Whether it is hepatic hydatid or malignant tumor, once the portal vein is invaded, it is likely to mean that the difficulty of the operation increases exponentially.

"The chest department has opened four tables in the operating room, and tonight there is an evil, and the chest department can't bring anyone out of the house. Dong Jia complained, "Mr. Zhao said, let me find you if there is something, and he will be responsible for the accident." Before I could call you, you came. ”

As he spoke, a figure rushed in, panting. It was like pulling a wind box in his throat, and when he heard the roaring sound, he felt that his breathing was not smooth.

"Professor Yang!" Dong Jia hurriedly shouted.

"How's the rescue?" the man was out of breath, probably running up.

"It's stable for the time being, but it's ......"

"I'm going to change my clothes. Professor Yang didn't look at Zheng Ren and Su Yun, for fear that he thought the two were passers-by.

"Is there a film?" asked Jung-in.

"Yes, CT done in the afternoon, both chest and abdomen. Dong Jia immediately turned around, took out the bag of tablets under the patient's bed, and handed it to Su Yun.

"You see, I'm going to take care of the patients, and don't have anything to do later. Dong Jia didn't forget to be polite in the end.

Su Yun carried the bag of tablets, didn't speak, turned around and went straight to the doctor's office.

The film was inserted into the reader, and Su Yun was stunned.

CT images at two levels are directly in view. On one level, a small snake meanders into view, the snake is not large, less than 10cm, but the shape is realistic. On the other hand, there is a mass of gauze.

Really, is this a test to put in?

Zheng Ren is still in the old posture, with his right hand on his cheek, watching the film seriously.

No matter how talented Su Yun is, after all, he is not from general surgery, and he doesn't know much about hepatic echinococcosis, a disease that is rare in the imperial capital.

Seeing that Zheng Ren was concentrating on watching the film, he took out a chest CT scan to watch.

The imaging display is shocking.

Hepatic echinococcosis erodes extensively, involving four abdominal and thoracic organs and vital blood vessels.

Looking at the images, there are some similarities with cancer.

It is also appropriate to say that it is worm cancer.

Hydatid worms erode about 65% of the liver to form large, hard masses and erode down the right kidney and renal veins.

The upward erosion penetrates a large area of the diaphragm and then invades the chest cavity and right lower lung, all the way to the vicinity of the pericardium.

Hydatid worms invade the largest venous vessels and their branches in the abdomen deeply, resulting in complete occlusion of the vena cava up to 17 cm long from the right renal vein to the right atrium level, and the four groups of vasculature, including the hepatic artery, portal vein, hepatic vein and bile duct, are severely damaged.

Similar to Budd-Chiari syndrome, except that portal erosion is simply too extensive to be treated by interventional surgery.

Looking at the erosion of the thoracic cavity, the vesicle wall is relatively thin, and Zheng Ren estimated that the sac of the right thoracic cavity should have ruptured, resulting in septic shock.

Just this surgery......

It's a little too complicated.

If it is done, the chances of the patient getting out alive are not great, and there is a 30% chance that the sky will be in the sky.

And that's not even if you get out of office alive, there's no more than a 20% chance of surviving the dangerous period.

In total, the chance of a patient being discharged from the hospital after surgery is 5-6%.

It's literally dancing on the tip of a knife!

"Boss, this surgery can't be done. Su Yun watched the film for two minutes and finally came to a conclusion.

Zheng Ren knew what Su Yun meant, but in fact, he himself thought so.

For this kind of non-doing or dying, and about 5% of patients who hope to survive after doing it, most doctors will choose to give up.

If you don't go on stage, it's okay with me. When you come to power, you get it.

Who can be sure of such a complex operation?

And the family is not there, and the operation is successful, and it will definitely not appear. Once it fails...... In Haicheng First Hospital, Zheng Ren performed hemostatic surgery for maternal hemorrhage, and the operation was successful, and the patient's family still took the patient away, and then prepared to sue Zheng Ren and the obstetric doctors.

However, since it is said that the medical office has been filed, it means that there is something to be done by the hospital. Zheng Ren looked at the film, and his mind was already thinking about how to operate.

Watching the patient die? Zheng Ren really can't do it.

Even if a disease like triple-negative breast cancer is counted, even if Zheng Ren runs out of all the operation time, there is no way to solve it.

However, although this patient looks heavy, there is still a glimmer of possibility.

Although Zheng Ren left the Haicheng First Hospital for a few months, he first carried out the mission, and then went to the earthquake relief, and he had not yet adapted to the situation of only doing interventional surgery.

For the first time, he habitually put himself in the position of the general inpatient in the emergency department.

No matter what, you have to rescue it, even if there is constant trouble in the future.

Let's try it, even if there is time for surgical training, Zheng Ren is still not sure.

This kind of surgery is simply too difficult.

"You are ......" Zheng Ren was pondering when Professor Yang's voice came. He hadn't recovered yet, panting, his chest was wet with sweat when he had just changed into a white suit.

"Hello Professor Yang, I'm Zheng Ren from the Department of Intervention. ”

Professor Yang, who led the group, saw Zheng Ren and Su Yun watching the film, and asked casually. Soon, however, Professor Yang recalled what Zheng Ren had just said.

"You're Zheng Ren from the Interventional Department?"

"Hmm. Zheng Ren nodded, not smiling, he was pondering how to do the surgery.

Even if you go to the system operating room to train for surgery, you still have to think about it.

Just surgery for this patient...... It's a mess, where is the idea.

"Is it Boss Zheng, who was nominated for the Nobel Prize?" Professor Yang asked in a low voice.

"Hmm. Zheng Ren hummed again.

"It's a blessing. Professor Yang stretched out his hand, shook hands with Zheng Ren, and then asked, "Can intervention solve the problem of the portal vein?"

"If you wait for the liver source, you can try it. However, the patient is currently in acute shock, and if the surgery is performed, reconstructive surgery will be performed by the vascular department. Zheng Ren replied dryly.

Professor Yang was visibly disappointed.

He knew about the patient's condition early in the morning, and originally wanted to delay as much as possible, and after the hospital authorized the slow liver transplantation, he did not expect a ruptured cyst at night.

I thought that the Nobel Prize candidates would have any good means...... Although Zheng Ren was telling the truth, Professor Yang couldn't help but sigh.

"Boss, what's the matter with this little snake?" Su Yun looked at the film and suddenly asked.

"It's a representation of the image of hepatic echinocystosis, and like the gauze below, it's not real. Two papers published in the European Journal of Radiology in 1990 and 1991 characterize this characteristic image: the serpentine sign and the spinning sign, which are conclusive in hepatic cyst rupture acute abdomen. Zheng Rendao.

"Hiss......" Su Yun took a breath, very embarrassed.

Determine the gauze and the small snake, in fact, is not important, important surgery.

"Alas. Professor Yang sighed, picked up his mobile phone, and asked Dong Jia to prepare to send the patient to the stage while contacting the person.

It's a hot potato, but if you don't have surgery, the patient will die.

No matter what you say, report it and give it a try.

As for the troubles in the future...... I'll talk about that later.

"Boss, this operation can't be done, you're new to the city, don't let people catch it. Not to mention Professor Zhao, the directors of various departments and the professors who lead the group are here, so don't show off. Su Yun shook his head and told Zheng Ren again.

"Can you do it with your breasts?" Zheng Ren suddenly asked.

"I can definitely do it on the chest, but the abdomen is ......," said Su Yun, who pointed his finger at the portal vein and right kidney on the piece, and said, "These, I'm afraid you can't do it either." ”

……

……

At this time, Professor Zhao of the Department of Intervention was at home, sitting in the study and looking at a foreign-language journal.

"Who did you call just now?" asked Professor Zhao's lover.

"The new Zheng Ren. ”

"The little doctor who wants your bed?" Professor Zhao's lover raised his eyebrows, and when he heard Zheng Ren's name, a murderous anger rose to the sky.

Cutting off people's financial means is like killing their parents, this is really reasonable.

"What a little doctor, he is Director Kong's treasure and a Nobel Prize candidate. Professor Zhao said with a smile.

"Pretend, you're fine, what are you calling him for?"

"This is not an afternoon hospital-wide consultation, there is a patient with hepatic echinococcosis, and all departments have gone to see it. ”

"Something to do with you?"

"Nope. If you want to reluctantly say that there is, you can also paste it. Finally, when an autologous liver transplant is done, the imaging will be faster. ”

"Then what are you calling Zheng Ren for?"

"I can't help it, it doesn't mean that Boss Zheng can't help it. Professor Zhao leaned back in his chair and closed his eyes, as if pondering something.

"He ......"

"The last time I did research, I heard that he was a general major. ”

"Then you let him go, are you giving others a chance to show his face?" Professor Zhao didn't understand.

"Chance, I'm afraid he won't dare to go. Professor Zhao smiled and said, "I came from Haicheng, and I don't know why I was favored by Director Kong." He was the head of the emergency department in Haicheng, and I was expecting him to have surgery. You say, no matter who it is, can let him go to surgery, which department should be done by an interventional doctor? This is not a show of face. ”

"As long as you have a lot of thoughts. ”

"If he dares to ask for surgery, he won't want to get a foothold in 912 in the future. Professor Zhao smiled: "If that's the case, it really won't be worry-free." ”

"Director Kong is too, a little doctor, as for snatching the bed from your hands. ”

"People are Nobel Prize candidates, and if I were Director Kong, I would do the same. He's going to retire anyway, it doesn't matter. It's a pity, if it were two years later, I would compete for the position of the director, and meet him again, how good it would be. ”

"So capable?" Professor Zhao's lover was surprised.

"I can't compare to him in surgery, especially TIPS surgery, other people's techniques, that's called a slip. However, he is young and vigorous, and he has such a big ability at this age, and his heart must be high. I don't know what the situation is today, if he really wants to go on stage without knowing the depths, he will have fun watching it. ”

"It's not really going to be the main knife. ”

Besides, Yang Rui, who stayed at home in the hepatobiliary surgery, was it a fuel-efficient lamp? For so many years, I haven't seen anyone he serves. A few years ago, he had a lot of trouble with Lin Guodong, and finally squeezed Lin Guodong away. Why did a little doctor who was less than 30 years old in the intervention department grab Yang Rui's platform? So, I really had some expectations. ”