Research Center.

Xiang Jianhua, Ning Hongru, Wu Yan and others are all in full swing to help sort out the information of the first surgical patient and do preoperative conditioning for the patient.

Xiang Jianhua said: "Lao Ning, can you help with the removal of liver cancer in Zhang Gu's surgery?"

Ning Hongru and Wu Yan glanced at each other: "Both of us have some experience in the field of liver cancer resection, and when the time comes, we can be regarded as able to go to the bottom." ”

"We're all secondary, though!"

"The most important thing is to ligate the severed portal vein, which is a core technology that only Zhang Gu has mastered. ”

Xiang Jianhua also said: "Yes, whether the liver can be rapidly expanded in a short period of time depends on Zhang Gu, which is the focus of this topic." ”

In the hearts of several people, they still have some doubts about whether the liver can grow rapidly after the first operation.

This is the whole subject, and the only point they are worried about.

Finally, it was time for the first patient's operation.

With the help of the little nurse, Zhang Gu put on a surgical gown and gloves.

Tian Sha said next to him: "Doctor Zhang, the patient's current liver volume is 1373ml, how much do we need to cut for our first operation?"

Zhang Gu said: "The patient's body weight is 65 kilograms, right?" ”

Tian Sha nodded again and again, admiring Zhang Gu's memory and being able to recite all the patient's conditions clearly.

Zhang Gu: "CT examination measured that after the patient's left liver and liver cancer were all removed, there was still 300ml left, which was 0.44 according to the body weight ratio, which was within a safe range, so the goal of this first operation was to remove 1070ml. ”

Tian Sha sighed twice and hurriedly wrote it down.

Next to him, Wu Yan, Ning Hongru, and Xiang Jianhua are all secretly pondering this "body quality".

"It seems that Zhang Gu has a formula for assessing the volume of the resected liver. ”

"His set of safety standards is definitely higher than our standard for routine liver cancer removal, and I don't know where it came from, so I have to ask him when I go back." ”

While everyone is speculating.

On the operating table, Zhang Gu, with the cooperation of Xiaomao, has already started the operation.

In patients under general anesthesia, a "human" incorporation is made under the costal margin, the right liver triangle, coronary ligament, and hepatorenal ligament are freed, and the first hepatic hilar blood vessel and bile duct are dissected......

Ning Hongru was beside him, watching Zhang Gu's operation, and nodded slightly.

He smiled: "I don't think we have to worry about liver cancer resection at all." ”

"You see his operation, very standardized, has been following the principle of 'no tumor', although the ligament and hepatic hilar vessels are free, but not the posterior inferior vena cava and small short hepatic vein, indicating that he has a very thorough understanding of liver cancer resection. ”

Wu Yan also secretly praised that Zhang Gu's operation, although the knife was fast and seemed to be chaotic, actually followed a set of principles, which was very standardized, and they didn't need to point fingers at all. ”

As time progressed, the surgery proceeded to the ligation of the portal vein.

This is the most critical and core part, which determines the success or failure of this operation. It also determines the success or failure of this issue.

Xiang Jianhua clenched his knuckles.

"Come on, Zhang Gu. ”

Xiang Jianhua understands in his heart that there is so much social attention and so much attention from leaders, and at this moment, these pressures are all on Zhang Gu alone.

This young man has taken on too much. None of them can help with this step, so they can only rely on Zhang Gu himself.

I saw that Zhang Gu chose to use 3-0 vascular sutures, and first ligated the small branches of the right anterior and right posteriors, as well as the small branches that supplied the hepatic artery. The left and right hepatic ducts and left and right hepatic arteries are separated but not ligated. Then, on the right side of the sickle ligament, the liver is cleaved and the liver cancer tissue is split with ultrasound.

Asked Jianhua and Ning Hongru about Wu Yan next to him: "Old Wu, how is this portal vein ligation part done?"

Everyone knows that Wu Yan has done the previous topic, and he still has some understanding of this portal vein ligation.

Wu Yan said: "Do you still remember that there are three grades of spleen-preserving techniques?"

Everyone nodded.

Wu Yan: "The portal vein ligation used by Zhang Gu in this operation is the highest grade at the beginning, and it requires the most operational skills. ”

When he said this, everyone became nervous. They all knew that the difficulty was very high, and at present, only Zhang Gu could take it down in the whole original city.

In other words, if something happens to Yiyi Gu now, there is no substitute. If that situation really happens, Ning Hongru and Xiang Jianhua can only go up and do conservative salvage surgery.

But in that case, although the patient's life could be saved, the operation failed.

Everyone didn't even dare to speak, and their eyes kept on the operating table.

At this moment, Zhang Gu's hands are extremely fast, in order to reduce the exposure time of the patient's wound, instead of clamping the blood vessels with titanium clips, he uses a quick operation to make up for it.

Once you've done that.

Zhang Gu: "Xiaomao, use a color Doppler ultrasound instrument to check the right portal vein and right hepatic artery. ”

After Xiaomao did the examination, he said: "There is no blood flow in the right portal vein of the liver, and the blood flow in the right artery is normal." ”

As soon as he said this, the corners of Zhang Gu's mouth curled slightly. The initial effects of portal vein ligation have come out.

Xiang Jianhua, Wu Yan, and Ning Hongru next to them were also greatly relieved! Although they did not know what the specific process was, they all remembered the result. As long as these two phenomena occur, it means that the portal vein ligation is successful!

Afterwards. Zhang Gu used a sterile bag to wrap the free right half of the liver, which is to prevent adhesions between the right half of the liver and the surrounding areas during the first and second operations. A latex drain is placed in the liver department.

The first operation was completed.

While everyone breathed a sigh of relief, they began to worry about new problems.

Does this really make the liver bulk?

Zhang Gu: "Tian Sha, how much liver volume is left?"

After Tian Sha measured, she hurriedly said: "1082ml of cancerous liver tissue was removed during the operation, and 291ml is left." ”

The faces of the crowd were solemn.

That's all there is left!

That's basically only 21% of the volume of a standard liver!

It is clear to everyone that patients are now facing two problems.

One is that only 21% of the liver remains, and whether the patient can survive. The second is whether the liver can rapidly expand by 100% in seven to fourteen days.

After Zhang Gu came down from the operating table, everyone gathered around.

Wu Yan: "Zhang Gu, how is the remaining volume of this liver, is it still safe?"

Xiang Jianhua and Ning Hongru both looked at each other with solemn faces. When they had liver cancer removal surgery before, they had never left a little bit of liver left.

This is really beyond their comprehension.

Zhang Gu was not worried at all, and said with a smile: "Don't worry, with the nutritional support of all blood supply, the patient is worry-free, you just wait and see, these days, you can use the color Doppler meter to monitor at any time to check the patient's liver volume growth and change." ”

"Tian Sha, you also have to record detailed change data every day. ”

Tian Sha nodded hurriedly.