Chapter 775 Intraoperative Cholangiography + Bile Capillary Anastomosis

"Boss, slow down, you'll feel dizzy." Standing on the right side of Zheng Ren, Su Yun subconsciously blew a breath and said.

"Fortunately, not too soon." Zheng Ren removed his left liver, and a pathological specimen basin appeared on his left.

Put the left liver full of echinococcosis in a basin, and intensive phobia patients will get sick just by looking at it.

The Xie Yi greeted the roving nurse, and carefully threw the basin and left liver into the yellow garbage bag to avoid contaminating the sterile field.

It wasn't until the left liver full of hydatids disappeared that Xie Yi let out a sigh of relief.

Taking this kind of liver...is really scary.

At the same time, after Zheng Ren removed the diseased liver, he quickly injected UW fluid from the portal vein.

UW fluid is the fluid used to preserve donor organs during organ transplantation. It mainly contains lactobionic acid, which is the main non-permeable anion and has a relatively large molecular weight.

It reduces cell swelling when refrigerated and contains marshmallow, hydroxyethyl starch, and adenosine.

On that side, portal vein resection and artificial pipeline repair have also started.

Zheng Ren devoted half of his energy to staring at the vascular surgery operation, and he was relieved when he saw that the blockage, resection, and suture went smoothly.

After all, Su Yun is a doctor who has done heart transplantation, this is no joke.

Heart transplantation in mice is definitely more difficult than heart transplantation in humans. Because the diameter of blood vessels is small, a microscope is required for suturing.

However, resection of the portal segment containing hydatid emboli and replacement of the portal vein with artificial blood vessels, the difficulty of suturing cannot be compared with that of heart transplantation. The hardness of the portal vein is relatively high, and it is less difficult to suture.

Zheng Ren knew that Su Yun would definitely be able to do it. In the system operating room, the relevant steps were not trained in detail.

Originally, he wanted to be a substitute himself, just in case. However, Su Yun didn't give him this chance, he cooperated with Director Bao very smoothly.

The liver invaded by hepatic echinococcosis was cut off, and the remaining liver of the patient was pitifully small.

"There will be liver failure for a long time after the operation." Some doctors in the stands couldn't hold back and asked.

"The volume of the liver is 1/3 of the original, and there is a high probability of liver failure."

"Then what's the point of this surgery?"

Yes, what is the significance of this operation? After stepping down, he will inevitably suffer from liver failure, and the chance of the patient surviving is less than 5%.

Is surgery still necessary?

Even for a normal person, cutting out such a large volume of liver tissue would probably be unbearable. What's more, this patient had a segmentectomy of the right kidney, segmental resection of the lung, partial resection of the pericardium, resection of the superior vena cava and diversion...

This series of operations, the traumatic blow is very huge.

In addition, the patient had septic shock before the operation...

Even on 912, many surgical professors felt a bit cold in the face of such a situation.

Professor Yang had the same idea in his mind as his colleagues who were whispering behind him, but he couldn't stop at all.

The assistant on the opposite side was as calm as an AI, and he couldn't keep up with his full concentration, let alone discuss postoperative problems with others.

The most important thing is - although the operation has gone through several hours, it has not yet reached the most critical step.

Autologous liver transplantation can solve the doubts of colleagues. But autologous liver transplantation is the most difficult!

If rejection is not counted, and only in terms of the difficulty of surgery, autologous liver transplantation is much more difficult than ordinary liver transplantation.

Ordinary liver transplantation only needs to anastomose large blood vessels and hepatic ducts, and the operation is very difficult...in fact, it is also very difficult. But since Professor Yang has undergone liver transplantation, he can definitely get it.

When the patient was sent, he first considered liver transplantation. But who would have imagined that the patient's hydatid cyst wall would rupture in the emergency department, leading to septic shock.

There was no time to wait for a liver source, so I had to do autologous liver transplantation.

At the thought of autologous liver transplantation, Professor Yang was filled with despair.

Large and small hepatic ducts, blood vessels...

Professor Yang has also tried this difficult operation. Although successful, he was not satisfied with his performance. Originally, he planned to hone his skills and then attack the last barrier of hepatobiliary surgery again. Unexpectedly, an extremely difficult operation in autologous liver transplantation fell from the sky and forced him to the operating table.

"Teacher Yang, what do you think of cutting liver to eight sections?" Zheng Ren gave Su Yun a helping hand, taking advantage of the interval, he said politely.

Professor Yang's hands are numb.

Cutting the liver into eight segments is indeed the best choice now. Judging by the condition, the eight-segment liver belongs to the intact but not the most important liver. If the autologous transplantation can be successfully performed and become the left lobe of the liver, the operation can be said to be a great success.

However……

Because there is not much left in the liver and the liver function is severely damaged, the operation time must be controlled within 2 hours.

This is still different from ordinary autologous liver transplantation. It is more difficult and unimaginable than that.

Professor Yang moved his hands, sighed, and asked, "Boss Zheng, are you sure? To be honest, I'm not sure at all."

Hearing what Professor Yang said, the operating room fell silent again.

Everyone can see the difficulty of the operation, and no one will say that Professor Yang is not good enough. The patient's condition is too serious, and manpower is always exhausted.

Can I just sigh?

It would be a great disappointment if such a wonderful operation did not succeed in the end.

"80% certainty." Zheng Ren said calmly, seeing that Su Yun's side had already started to block the superior vena cava, and it was about to be resected and sutured.

Eighty percent...is this high?

Professor Yang was a little puzzled.

He raised his head, and his cervical spine made a toothache creaking sound because he had maintained a posture for a long time.

Without thinking about moving his cervical spine, Professor Yang looked into Zheng Ren's eyes, trying to see if this was a joke.

"I'll do an intraoperative cholangiogram later. It's no problem to anastomose bile ducts. Thin-branched bile ducts can also be anastomosed." Zheng Ren's words completely stunned Professor Yang.

Generally speaking, autologous liver transplantation anastomoses bile ducts, which are only thick bile ducts, and the remaining capillary bile ducts will close by themselves. Postoperative drainage is required to avoid complications such as infection.

But what did I hear?

Intraoperative cholangiography? And then to anastomose the capillaries? !

This...Professor Yang has heard of this kind of technique, but only when a master-level character proves that he can do it, he will do it once.

In theory, it works. But, in this case, would anyone be able to do it?

"Zheng... Boss Zheng, you are not joking." Professor Yang began to stutter.

In his opinion, this is a joke.

"Cut the eight segments of the liver and prepare for the transplant. The patient's vital signs are not very stable, and we have no time." Zheng Ren glanced at the ECG monitor and said.

"Are you coming to my side?" Professor Yang said this sentence again.

"You come first. I'll assist you with autologous liver transplantation after the radiography." Zheng Ren narrowed his eyes, as if smiling.

On the operating table, being robbed of the position of the surgeon is a great shame!

However, Professor Yang felt relieved when he heard what Zheng Ren said.

If he dares to say that, there must be a great possibility that he can do it. If it was an ordinary young doctor, Professor Yang would have coaxed him down long ago.

But standing opposite him was a doctor nominated for the Nobel Prize. The halo of the Nobel Prize shrouded him, and faced with such a situation, Professor Yang could only choose to believe it.

"Okay!" Professor Yang gritted his teeth and said.