Sun Mei hurriedly pulled Yang Ruixue out, and said as she walked, "Sorry Dr. Dave, we didn't arrange it." ”

"I'm not a nurse, I'm also a regular doctor, I want to come over to observe the operation, why can Tao Le come on stage, I can't!"

Yang Ruixue was even more excited, and Sun Mei couldn't pull her for a while.

Her words did not impress Professor Dave, but made him even more dissatisfied.

"As I recall, I have categorically declined the request to observe the surgery. There should be no other doctors than the team involved in the surgery. ”

"In the words of the Chinese people, this is a violation of the yang and the yin, and it is dishonest. I'm going to have a good talk with the hospital leaders, maybe I should form a new team on my own and hire my former assistants instead of continuing to trust you. ”

As soon as he said this, Director Shen, Director Ran, Deputy Director Jin and Mr. Guo were all anxious in an instant.

After just watching half of the surgery today, they all felt that they had benefited. During Dave's three years here, the entire hospital's surgery will be comprehensively improved, provided that he can't leave the medical staff of the hospital alone and form a separate team.

A few people who didn't want to say anything more didn't care about offending Vice President Chang at this time.

"Xiao Yang, what are you talking to the experts? Get out of here, don't interfere with the operation! Director Ran said.

"Today, we made an exception to let you into the operating room because the hospital took care of the young people. But instead of doing your homework, you're still making a lot of noise here to affect the operation, what are you like? Director Shen shook his head.

"Today's incident, I will report it truthfully to the medical department after the operation." Nurse Sun couldn't help but be angry: "If you don't leave, if there is any problem with the operation, the responsibility is on your head, can you afford it?" ”

This sentence made Yang Ruixue sober up. It occurred to her that this was an operation with a high mortality rate and more complications after surgery.

If this German expert is really unreliable, and in the end there is a problem that lies on his head, then what is good?

Thinking of this, Yang Ruixue pushed away Sun Mei's hand, glanced at Dave and Tao Le coldly again, and then threw down her gloves and went to change her clothes and leave.

The head nurse shook her head and used her mobile phone to contact the roving nurse, asking her to read the latest doctor's instructions on the system side and bring back the crystals and colloids to be replaced.

Seeing Yang Ruixue being swept out of the house, Chen Ke had a feeling of being hurt by something.

He always felt that if he made a slight mistake, he would be the next person to be kicked out, which would be a shame!

All of a sudden, he gathered all his energy, observed, and watched the nurse of the main table attentively, acting strictly according to her requirements, and did not make any mistakes for a while.

The first circuit nurse moved quickly, and in a short time, the red blood cells and fluids were on top, the patient's blood pressure rose back to 100/70, and his heart rate dropped to 90.

No one mentioned the episode again. The operation went ahead as if nothing had happened.

Dave inserts his left index finger behind the uncinate process, puts his thumb in front of the head of the pancreas, lifts the uncinate process and peels it off to the right, and then clamps it with a vascular clamp and ligates it.

The surgery is performed in the middle and posterior part of the body, and the most difficult reconstruction of the digestive tract is to be performed.

Because multiple organs have been removed, the entire digestive tract of the patient's body has been completely destroyed, and the remaining organs must be put together to form a complete and usable internal circulation.

Specifically, there are three stages of pancreatic stump anastomosis, biliary-intestinal anastomosis, and gastroenteroenteric anastomosis, with the first stage being the most difficult.

The so-called anastomosis, simply put, is the suturing of two organs together.

The main complication of pancreatic head duodenal surgery is pancreatic fistula, with a mortality rate of more than 30%.

In addition to the patient's age or liver dysfunction, most of the reasons for the occurrence of pancreatic fistula are technical reasons.

Improper management of pancreatic stumps, poor anastomosis techniques, and damage to peripancreatic organs during surgery can directly or indirectly lead to the occurrence of pancreatic fistula.

In addition, the latter two anastomoses can also be problematic, and complications such as biliary fistula and gastric emptying disorders can form if you are not careful.

Therefore, these three items are anastomosive, and the requirements for surgeons are extremely high.

Although Dave is a master of the arts, he is now more rigorous and meticulous. For the treatment of pancreatic stumps, he chose pancreatic-jejunal anastomosis, and the surgical method he chose was the residual pancreas-jejunal end-entrapment anastomosis.

Although this is the most commonly used method of treating pancreatic stumps, Tao Le clearly knows that this patient's pancreas is not the same as most people, and her main pancreatic duct is significantly posterior in the pancreatic neck.

If no special attention is taken, the anastomosis can cause damage to the main pancreatic duct, leading to the occurrence of pancreatic fistula.

Dave didn't disappoint her. He was really experienced and spotted the problem at a glance.

The solution is also decent, with about 1 cm of free left during anastomosis, allowing the main pancreatic duct to approach the center of the residual pancreas, making pancreatic-intestinal anastomosis more convenient.

Dave methodically pulled the jejunum near the residual pancreas, bringing the two together.

He used a small round needle and a 3-0 silk thread and began to suture it.

Of all the organs, the pancreas is the most difficult to suture. Its tissue is so fragile that stitching it is like embroidering on tofu, which is neither tight nor loose.

Tightening may cut the pancreas, while loosening can lead to a pancreatic fistula.

Dave's needlework is good, and Director Shen and the three of them are very fascinated, and their faces are full of admiration.

Tao Le sighed in his heart. It is not enough, the stitches are not fine and dense enough, and there is still a possibility of pancreatic fistula.

If it weren't for this situation, she couldn't control herself and wanted to get started and stitch it for him.

But if you think about it, you know that it is impossible, in addition to Dave, there are also surgical masters such as Director Shen and Deputy Director Jin present, so they can't take their turn to play.

The stitching is complete. Dave carefully inserted the residual pancreas into the jejunum and completed the first step of pancreaticojejunostomy.

Three hours had passed since the operation, and beads of sweat were pouring down Dave's forehead. The nurse stepped forward to wipe his sweat, and he went down again.

The biliary-intestinal anastomosis, the gastroenteroenteric anastomosis, and finally the abdominal drainage was completed.

It took six hours for the operation to finally enter the final step, irrigating the abdominal cavity and closing the abdomen.

Tao Le thought about it and took the initiative to make a request: "I'll do the abdominal sutures." ”

Compared with the previous operation, the suture of the abdomen is much simpler, and it did not arouse the objections of the senior assistants.

Dave had seen Tao Le's performance during the teaching operation, and was amazed by her suturing skills, and immediately nodded in approval.

Tao Le knew that suturing was only secondary, and she mainly wanted to take this opportunity to use a gold finger on the patient.