If you are in the country and have a non-emergency liver transplant, it usually takes a lot of time to prepare for the surgery in advance. For example, imaging of blood vessels in the liver, CT or even MRI scanning of the liver, such as a large amount of blood preparation, such as the use of autologous blood reinfusion devices, such as through 3D reconstruction, vascular anastomosis simulation of the donor and recipient livers. In short, before the actual operation, the doctors will use all means and methods to simulate the possible situation of the operation as much as possible in the virtual situation.

But this approach to stability cannot be achieved in Polythanvia.

As the least developed country in the world, Polytavia is incredibly short of medical resources. There is not even a CT machine in the country, let alone liver vascular imaging, and at the same time, 3D reconstruction can be completed.

Originally, it would have been almost impossible to carry out a liver transplant under such circumstances. But after all, the Chinese medical team is stationed in several nearby countries, so this patient with schistosomiasis cirrhosis was first sent to Tanzania, which has the most abundant and abundant relevant examination equipment.

Although a liver transplant is available in Tanzania, the 16-year-old girl with schistosomiasis cirrhosis is required to undergo the surgery at her own expense, according to Tanzanian policy. Moreover, there are no hepatobiliary surgeons in the Chinese medical team stationed in Tanzania this year who can complete liver transplantation independently. As a result, the little girl and her mother had to travel to Tanzania by water and then undergo a CT scan at their own expense. Eventually, the two returned to Polythanvia with the results of a CT scan from the local hospital, and waited for surgery.

The consequence of this tossing is that the timeliness of CT scans is almost unusable. Even in Tanzania, their medical equipment is basically obtained by external aid. The results of the old and inaccurate machine, combined with the time it took to perform four and a half months, created great challenges and uncertainties for Politavia's first liver transplant.

Huge challenges and uncertainties were placed on Chen Tianyang, and the result was a series of foul language and shaking his head.

Chen Tianyang had foreseen that the operation would be troublesome before the operation, so he decided to make all the preparations as much as possible. Foreseeing that the bleeding during the operation could be very large, the medical team organized several blood donations through the Polythanvian Red Cross, the United Nations peacekeeping force, and the local Chinese community. Finally, 10,000cc of whole blood was prepared for this little girl with AB blood type, which is rare in Africa.

But for other problems, Chen Tianyang is really a clever woman, and it is difficult to cook without rice. For example, now he is scolding, and even thinks that he may not be able to get off the stage.

The donor liver is being resected at the same time, and theoretically speaking, the resection speed on Chen Tianyang's side is faster than that of the donor. But according to the situation in the operating room next door, Chen Tianyang is now about thirty minutes behind.

The little girl's schistosomiasis cirrhosis had reached the stage of decompensation, and severe edema and fatigue and jaundice were only the most basic superficial symptoms. She has a lot of angiogenesis in her liver. These blood vessels have either not been scanned by the old CT machine in Tanzania through vascular enhancement, or they have only been newly developed in the last four months. In short, Chen Tianyang is now scolding the street, while quickly blocking the bleeding point on the little girl's liver - because the hyperplastic blood vessels are too thin, he can only keep blocking and loosening the superior mesenteric artery, and judge the nature of the blood beads on the liver section through the new bleeding point.

All in all, Chen Tianyang is in a hurry now.

"Director Chen, let's help. Just when Chen Tianyang's pressure was about to reach its peak, Dr. Wei walked in with his head-mounted magnifying glass, "I'll help you ligate the hyperplastic blood vessels, and you continue to cut down." ”

If doctors from non-organ transplant departments come to carry out liver transplants, if this kind of cross-border is placed in domestic hospitals, even if there are no disastrous consequences, it may be regarded as a serious violation. But this is a forced choice to ensure that the operation goes smoothly, and no one can find out the compliance issue from this - when it comes to compliance, the liver donor of this surgery did not even receive a full psychological evaluation......

Chen Tianyang gave up a little space and continued to operate to remove the remaining liver. This time, he was careful not only to leave enough space for right hepatic piggyback transplantation, but also to expose the left and middle veins of the liver as much as possible, leaving enough veins for subsequent vena cavoplasty to facilitate suturing.

The challenge is still huge, but at least Chen Tianyang has a chance to start.

Qian Yihong, from the Department of Obstetrics and Gynecology, is adjusting her blood transfusion strategy, and she has stopped the next whole blood transfusion, and instead asked for a change to intravenous saline to replenish blood volume. At the same time, she also asked Hu Jia to take out two low-molecular-weight heparins, ready to deal with possible DIC at any time - the patient has undergone more than one hour and fifty minutes of surgery, the amount of bleeding is more than 1200cc, plus she belongs to the end-stage cirrhosis, the possibility of DIC during the operation is very high.

And Sun Lien...... He stood in the corner of the operating room, his eyes fixed on the patient lying on the operating table, and used his own eyes as a life monitor.

"Fina Mubarn Lebadon, female, 16 years old. Schistosomiasis infection (70165.35.18), cirrhosis (26294.24.18), hepatectomy (02.18.31)"

In addition to the clear three status bars, Sun Lien found three shallow shadows after liver resection, and he could probably see that the first two were "vena cava embolism" and "biliary tract infection", but the third line was too shallow, and he was a little unsure of what he was seeing.

Judging by the current situation, it is indeed the most likely DIC.

Liu Tangchun has been standing in the distance, holding his hands on his chest and watching the operation process. The reason why this operation was able to be carried out was that Comrade Liu played a very important role in it. was able to arrange the mother and daughter to Tanzania for CT vascular enhancement scans, relying on Liu Tangchun's face. can get together 10,000cc whole blood in a short period of time, relying on Liu Tangchun's face. It was Liu Tangchun who was even able to make the mother and daughter decide to undergo surgery in the medical team to aid Boli, instead of continuing to seek help from churches, wizards, and even gods—but this time it was not his face, and Lao Liu's face could not be sold to the Polythanvian peasant woman. He relied on his sincerity and hard work.

Liu Tangchun had many sincere exchanges with the patient's parents, and he prepared a large number of liver transplant cases and PPT very seriously, but in the end, it was Liu Tangchun's heartfelt words that moved the parents.

"We have come from China, from Asia, tens of thousands of kilometers away, to heal in your land, not to gain your prostration. Liu Tangchun said sincerely, "A few decades ago, our country was also poor, and our people were also suffering from illness. So when we have the ability, we want to help more people who are still suffering. It's like we've walked through time and reached out to our once poor and miserable selves. ”

Liu Tangchun watched as the speed of Chen Tianyang's hands became stable and smooth, and quietly let go of his palm, which had been hidden under his armpit, which had been grabbed to a white color.