"Applause!"

Bang Bang Bang!

Ruan Bin was a little stunned, and asked me to be my assistant? It seems that his sharp operation history has reached the ears of Professor Chen through Director Qian's mouth.

"Ruan Bin, congratulations!" Zhou Tianlei cast an envious look.

"You've got a treat for supper tonight. Huang Hongwen squeezed his eyebrows and said.

To be honest, he didn't really care about this kind of opportunity. It can be said that as long as he has money, he can beat everything in minutes.

"Have a treat for supper, do you want to treat the big sword?" Ruan Bin smiled and said with a smile.

Zhou Tianlei: ......

Huang Hongwen shook his head vigorously: "I don't want to use penicillin anymore......"

............

At 9 o'clock in the morning the next day, many doctors from the emergency department came to the hospital, and most of them were general surgery doctors.

There are directors, deputy directors, attending and so on.

Vice President Lin also came in person!

Most people are looking forward to this surgical lecture, but there is one person who is depressed at this time. That is, the chief of general surgery is a little depressed.

Originally, he worked as an assistant with Director Qian, but he didn't expect to be squeezed down temporarily. Let a resident doctor in the emergency department steal a job!

Although he was depressed in his heart, he wanted to complain and fight again, but he knew that Chen Chengquan personally named Ruan Bin as an assistant, and he was embarrassed to say anything.

"Hopefully, tomorrow's second surgery lecture will bring me back. This Ruan Bin doesn't know how to have pancreaticoduodenectomy at all, and if he is in a hurry, he will definitely reveal his true form. I don't know what Professor Chen thinks. The chief of general surgery thought bitterly.

............

Soon, the operation was about to begin.

"Are you Dr. Ruan?" Chen Chengquan was slightly surprised when he saw Ruan Bin. I didn't expect the other party to be so young. I guess it's not been a few years since I graduated from college.

"Yes, hello Professor Chen. Ruan Bin looked at the bald guy in front of him and greeted him neither humbly nor arrogantly.

"Well, young and promising!" Chen Chengquan smiled slightly.

After a preoperative explanation, enter the operating room.

In addition to nurses and anesthesiologists in the operating room, there are also Chen Chengquan, Ruan Bin, and Director Qian.

The patient was an uncle about 50 years old with an ampullary tumour in the middle stage.

Director Qian is the No. 1 assistant and Ruan Bin's No. 2 assistant.

After the anesthesia was successful, the patient was placed on a supine operating table, and the legs were divided, and Professor Chen began to disinfect the skin of the patient in the routine surgical area and spread sterile towels.

Every movement is meticulous.

I saw him make a 1cm incision in the skin on the umbilical margin, puncture the pneumoperitoneum, and then puncture the cone and place the sheath tube into the lens.

Under laparoscopic surveillance, 0.5cm incisions were made on the right upper quadrant, right lower quadrant, left upper quadrant, and left lower quadrant, and the forceps were punctured and sheathed.

The next step is to investigate!

It was found that there was no adhesion and ascites formation in the abdominal cavity, and the liver was dark red, tough, and there were no nodules. The surface of the gallbladder is smooth, the tension is slightly high, and it is chronically inflammatory. The common hepatic duct and common bile duct are dilated, and the diameter of the common bile duct is 1.2 cm. The descending duodenum is thickened near the ampulla and slightly adhered to the surrounding tissues, and the pancreas is markedly enlarged.

"The situation is a bit complicated!" Seeing this, Chen Chengquan's brows furrowed slightly.

"The ampullary tumor is more than 6cm, and the tumor has spread to the tail of the abdominal aorta, the distal mesenteric vein, the Jingmen vein, and the right renal artery......" Director Qian couldn't help but take a cool breath!

The previous preoperative pathological results showed that there was a discrepancy in adenocarcinoma!

Previous examination results showed adenocarcinoma in the mesenteric vein, Jingmen vein, and caudal end of the abdominal aorta, but it was not expected that the right renal artery had also spread. It looks slight, but it's not easy to deal with!

A group of doctors watching the operation video outside were also shocked!

"This surgery is already extremely difficult! I have to do a combined angioctomy and reconstruction. It is estimated that the diseased blood vessels of the mesenteric vein and the static portal vein will be excised and then anastomized. However, this is the location of the distal mesenteric vein, and it will not be a good anastomosis when the time comes. A doctor said solemnly.

"I guess we'll have to use artificial blood vessels!"

"I don't think there should be any problem with the revasculation anastomosis of the mesenteric vein and the Jingmen vein at Professor Chen's level. At present, the biggest problem is the problem of the tail end of the abdominal aorta, the tumor cells have spread here, how to do it? Whether it is to remove the cancer cells around the tail of the abdominal aorta or to remove the tail end of the abdominal aorta, it is extremely dangerous!" said the director of the Department of General Surgery, shaking his head.

"And what about the right renal artery?"

At this time, Chen Chengquan also knew the thoughts of the doctors who watched the live broadcast of his operation, it was nothing more than such a complicated operation, did it still need to be carried out?

After all, he is not a god either!

Not all pancreatic cancer surgeries can be performed successfully.

"In fact, the most difficult thing to deal with is not the tail of the abdominal aorta and the right renal artery, but the most difficult thing to deal with here - the mesenteric vein root!" Chen Chengquan used the operation forceps to open the blood vessels at the mesenteric vein root, allowing everyone to see the part of the mesenteric vein root.

Since he is teaching surgery, of course he has to analyze it while operating!

Let these doctors learn more!

"It's ...... The cancer has spread to the roots of the mesenteric veins? Oh my God! What is this going on?"

"I thought that only the distal end of the mesenteric vein had spread to the cancer cells, but I didn't expect the root to have spread to it. This surgery is almost unnecessary! The root can't cure this place!"

At this time, whether it was Director Qian in the operating room or the more than 20 doctors outside, they were all dumbfounded.

They didn't expect this place to be completely cancerous!

"At the end of the abdominal aorta, I can reintegrate the mutated vascular branches and anastomoses them with the artificial vessel. Although there is an increased risk of postoperative complications, it can still be done. I can also remove the lesion part of the mesenteric vein and reconstruct the mesenteric vein. You can do it!"

"As for the right renal artery, although it is more tricky, artificial vascular bridging surgery can also be used. But the root of this mesenteric vein has been affected by the spread of cancer cells, and to be honest, I can't think of any effective way to solve it at present!" Chen Chengquan boldly admitted that he also feels tricky at present, and there is no perfect solution in his head!

If the whole intestine is removed, it is equivalent to the removal of all the intestines, and the person is finished.

If it can't be solved, this surgery can't be completely successful!

However, now Chen Chengquan said that he could not solve it except for the root of the mesenteric vein, and everything else could be solved, which also made everyone deeply admired.

In the eyes of many good general surgeons, they can't proceed with the spread of cancer cells at the end of the abdominal aorta alone.

Abdominal aorta!

Remove it, bleed profusely, don't cut it off, wait for death.

Clear it up little by little, there is no such knife skill!

：。 : I want to talk about "Krypton Doctor" with more like-minded people, pay attention to "excellent reading literature" on WeChat, talk about life, and find confidants~