I also quickly sorted out the steps and procedures of the year in my mind. This choice cannot be made by oneself, although only one knows the consequences of the two choices, but 1 the choice should be given to the family.

Du Wenhao walked to the window and said to Sima Yong and Hui'er, brothers and sisters standing in the courtyard outside the window: "Ling Zun's illness is worse than I expected, the evil poison in the body has spread, and now there are two choices: one is to stop the operation, in this way, Ling Zun can live for two or three months at most; The second is to continue the operation, which will have two possibilities, one is to die during the operation or within a few days after the operation due to various uncontrollable reasons; The other is that the operation is successful, and Ling Zun can live for at least five years. ”

Death on the spot, or live for a few days, three months, or five years, this choice will choose the last one, but the possibility of the last one is not very large, and if you don't get it right, you will die on the spot!

The brother and sister looked at each other, and their expressions were very cold. Sima Yong didn't have any opinions, and looked at his sister: "What should I do?" ”

Hui'er said sadly: "If the operation is stopped." My father can only live for three months at most, and he will continue to operate, but he may live for at least five years. Just this one! ”

Ear Ma Yong nodded with tears in his eyes: "Okay!" Imperial Doctor Du, please continue the operation! ”

Du Wenhao nodded and returned to the operating table.

According to the cancerous situation of the exploration, he quickly made the choice of surgical method. First, the perigastric circulation is blocked, and the blood vessels are sutured and ligated at the source of the descending branch of the left blood vessel of the stomach, and because the cancer has penetrated the serous membrane, it is covered with gauze sutures to prevent cancer cells from metastasizing in the abdominal cavity.

Transverse to the hepatic flexure of the colon at the place where the omentum attaches to the transverse colon, and free omentum and anterior transverse mesocolon1 to clear the lymph nodes around the middle colonic artery. Lymph nodes around the anterior pancreatic head, subpyloric and pancreaticoduodenal arteries, and in the ligaments of the hepatic artery and common bile duct are then removed.

Then, cut the spleen-colic ligament, cut the lateral peritoneum of the spleen, and flip the spleen and pancreatic tail to the right to lift 1 free to the left border of the submesenteric vein. Double ligation cuts the splenic artery and severes the splenic vein.

Pancreatic body resection is a little troublesome, a intestinal forceps is placed on the head side of the pancreas at the cutting line, and there is a jacket intestinal forceps 1 on the tail side to cut off the pancreas between the front and back of the pancreas, while cutting, let Pang Yuqin clamp it with a cord-like tube pliers, and then find the main pancreatic duct in the center of the pancreatic section after cutting, ligation, and after strictly stopping the bleeding, a few stitches are loosely sutured, and a suture is added to the main pancreatic duct. Free the esophagus, cut the vagus nerves on both sides, clear the tissue around the esophageal cardia, and cut the esophagus.

Next, total gastrectomy and digestive tract reconstruction.

First, the omentum and omentum are removed, then the atresia duodenum is cut to remove the lymph nodes around the stomach, the vagus nerves on both sides are cut off to pull the esophagus downward, the lymph nodes on both sides of the cardia are removed, the esophagus is cut off and removed with two vascular forceps, and the contralateral edge of the mesojejunum corresponding to the esophageal end is cut and merged, and the full-thickness interrupted suture is done on the posterior wall of the esophagus.

Due to Sima Guang's old age and physical decline, he was intolerant of long-term surgery, so Du Wenhao postponed the operation again and again, on the one hand, because of the fake pregnancy of Liu Guifei in the palace, on the other hand, it was also his need to prepare for surgery.

He developed several different surgical protocols. The most important thing is to speed up the progress of surgery, minimize the operation time and reduce the risk of surgery.

The preparation of these days was not in vain. The cancerous situation seen after the laparotomy did not show his surgical plan, so he acted skillfully and quickly, without hesitation, as if he had done this kind of surgery a thousand times, and Pang Yuqin and Xue Xiu'er's eyes were straight.

After Du Wenhao removed the whole stomach and adjacent cancerous tissues, he made a replacement for Sima Guang.

He inserts a section of jejunum between the esophagus and duodenum, flexes the jejunum, and sutures the sides into a double lumen to prevent duodenal fluid from refluxing into the esophagus and replace the stomach to store food.

Finally, the abdominal cavity was carefully flushed, Jiang Zhi drained, and the abdomen was sutured layer by layer.

After the operation was completed, Du Wenhao only felt that his whole body was about to fall apart, his legs trembled, and he wanted to sit on the ground, he held it up and looked at Xue Rou'er, who was in charge of monitoring vital signs: "How is it?" ”

"The pulse, temperature and breathing were relatively normal! No problem! ”

"Okay, pour him with revival saline, and then send him to the special care ward, and a special person will take turns to accompany him, observe him day and night, and don't take it lightly. Wait until you wake up. Place the bed on a small slope to allow low drainage of abdominal exudate. In addition, the abdominal band on the abdomen helps breathing, reduces tension at the wound sutures, and relieves pain and discomfort. ”

"Hmmm! I see. Xue Zhen'er nodded.

Also, encourage him to take deep breaths. Turn over frequently, get out of bed as soon as possible, pay attention to the observation of drainage fluid and urine output, pay special attention to lung infection and incision infection and other complications, so as to achieve early treatment and early treatment. ”

"Okay!"

Pang Yuqin helped Du Wenhao wipe his sweat. He smiled and said, "Husband, you have taught us all this, don't worry." Rou'er has been in charge of nursing a lot and is very experienced. ”

Du Wenhao smiled: "I know, it's just that Lord Sima is different, and he needs to take special care of it." ”

Xue Zhen'er nodded and said, "Okay!" I am personally in charge of the care. ”

Sending Sima Guang out of the operating room, Sima Guang's son Sima Yong and daughter Chao'er and others all greeted him. looked nervously at his unconscious father and at Du Wenhao.

Du Wenhao said: "The operation is successful so far, and the key is to look at the next few days, and the nursing is very heavy."

Sima Yong asked anxiously: "Can that father live for more than five years?" ”

"I'm sorry, I can't tell you yet, it depends on the situation, but we'll do our best to take care of it." "The house said" was sent to the ward, where Sima Guang's wife Wu and other relatives had gathered, as well as many other relatives and friends of the Sima family who had received the news. are anxiously waiting. Seeing Sima Guang pushing, at least he was still breathing, and he was still alive, and the stones hanging in his heart were slightly lowered, and he gathered around and chattered non-stop.

Du Wenhao didn't bother to explain, and asked them all to leave the ward, and only two people could be left to accompany them at a time.1 can take turns to exchange looks. Relatives and friends began to discuss how to accompany him, and Sima Guang's wife Wu insisted on accompanying him throughout the whole process, so Du Wenhao asked Pang Yuqin to add another bed for escort in Sima Guang's special care ward. Wu and his daughter Hui'er accompanied them first, and after discussing how to rotate, the rest of the people left. ※ Yuzu Hao and Pang Yuqin are simple and special! Later, when he returned to the house, Du Wenhao gave one or two prescriptions for vocational training, and handed them to Pang Yuqin: "Grab the medicine according to the prescription, now start to administer the medicine slowly through the gastric tube, withdraw the gastric tube after ventilation, and then take it orally, a small amount and many times." ”

Pang Yuqin took the prescription and looked at it: "This one is for antibacterial and anti-inflammatory, I know this, but this one is all for strengthening the peiben, invigorating blood and dissolving phlegm, clearing heat and detoxifying, why do you use these?" ”

Du Wenhao said: "Lord Sima's stomach disease, the accurate name is stomach cancer. What this disease is most afraid of is the metastasis of cancer cells in the body, what is a cell I told you before, remember? ”

Du Wenhao taught Pang Yuqin a lot of modern medical knowledge, including the knowledge of cells, Pang Yuqin nodded: "You said that the human body is actually composed of many cells. ”

"Yes, it's easy to understand. Carcinogenesis and metastasis are the leading causes of death in cancer patients. Metastasis of gastric tuberculosis usually occurs within three years after surgery, so preventing cancer cells from metastasizing is the main treatment direction after surgery, and surgery has caused a serious blow to the patient's body. Cancer cells can take advantage of the weakness to enter and lead to metastasis. Therefore, within one year after the operation, we should mainly pay attention to the evil diseases of phlegm, tuberculosis and poison, and give the right to cultivate the foundation, dissolve phlegm and detoxify, and invigorate blood and dispel diseases. Improve the ability of the human body to fight diseases, especially the ability to resist the invasion of cancer cell metastasis, so as to achieve the purpose of preventing and controlling cancer cell metastasis. ”

"Obviously, these drugs prescribed by my husband are used to strengthen Peiben, dissolve phlegm and detoxify, invigorate blood and eliminate guilt, and prevent cancer cells from metastasizing."

Du Wenhao nodded and said, "That's right; Lord Sima's stomach has been completely removed, I used a small intestine to help him make a stomach, of course, it is not comparable to the original stomach, the diet will be greatly affected, plus the damage of the operation itself, the body's resistance will definitely decline significantly, within a year after the operation, Fuzheng Peiben is the key, and Fuzheng Peiben has a medicine that is the most effective, but unfortunately, the medicine market has not been sold

Pang Yuqin said curiously: "What kind of medicine is it?" ”

"Cordyceps! This is a kind of tonic and strengthening medicine, which is the most effective way to replenish deficiency and strengthen the body, and is the choice of nourishment for the elderly and infirm. It can regulate the human immune system. Enhance the ability to fight tumor cancer, and also have a direct anti-cancer effect. It would be best if you could buy this medicine. ”

Pang Yuqin thought for a while: "Why haven't I heard of this medicine?" ”

Cordyceps sinensis has been known to the ancients for a long time, and it has been recorded in the Jin Dynasty, but it was used as a medicinal material in the Ming Dynasty, and the earliest medical record of it as a traditional Chinese medicine was in the Qing Dynasty's "Materia Medica", so it is normal for the people of the Song Dynasty to know this medicine.

Du Wenhao said with a smile: "This medicine is not produced in the Central Plains, and it is mainly produced in the alpine and snow-capped mountains of Tibet. Therefore, few people know about the Central Plains healers. ”

"And how do you know?"

"I" hehe, when the bell doctor used to walk the rivers and lakes, I happened to meet a monk from Tibet, he brought this medicine, but he brought it as food, said to eat to increase strength, I bought some, and tested the efficacy of this medicine. ”

Pang Yuqin nodded and said: "This medicine is so good, but unfortunately, Tubo is tens of thousands of miles away from us, and there is no way to purchase it." "The house said "small" yes. Du Wenhao said, "Actually, you don't have to enter the hinterland of Tubo, you can also find this medicine in the west of Shudi, but the quality is not as good as that of Tubo." ”

The two were talking, and suddenly, Wu Cong, a guy in the front hall, hurriedly ran in: "Sir! Father-in-law Ning came and said that there was an emergency, so let you follow him into the palace immediately! ”

Du Wenhao was taken aback, Gonggong Ning was a eunuch beside the emperor, and he came suddenly. Could it be that something happened in the palace? Hurriedly ran to the front hall and arched his hand: "Father-in-law Ning, is there something wrong?" ”

Father-in-law Ning's face was gloomy, and he said in a low voice: "Let's talk about it on the road, let's enter the palace with our family first!" ”

didn't even have time to take a sedan car, so Father-in-law Ning asked Du Wenhao to enter the palace directly in his own carriage. Du Wenhao called Pang Yuqin, Xue Rou'er, Yan Miaoshou, and Hantou to "Ding instructed a few words about the care of Sima Guang's illness, and then got into the car.

After walking for a while, Gonggong Ning said: "The emperor is sick!" ”

"Huh? When was this? ”

"Just the net!"

"What are the symptoms?"

"I don't know what to do. We don't know what the symptoms are, so you have to go and see them

"What is the reason?"

"It's not a matter of changing the law yet!" Gonggong Ning said in a deep voice, "When the emperor came back from his last private visit to Weifu, he personally sent secret agents to various places to secretly visit the people's attitude towards the change of law. These days, the secret guards of secret visits continue to come, and the emperor has been in a very bad mood, and it seems that the effect is not what the emperor thinks. At noon, the Empress Dowager and the Empress Dowager came to the emperor with a stack of folds, all of them were against the change, and they were all prefects and governors from all over the country, and they were all about the local people resisting the change. After reading it, the emperor said that he already knew, but the empress dowager and the empress dowager cried and persuaded the emperor to abolish the new law. ”

Du Wenhao asked in a deep voice: "How is the emperor's medication during this time?" ”

Gonggong Ning sighed and said, "The emperor always says that he is not sick, so this medicine is always drunk without a meal." ”

Du Wenhao was taken aback: "Why?" Didn't you say it, the emperor's illness is already quite serious, and he must insist on taking medicine. Long-term treatment.

Last time, the emperor also promised me. ”

"The emperor doesn't want to eat. Who can persuade him? The emperor said that he had no other symptoms except for loss of appetite. So let's not be so nervous. ”

Du Wenhao hurriedly said: "The emperor has chronic tuberculosis (chronic renal failure)!" This disease is very insidious, and many people have already had huge damage to their kidneys, so they will show obvious symptoms. It is also very slow, and it is easy to be confused with other diseases, such as fatigue, indigestion, etc., in fact, the last time I examined the emperor, there were already obvious symptoms of kidney failure, indicating that the damage to the kidney is already very serious, if you do not adhere to the treatment, it will be further aggravated! ”

Father-in-law Ning smiled: "It's not so serious, right?" Our family has been following the emperor, the emperor's health has always been good, you know, the last time the emperor fainted, it was because of the ministers' kneeling, there was no way. This time I fainted, most of it was because the Queen Mother was crying, so I asked you to act. ”

Du Wenhao said with a bitter face: "But the emperor's illness is real!" Do you know the story of Bian Que seeing Cai Huangong? The disease is incurable when it is on its surface. When you are sick and blind, there is no cure

Gonggong Ning's face sank: "How can Lord Du compare a faint monarch like Cai Huan with the emperor?" ”

"I don't mean that, I'm a doctor, chronic kidney failure is a very serious disease, once this disease reaches the end stage, there is no cure, and I can't do anything at that time!"

Gonggong Ning glanced at him: "My lord, this is alarmist, right?" ”

Du Wenhao said: "Forget it." I'll tell the emperor directly in a while. This disease really can't be taken lightly! ”

The carriage hurried to the palace, in the emperor's bedchamber. The emperor was lying on the dragon bed, his eyes closed, and the empress dowager, the empress dowager, and the empress were standing aside, looking anxiously.

On the square bench in front of the bed, there was an old man, it was Cheng Wei Zhan, the great doctor of the Taifang Pulse of the Tai Hospital, who was called again this time, and was calling the pulse there with a bitter face. Obviously, it was not possible to show why the emperor was in a coma. It's just that with the experience of the last time, he didn't dare to talk nonsense, just delayed the time and waited for Du Wenhao to come.

Seeing Du Wenhao, Wei Zhanchang breathed a sigh of relief, and hurriedly stepped forward and said, "Lord Du, you are here, the emperor has fainted again." The humble medical profession is shallow, so let's ask Lord Du to diagnose and treat the emperor. ”

Du Wenhao is the emperor's imperial physician. I don't shirk either. After sitting down. Raise the wrist to check the pulse, and sure enough, there is no syncope pulse evidence, obviously pretending again.

This time, Du Wenhao is ready to take advantage of this opportunity to explain the emperor's chronic kidney failure disease clearly, arouse the attention of the emperor and the empress dowager, treat it as soon as possible, and treat it in strict accordance with his own requirements, otherwise, it will cause a catastrophe.

However, you have to let the emperor wake up first.

Du Wenhao took out the golden needle from the first-aid kit and took the acupuncture point for Song Shenzong. Song Shenzong also cooperated, and after a while, he woke up slowly. But he closed his eyes and said nothing, looking very weak.

The Empress Dowager and the others all breathed a sigh of relief, and asked Du Wenhao in a low voice: "What did the emperor get?" ”

Du Wenhao said to the Empress Dowager: "Ancestor, the emperor fainted because of the kidney tuberculosis!" ”

"Tuberculosis?" The Empress Dowager asked with a wrinkle.

"Yes!" Du Wenhao looked solemn, got up and said: "The emperor is worried about changing the law day and night, long-term eating disorders, and internal injuries. Overwork weakens the body's righteous qi, and external wind heat and damp heat take advantage of the void. Hurting the internal organs, the water is damp and retained, and the spleen and kidneys are decayed, the good and the false are evil, and the cold and heat are mixed. ”

The Empress Dowager frowned and said, "You don't have to explain this to the mourning family, you just say that it doesn't matter if the emperor's illness matters." ”

"Very important!" Du Wenhao tried his best to let his words attract the attention of the Empress Dowager, and said: "The evidence of renal tuberculosis, the disease is lingering, the syndrome is changeable, the spleen and kidney are decaying, the turbidity and yin are not discharged, the spleen and stomach are reversed, the liver wind is moved, the water and qi are ejaculating the heart and lungs, and the crisis is born." The inside will be closed and the outside will be removed, the yin will be exhausted and the yang will die, and the yin and yang will be separated! ”

The Empress Dowager, the Empress Dowager, and the Empress all looked at each other in horror: "Won't it?" The emperor usually doesn't have anything bad. Netcai is just angry. ”

Du Wenhao said: "Weichen is by no means alarmist, last time Weichen gave the emperor a consultation. I have already seen the problem, and prescribed medicine for the emperor to take, but the emperor did not insist on taking it, and Weichen also said that the emperor can't be tired or angry with this disease, and he must recuperate. The emperor is now sicker than before, and if he is not strictly treated, it will be dangerous! ”

The Empress Dowager said: "Didn't the mourning family let you be responsible for the emperor's illness?" ”

"But the emperor didn't insist on taking the medicine according to Weichen's requirements! There is no meditation and recuperation. ”

The Empress Dowager said: "Why doesn't the emperor want to recuperate quietly, but everything in the world has to be taken care of by him, how can he recuperate calmly!" ”

The queen mother next to her interjected and said gently: "Lord Du, please treat the emperor's good life." ”

The Empress Dowager also said: "Exactly." You will stay in the palace for the next few days and don't go back, take care of the emperor's dragon body. Xiao Ningzi. You can help settle Lord Du's residence, just find a vacant room next to the emperor's bedroom, and deal with it immediately if you have something. ”

Du Wenhao and Father-in-law Ning bowed down and agreed.

Du Wenhao wrote the prescription with a pen and handed it to the waiter of the Imperial Medicine Hospital of Tai Hospital to take the prescription. The house said: "Seeing that the emperor is no longer in trouble, the empress dowager waited for the empress dowager and the queen to dare not mention the abolition of the law change, so they could only say goodbye and leave."

When they're all gone. Song Shenzong sat up and smiled at Du Wenhao: "This time you have relieved the siege for Lian again!" Very good! ”

Du Wenhao arched to the ground: "Your Majesty, your kidney tuberculosis is really serious. It must be treated strictly. ”

Song Shenzong said with a smile: "I have already heard what you said, and you are right to say so, lest the Empress Dowager and the Empress Dowager cry and abolish the law change." ”

"Your Majesty, what Weichen said is true! If the emperor does not have the ability to give birth to this disease, it will be treated in time. Yes, "It's going to be life-threatening!" ”

Song Shenzong frowned: "You have already said this last time, but Lian feels that there is nothing wrong with his body, except for his appetite is not very good and insomnia, this is not a big problem, you just prescribe a medicine to Lian to recuperate."

"But Your Majesty, this disease can't be cured by conditioning, you must prescribe the right medicine! Take the medicine strictly according to the requirements, you are so intermittent, there is no effect! ”

"Well, the Empress Dowager has already said, let you stay by Lian's side to treat Lian, you can treat it, Lian will not embarrass you, and will take medicine according to your requirements." That's all right, right? Huh"

Song Shenzong once again became Yu, and she fainted by pretending to dodge the cry of the Empress Dowager. And under Du Wenhao's emphasis, it is estimated that the Empress Dowager will not use this trick to force herself to abolish the law change in the short term, so he is very happy. He smiled and stood up, walked over to the bookcase and sat down.

Originally, he was in a slightly better mood, but when he saw a large number of folds on the table, he began to be depressed again, restrained his smile, was stunned, sighed, and slowly picked up the folds and began to read.

Du Wenhao didn't listen to him and let him quit, and before the medicine was delivered, the Empress Dowager told her to stay by the emperor's side, so she stood quietly in the corner and waited.

After a while, Song Shenzong suddenly slammed the table and slammed it, startling Du Wenhao, peeking in, only to see Song Shenzong's face pale, he slammed a piece of music in his hand to the ground, and kept walking around the room with his hands behind his back.

Du Wenhao hurriedly withdrew his gaze and stood with his hands down, one thing is not about himself.

Walking around the circle, Song Shenzong suddenly stopped, pointed at Du Wenhao, and said loudly: "You say, is it good to change the law?" ”