solution into the portal vein.
UW solution was used to preserve the donor organs during organ transplantation. It mainly contained lactose acid, which was the main non-permeable anion and had a relatively large molecular weight.
It could reduce the swelling of cells during cold storage. It also contained glutathione, hydroxyethyl starch, and adenosine.
On the other side, portal vein resection and artificial pipeline repair had also begun.
Zheng Ren divided half of his attention to the vascular surgery surgery. When he saw that the blockage, resection, and suture were very smooth, he was relieved.
After all, Su Yun was a doctor who had done heart transplants. This was not a joke.
Heart transplants in mice were definitely more difficult than heart transplants in humans. Because the diameter of the blood vessels was small, a microscope was needed to suture them.
However, to remove the segment of the portal vein that contained hydatid emboli and replace the portal vein with an artificial blood vessel, the difficulty of suturing it could not be compared to heart transplants. The hardness of the portal vein was higher, so the difficulty of suturing it was lower.
Zheng Ren knew that Su Yun would definitely be able to do it. In the operating theater of the System, the relevant steps were not trained in detail.
Initially, he wanted to be a substitute, just in case. However, Su Yun did not give him this opportunity. He and Chief Bao cooperated very smoothly.
After cutting off the liver that had been invaded by the hydatid worms, the remaining liver of the patient was pitifully small.
“Will the liver fail a long time after the operation?” someone in the grandstand could not hold it in anymore and asked.
“The volume of the liver is one-third of the original size. There is a high probability that the liver will fail.”
“Then what’s the significance of this surgery?”
What was the significance of this surgery? After the surgery, the patient would definitely suffer from liver failure, and the chances of the patient surviving were less than 5%.
Was there still a need for surgery?
Even a normal person would not be able to withstand the loss of such a large volume of liver tissue. Furthermore, this patient had his right kidney segmented, his lungs segmented, his pericardium partially resected, and his superior vena cava resected and rerouted…
The trauma of this series of surgeries was huge.
In addition, the patient had gone into septic shock before the surgery..
Even in the face of such a situation, the hearts of many professors of the surgical department had turned cold.
Professor Yang had the same thoughts as his colleagues who were whispering behind him, but he could not stop at all.
The assistant opposite him was as calm as an AI. He could not keep up with him, even if he was fully focused, let alone discuss the post-surgery problems with others.
Most importantly, although the surgery had already undergone a few hours, it had yet to reach the most crucial step.
The autologous liver transplantation could solve the questions of his colleagues. However, the autologous liver transplantation was the most difficult!
If the rejection was not considered, the difficulty of the autologous liver transplantation was far greater than that of the ordinary liver transplantation.
The ordinary liver transplantation could be done as long as the large blood vessels and liver tubes were anastomosed. The difficulty of the surgery…was actually very high. However, Professor Yang had performed a liver transplant before, so he could totally get it done.
When the patient was sent over, the first thing he considered was a liver transplant. However, who would have thought that the patient would have a rupture of the hydatid cyst wall in the emergency room, resulting in septic shock.
There was no time to wait for a liver source, so he could only do an autogenous liver transplant.
When he thought of an autogenous liver transplant, Professor Yang’s heart was filled with despair.
Large and small liver tubes, blood vessels…
Professor Yang had tried this kind of difficult surgery before. Although he had succeeded, he was not satisfied with his performance. He had originally planned to hone his skills and then once again tackle the final barrier of the Department of Hepatobiliary and Pancreatic Surgery. He did not expect that an extremely difficult surgery for an autologous liver transplant would fall from the sky and force him to the operating table.
“Professor Yang, how do you feel about cutting the liver into eight pieces?” Zheng Ren gave Su Yun a hand as he said politely during the interval.
Professor Yang’s hand was numb.
Cutting the liver into eight pieces was indeed the best choice at the moment. Based on the condition of the liver, eight pieces of the liver was considered intact, but it was not the most important part of the liver. If he could successfully perform an autologous transplant and form the left lobe of the liver, the surgery could be said to be a great success.
However…
Because there was not much left of the liver, the liver function was severely damaged, and the operation time had to be controlled within two hours.
This was still different from a normal autotransplantation. It was more difficult than that, and it was unbelievably large.
Professor Yang moved his hand, sighed, and asked, “Chief Zheng, are you confident? To be honest, I’m not confident at all.”
Upon hearing Professor Yang’s words, the operating theater fell silent again.
Everyone saw the difficulty of the surgery. No one would say that Professor Yang was not good enough because of this. The patient’s condition was too serious. There would always be a time when human resources were exhausted.
Could he only sigh?
If such an amazing surgery did not succeed in the end, it would be too disappointing.
“Eighty percent sure,” Zheng Ren said lightly when he saw that Su Yun’s side had already started to block the superior vena cava and was about to be resect and suture.
Eighty percent… Was that high?
Professor Yang was a little puzzled.
He raised his head. Because his cervical vertebra had been in a posture for a long time, it made a squeaking sound that made one’s teeth ache.
Professor Yang did not have the time to move his cervical vertebra. He looked into Zheng Ren’s eyes, trying to see if it was a joke.
“After the intraoperative cholangiography, there will be no problem in anastomosing the bile duct. The thin branch of the bile duct can also be anastomosed.” Zheng Ren’s words completely knocked Professor Yang out.
Generally speaking, autogenous liver transplantation was anastomosing the bile duct. It was only a thick bile duct, and the remaining bile duct would close by itself. After the surgery, drainage was needed to avoid complications like an infection.
But what did he hear?
Intraoperative cholangiography? And then anastomosing to the capillaries?!
This… Professor Yang had heard of this kind of surgery, but only a master would do it once when he proved that he could do it.
In theory, it could work. But, under such circumstances, would anyone be able to do it?
“Chief… Chief Zheng, you’re not joking, right?” Professor Yang began to stutter.
In his opinion, this was just a joke.
“Cut the liver into eight pieces and prepare for the transplant. The patient’s vital signs are not very stable. We don’t have much time,” Zheng Ren said, glancing at the ECG monitor.
“You’re coming to my side?” Professor Yang said again.
“You go first. After the contrast, I’ll help you with the autogenous liver transplant.” Zheng Ren narrowed his eyes, as if he was smiling.
It was a great shame to lose the position of surgeon at the operating table!
However, when Professor Yang heard Zheng Ren’s words, his heart suddenly relaxed.
Since he dared to say that, the possibility of him succeeding was very high. If it was an ordinary young doctor, Professor Yang would have coaxed him out long ago.
However, the person standing opposite him was a doctor nominated for the Nobel Prize. Under the halo of the Nobel Prize, and in the face of such a situation, Professor Yang could only choose to believe it.
“Okay!” Professor Yang said, gritting his teeth.