Chapter 948: Bleeding Heart
Zheng Ren did not say anything. He just changed his clothes in silence.
“Let’s go and take a look at the situation.” Chief Kong also took the time to change his clothes, put on a sterile hat, and quickly walked in.
He first went to the operating table, and Chief Kong began to review the images of the surgery process.
During the process of removing the stent, the angle was slightly off, and it touched the liver parenchyma, causing a small artery to rupture and bleed.
This was also the reason why there was only one stent removed during the TIPS surgery in the past and no recycling was done.
Placing the second recycled stent and waiting for the patient to adapt to the blood ammonia situation before removing it and expanding the outflow tract was indeed a perfect idea. However, there were many difficult points in the process of removing the second recycled stent.
Zheng Ren only dared to do this because he had already reached the level of a legend in the skill tree of interventional surgery. However, before he could teach Zhu Liangchen many details, he tried to do it himself.
This matter…
Actually, it could not be said that Zhu Liangchen was completely wrong.
However, this kind of mistake was completely unnecessary.
He stood behind Chief Kong and watched the video of Zhu Liangchen performing the surgery. However, he went to the System space and selected the surgery training.
The System operating theater rose from the ground. Zheng Ren entered without hesitation.
His heart was bleeding.
Although there was still time for the surgery training, this was completely unnecessary ‘consumption’. Zhu Liangchen was a bastard!
Zheng Ren thought hatefully in his heart.
His heart was already bleeding. He did not waste the surgery training time and directly began the surgery.
Actually, with Zheng Ren’s interventional surgery level, he could have gone up on stage directly. However, this was, after all, an accident. Taking over Zhu Liangchen’s surgery on his own and doing it on his own were two different concepts.
Zheng Ren still chose to buy a safe time for the surgical training. If there were any problems, it would be better to let the experimental subject suffer in the operating theater.
Zheng Ren had studied this kind of complication a long time ago. Embolization was undoubtedly the best choice.
He first let the stent deflate a little. After the angiography, he immediately saw that there was blood flow.
Zhu Liangchen had already finished the puncture work. Zheng Ren began to super-select the arteries.
The liver of patients with advanced cirrhosis had atrophy, and the arteries had anatomic abnormalities due to various reasons. In addition, the spleen was large, and the coagulation mechanism was not good. Therefore, an hour or two of pressure from the covered stent to stop the bleeding did not have much effect.
The results of the angiography showed that the bleeding small artery was a fourth- and fifth-grade artery. It was very thin, and the super-selection was extraordinarily difficult.
However, for Zheng Ren, the difficulty of this super-selection was no more difficult than the interventional embolization of the prostate.
Crossing his left and right hands, Zheng Ren was very skilled and meticulous in the super-selection.
Because the liver function of patients in the late stage of cirrhosis was very poor, on top of the liver atrophy, so fewer embolizations were done so as to avoid causing liver failure in patients.
The guide wire entered, layer by layer, and finally came to the artery that was bleeding.
It was almost as if he was embolizing the point of bleeding. Zheng Ren was sure that even if his level of interventional surgery reached the prime level, he could only do this step.
There was nothing special about the surgery. It was just a test of the technique of the super-selection, embolization, and re-imaging.
Zheng Ren was very confident, but the System only gave him 85% of the surgical progress bar.
It was strange. Why was it like this?
After observing for a few minutes, Zheng Ren found that other than a small artery, blood was seeping out from the tunnel where the stent was placed.
This was the result of repeated friction, which resulted in a large area of damage to the liver.
Zheng Ren was also helpless.
Zhu Liangchen’s technique was not right, which caused even more side damage to the surgery.
What should he do? Zheng Ren felt a little helpless for a moment. Embolization of small arteries could solve a very big problem. The patient would be fine if he left the stage just like that. The problem of bleeding might get better very quickly, but it could also continue to bleed, causing the condition to deteriorate and eventually develop hemorrhagic shock.
He could not wait for the patient to heal himself. He had to solve this problem! Zheng Ren immediately made his own choice.
It was better not to try his luck. Although Zheng Ren had the bonus of luck, deep in his heart, he was disgusted by this.
After the super-selection, he found a few blood supply arteries at the location of the bleeding contusion, super selected, and embolized.
Zheng Ren was faced with a difficult problem. The more meticulous the super-selection was, the smaller the scope of hemostasis. In this case, he had to do more super-selection and embolism.
It was very difficult to obtain the greatest benefit and the least damage.
Fortunately, there was a lot of time for surgical training. Zheng Ren simply tested and did it bit by bit.
Fortunately, this was the operating theater of the System, so mistakes could be made.
As time passed, Zheng Ren gradually found a balance point. The location of the third- and fourth-grade small arteries that were embolized could avoid causing more damage to the patient, but it could also successfully stop the bleeding.
However, Zheng Ren felt a little sorry for wasting the time of the surgical training.
Fifteen hours later, Zheng Ren finally saw that the surgical progress bar had reached 97%.
That was it. No matter how many platelets there were, it would be difficult to achieve.
After all, the patient’s platelets were less than half of the normal person’s. Under such circumstances, reaching 97% of the surgical progress bar was almost the limit.
He glanced at the simulation mannequin and felt a little regretful.
He turned around and left the operating theater of the System, returning to reality.
Chief Kong finished flipping through the course of the surgery and said in a low voice, “Old Fifth, Boss Zheng and I will go up. You take a rest.”
Zheng Ren quickly went to scrub his hands.
He could not wait for the Professor to finish his preparations before going up on stage with Chief Kong, just like Rudolf Wagner.
He still had to show respect to the old chief.
Seeing Zheng Ren run off to wash his hands and get ready, Chief Kong took a deep look at Zhu Liangchen and shook his head slightly.
Zhu Liangchen felt his mouth dry and his tongue dry. He was a little embarrassed, but he was also a little dissatisfied with Zheng Ren’s arrival.
All kinds of complicated emotions interweaved. He lowered his head and did not look at Chief Kong.
Chief Kong did not do anything. He scrubbed his hands and went on stage.
“Boss Zheng, you do it.” After Chief Kong went on stage, he stood directly at Zheng Ren’s hand and pushed him into the position of the surgeon.
Zheng Ren did not continue to be polite. He directly stuffed the micro-guide wire into it and began the super selective arteriography plus arterial embolization.
In the operating room, Zhu Liangchen was stunned as he looked at the old man and the young man at the operating table through the lead-lined glass.
Did he make a mistake? He did not think so.
It must be a problem with the surgical design. Two membrane-covered stents should not have been placed in the first place!
The second stage of the surgery was very difficult. It completely violated the rules of TIPS surgery that had been performed for so many years.
Zhu Liangchen tried for a long time, but he did not use too much violence. They were all old doctors who had performed hundreds of TIPS surgeries. They all knew in their hearts that violence would definitely not solve the problem.
They might be able to remove the membrane stent with violence, but it would definitely cause massive bleeding. In the end, Zhu Liangchen had no choice but to call Chief Kong and ask for help.
He would be able to stop the bleeding successfully, right? Zhu Liangchen began to look forward to it.
As for the future, it was better not to touch the TIPS surgery. Even if it was modified, the risk was too great.