Chapter 417： Split liver

"The liver is smashed. At least it is a Class III trauma." After Huo Congjun opened his abdomen, he saw the turbulent blood in the abdomen, and the two little doctors sucked desperately to barely expose it.

Zuo Liang just stretched his head and said, "It is blunt liver trauma, it has irregular cracks, and the inferior vena cava is broken."

"The duodenum also ruptured." Huo Congjun looked down all the way, his brows frowned tightly.

"Blood loss is fast." The anesthesiologist reported.

Huo Congjun said with gratitude, and said, "The gallbladder has also been broken and needs to be cut off."

"It can only be cut off." Zuo Liang agreed.

Huo Congjun glanced quickly and lightly at the situation in the abdominal cavity. While filling up the inferior vena cava, he said, "The right lobe is very damaged. What do you think should be done?"

"Block the hilum, bluntly split the liver tissue with vascular forceps, ligate and cut off blood vessels and bile ducts, and then do a right trilobectomy." Zuo Liang was the answer.

However, after listening to his words, the doctors present showed smiling smiles, including another young attendant who had not waited for the third assistant to wait.

Everyone's smile is certainly not an encouragement to Zuo Liangcai. For Zuo Liangcai, who likes to read inspirational books and always scrambles for all opportunities, most of the middle and low-level doctors don't particularly like him.

Everyone's smile at this moment is the same as the reason everyone doesn't like Zuo Liangcai-this gentleman thinks too much.

It is like that in his answer to Huo Congjun, he deliberately or unintentionally omitted fingering.

Blunt dehiscence of liver tissue can be handled with finger pinching. When the hilum is blocked, you can also use finger pinch to solve the problem.

And Zuo Liang did not talk about the reasons for finger pinching. Everyone can easily think that Ling Ran's free-hand hemostatic technology is so famous that he has published a paper. At this time, if finger pinching is used, Ling Ran's competition The force will be greatly enhanced.

However, careful thinking is because careful thinking is always useless.

Zuo Liang was able to think of hiding fingering, and everyone could see through him, so that doctors who did not think **** was better, had to think deeply about the advantages of **** ...

Huo Congjun will not forget Ling Ran's technology because he did not mention it because of Zuo Liang.

In fact, Huo Congjun thought deeper.

"In accordance with this approach, it is a regular liver resection." Huo Congjun summarized Zuo Liangcai's words once and turned to Ling Ran, and asked, "What do you think? Do regular liver resection?"

"Debridement is more suitable," Ling Ran answered.

Zuo Liang just swaggered: Huo Congjun asked like this, the answer is naturally obvious. Where do you need to answer again.

"Doctor Zuo, you talk about the advantages and disadvantages of regular liver resection and debridement resection." Huo Congjun fiercely named Zuo Liangcai.

This question is a little bit more difficult. People who do n’t read the book ca n’t answer, and people who read the book can easily answer it.

Zuo Liangcai was slightly balanced in his heart, saying: "Regular resection is performed according to anatomical divisions. The overall resection area is relatively large. If the patient is intolerant, complications and even death are prone to occur after surgery. Debridement Resection is irregular. It does not conform to the distribution of liver segments or leaves. During the operation, the blood vessels and biliary tract must be continuously ligated, but the liver tissue can be maintained to the greatest extent, but the test of the degree of involvement of different functional areas of the liver ... ... "

"There is one more point. Regular liver resection has high technical requirements. If it is not good, mistakes are easy to occur." Huo Congjun paused and said, "We need to hurry up, so we use debridement. Ling Of course, you're my assistant, Doctor Zuo, you're dealing with duodenum. "

"Yes."

The junior doctors responded very quickly, but some people looked as usual, and some people were unwilling.

Ling Ran stood opposite Huo Congjun and helped.

Huo Congjun looked at the monitor and said to the anesthesiologist, "Pay close attention to the acid level."

"Yes. It is currently 6." said the anesthesiologist.

"Pay attention to sodium bicarbonate," Huo Congjun said, and then bowed his head, "emergency liver resection, let's hurry up."

"Yes."

"Electric knife." Huo Congjun swept in the direction of the split liver and lowered his head. "I'm going to remove bloodless liver tissue now, Ling Ran, do you know what to do?"

"Ligat the severed blood vessels and bile ducts." Ling Ran started as she spoke.

For a contestant who had done hundreds of replantation of broken fingers, suture of blood vessels was as simple as eating and sleeping, and the doctors nearby also trusted Ling Ran extremely.

Those patients who come and go for replantation of broken fingers are all looking at them. Now when we say Yunhua Hand Surgery, everyone will naturally add the Yunyi Emergency Department, and even the name of the surname. To Ling Ran.

That is, for ordinary people, the frequency of emergency treatment of replantation of severed fingers is too low, otherwise, Ling Ran's reputation will not be limited to industrial areas.

But for doctors, they have the ability to judge the skills of another doctor.

The operation time, the effect of the operation, the difficulty of the operation, the prognosis and so on are all seen by doctors. In addition, quantity is also a very important benchmark. Nowadays, even if Ling Ran is young, no one will question his level of broken finger replantation or tang stitching.

Not to mention access to blood vessels.

Huo Congjun also gave Ling Ran a great deal of trust, and he made an incision and let Ling Ran complete the more important vascular ligation work.

Ling Ran's fingers danced up and down.

He also stitched and ligated with both hands without the need for additional assistants, moving as fast as Huo Congjun.

Huo Congjun nodded in his heart only when he was racing against time.

One of the most important things in emergency liver resection is fast.

Because once the incision is made, the wound is more fissured. With the richness of blood flow in the liver, the blood loss of thousands of milliliters per minute.

At this time, the speed of the suture is very critical.

On the contrary, the suture is not good enough, and after a while, you can return to double ligation, which has little effect.

"I'll cut again, and then we'll come back and check again." Huo Congjun's movement was also quick, reminding Ling Ran by the way.

Ling Ran nodded, still flipping his fingers, quickly ligating the exposed blood vessels and bile ducts.

Both men's spirits became tense, and the room became silent for a while.

"You can't simply speed for speed." Zuo Liangcai muttered again. He couldn't see anything in the abdominal cavity. He could only see that Ling Ran and Huo Congjun were moving very fast, and he felt that Ling Ran was rough.

Huo Congjun had no objection to this, and said, "The ligation of large blood vessels must still be of high quality."

"Yes." Ling Ran replied, without any change in movement or speed.

As the saying goes, you say you, I do mine. For Ling Ran, if he always obeys the advice of others ~ www.novelhall.com ~ then life has been messed up. Too many people are willing and willing to give him advice.

Huo Congjun also no longer said that it is also very consuming to complete the resection itself while retaining liver tissue as much as possible.

After all the cuts were made, Huo Congjun dropped the scalpel and started to check the blood vessels and bile ducts ligated by Ling Ran.

"Small blood vessels are ligated?" Huo Congjun was surprised.

"Lest it be repeated." Ling Ran said.

"This ... let me see ..." Huo Congjun felt that he was like a painter, Ling Ran was like an artist, and the painter was painting in front, and the painter followed behind, and he supplemented the painting. It's over.

The most amazing thing is that the details of the artist's paintings are almost perfect.

"Your liver has been debrided and you have learned." Huo Congjun couldn't help sighing after watching all the ligated blood vessels.

"Slightly different from the blood vessels in the extremities, just get used to it." Ling Ran summed up his experience.

This time, Huo Congjun laughed.

It is said that the vascular anastomosis is very close, but can it be done so fast without considering the characteristics of the liver? Can you not understand the anatomy?

"Have you practiced it yourself?" Huo Congjun asked.

Ling Ran said: "I understand."

"Well ..." Huo Congjun didn't want to ask any more, his eyes narrowed and the bleeding had stopped, and he simply said, "The rest is left to you."

"Yes." Ling Ran didn't say a word of modesty, and took over to deal with the wound.

What Zuo Liangcai saw was called jealousy. He never had such an opportunity.

"Doctor Zuo also came to help." Director Huo pulled Zuo Liangcai back to the position of second aid.

"Yes ..." Zuo Liang went into the operation area with no resistance.

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