The Surgeon's Studio c1-799

by Black Ursa Prime

Could Professor Zhao easily admit defeat? Zheng Ren did not know, and he was not willing to expend his energy to guess. However, Professor Zhao's intention of asking him to take a look at liver hydatid disease and whether he could perform interventional surgery was too obvious.

  Su Yun took out his phone and dialed a number. "Let me ask."

  Soon, Su Yun picked up the phone. He glared at Zheng Ren and communicated with whoever it was on the other side.

  The other side seemed to be very busy. After saying a few words in a hurry, he hung up the phone.

  "The patient was thrown to the entrance of the inpatient department. You know that, right?" Su Yun asked.

  "I know."

  "Originally, Professor Yang wanted to see if he could have a liver transplant. Not to mention the hospitalization fee, there wasn't even anyone who signed the contract before the operation. Even general surgery was very difficult. Later, he reported it to the medical administration division and was waiting for the results. The patient went into anaphylactic shock," Su Yun said, "He's in the midst of resuscitation. It doesn't involve the interventional department at all."

  No matter how much he thought about it, he knew he just needed to check. Zheng Ren nodded and said, "Go and see when the young patient's mother will come out."

  "Oh? You're quite caring. You've gotten along with the young child so quickly?" Su Yun glanced at Zheng Ren. He wanted to squeeze out a smile on his face, but in the end, he left expressionlessly.

  Seeing Su Yun enter the ultrasound room, Zheng Ren said to Xie Yiren apologetically, "Yiren, you can go back first."

  "No." Xie Yiren gave Zheng Ren an unexpected answer.

  In Zheng Ren's impression, the gentle Xie Yiren would say yes, allergic to the word 'no'.

  Zheng Ren was surprised.

  "Don't think of ditching me like last time," Xie Yiren said firmly. She held Zheng Ren's hand tightly as if she was afraid that this guy would run away again.

  "Okay, let's go and take a look together then." Zheng Ren was just afraid that Little Yiren would work too hard but seeing that she insisted, there was no need to say anything about it.

  Soon, the little patient's mother came out. Zheng Ren quickly sent a message to the little boy on QQ.

  The little boy instantly turned off his phone and the flickering light disappeared. He came out of the corner regretfully and gave Zheng Ren a thumbs up.

  Zheng Ren nodded and smiled.

  "Mommy, I'm here." The little boy ran over and held his mother's hand.

  The two of them talked while walking away. When they were about to turn the corner, the little boy turned back and made a face at Zheng Ren before disappearing.

  Zheng Ren looked at the thin and small figure with his naughty face. There was turmoil in his heart.

  "Let's go, Boss." Su Yun ran out and said, "Chief Qi said that we should look for him for surgery tomorrow."

  That's good. Zheng Ren's heart was relieved.

  He had almost forgotten that this was the Imperial Capital Hospital.

  It was said to be a small outpatient surgery. In Sea City General Hospital, he could open up an emergency operating theater, borrow a needle and a puncture gun, and perform an emergency ultrasound. However, in the Imperial Capital Hospital, he could not do it so casually. There were procedures involved.

  Since Chief Qi had agreed to let him perform the puncture, the rest of the matters would be much easier to handle.

  Zheng Ren saw chief Qi walk out from afar. He bowed and headed straight to the general surgery department with Su Yun.

  As they walked, Zheng Ren recalled liver hydatid disease.

  As the name implied, this was a parasitic disease. It was mostly found in Qinghai, Gansu, Tibet, and other places. It was already very rare everywhere else.

  Zheng Ren had only seen one case of liver hydatid disease in Sea City. It was a very simple disease. At that time, he still could not go up for surgery. According to Zheng Ren's estimation, the surgical progress bar of the surgery performed by Liu Tianxing was only 70%. Just like that, Liu Tianxing bragged about it for half a year.

  The surgery was extremely difficult, but it should not be difficult for an Imperial Capital doctor, right? Zheng Ren had always been confused about this.

  Soon, they arrived at the Department of Hepatobiliary and Pancreatic Surgery.

  The earliest general surgery department had long been divided into departments such as hepatobiliary, gastrointestinal, and glandular surgery. It was not a general surgery department. Zheng Ren still remembered that when he came here last year, he coincidentally met a small patient with P-J syndrome in the gastrointestinal department. Then, he went up on stage to take a look.

  That basin of intestinal polyps was still fresh in Zheng Ren's memory. However, the division of departments at Sea City General Hospital was not that detailed, so Zheng Ren was still used to calling it general surgery.

  There were people wearing white clothes running in the corridor. The air was filled with the smell of disinfectant.

  It was a very familiar feeling. In just a moment, Zheng Ren felt the hormone levels in his body rise as his heart rate rose to 110 beats per minute.

  "Dong Jia!" Su Yun shouted at the entrance of the resuscitation room. His voice was not loud, but the people inside could hear him clearly.

  "Brother Yun!" A doctor in his thirties walked out, his forehead covered in sweat.

  "How is it?"

  "What are you guys doing here?" The chief resident, Dong Jia, was so busy that he could not help but ask that question.

  "You seem busy. Are you panicking just because of a major resuscitation? My boss came to take a look and tell me about the situation," Su Yun said disdainfully.

  Dong Jia looked at Su Yun and Zheng Ren who stood behind him in surprise. How could he hide from such a troublesome matter as long as he could? He was still in a hurry?

  However, he was busy on the other side and the nurse was pushing the medicine. He did not have time to think too much and directly told him.

  "A young female patient, 22 years old, diagnosed with terminal liver hydatid disease. She was admitted to the hospital today for emergency treatment. 45 minutes ago, the patient showed signs of infection and poisoning. She is now being treated."

  "End-stage?" Zheng Ren asked.

  Hydatid disease was a serious zoonotic disease. Domestic dogs were the main source of infection for hydatid disease.

  Contact with sick dogs and eating food or water contaminated by eggs of the hydatid disease were the main ways of contracting the disease.

  China's hydatid disease was mainly divided into three types: cystic, vesicular, and vesicular mixed. Among them, vesicular hydatid disease was the most serious and had a high mortality rate. It was even called 'insect cancer'.

  If it was the terminal stage, it meant that the hydatid disease had eroded at least two or more organs.

  When Su Yun heard Dong Jia say this, his expression became solemn.

  "The thoracic cavity, abdominal cavity, and portal vein have all been eroded. It's very difficult to perform the surgery."

  Dong Jia did not waste any more words and said everything that he could.

  The surgery could only be completed by a thoracoabdominal incision. Moreover, when it came to the portal vein, there was a high probability that the vascular department would have to go on stage and perform the surgery together with many other departments.

  In particular, the portal vein needed to be rerouted. This was something that required a lot of skill.

  Why were clinicians still working tirelessly on TIPS surgery, which was so risky? Wasn't it because the risk of portal azygos devascularization was higher?

  Chapter 767 - Advanced Stage Parasitic Cancer (Part 2)

  Regardless of whether it was a liver hydatid or a malignant tumor, once it invaded the portal vein, the high probability meant that the difficulty of the surgery would increase exponentially.

  "The thoracic department has opened four operat
ing theaters in the operating theater. They've gone crazy tonight and even the thoracic department's experts can't really help." Dong Jia complained, "Professor Zhao said that he wanted me to look for you if there's anything. If anything happens, he'll be responsible. He hasn't even called you and yet, you're already here."

  As he spoke, a figure rushed in quickly, panting.

  "Professor Yang!" Dong Jia quickly shouted.

  "How's the resuscitation?" The professor was still out of breath and had probably ran all the way there.

  "It's stable for now, but..."

  "I'll go change." Professor Yang did not look at Zheng Ren and Su Yun. He probably thought that they were passersby.

  "Do you have radiographic films?" Zheng Ren asked.

  "Yes, I have CT scans done this afternoon. I have both c.h.e.s.t and abdomen." Dong Jia immediately turned around and took out a bag of radiographic films from under the patient's bed and handed it to Su Yun.

  "You guys take a look first. I'll go take care of the patient. Don't let anything happen later." Dong Jia did not forget to be polite in the end.

  Su Yun carried the bag of radiographic films and did not say anything. He turned around and went straight to the office.

  When the radiographic films were inserted into the radiographic film viewer, Su Yun was stunned.

  Two layers of CT images were directly reflected in his eyes. On one layer, a small snake appeared in his field of vision. The snake was not big, less than 10 cm, but its shape was realistic. On the other layer, it was a ball of gauze.

  What the f*ck? Was this put in as an experiment?

  Zheng Ren was still in his usual position. He rested his chin on his right hand and looked at the radiographic films seriously.

  No matter how talented Su Yun was, he was not from the general surgery department. He did not know much about liver hydatidosis, which was a rare disease in the Imperial Capital.

  Seeing that Zheng Ren was focused on the radiographic films, he took out a c.h.e.s.t CT scan to take a look.

  The imaging findings were shocking.

  Liver hydatid disease was widespread, involving four abdominal and thoracic organs as well as important blood vessels.

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

  It was also appropriate to say that it was parasitic cancer.

  Hydatid worms invaded about 65% of the liver and formed a huge and hard lump. They also invaded the right kidney and renal veins.

  The hydatid worms invaded a large area of the diaphragm, then invaded the c.h.e.s.t and right lower lung, and spread to the pericardium.

  The hydatid worm went deep into the largest vein and its branches in the abdomen, causing a total occlusion of the vena cava, which was 17cm long, from the right renal vein to the right atrium. The four sets of blood vessels that entered and exited the liver at the same time, including the hepatic artery, the portal vein, the hepatic vein, and the bile duct, were all severely damaged.

  It was similar to Budd-chiari syndrome, but the range of the portal vein erosion was simply too wide. It was impossible to treat it through interventional surgery.

  Looking at the erosion of the c.h.e.s.t cavity, the wall of the bubble was relatively thin. Zheng Ren estimated that the cyst on the right side of the c.h.e.s.t had ruptured, resulting in septic shock.

  However, this surgery...was a little too complicated.

  If it was done, the chances of the patient leaving the hospital alive were not very high. At the very most, there was a 30% chance.

  That was not even counting. Even if the patient left the hospital alive, the chance of surviving the critical period was not more than 20%.

  After calculating, the probability of the patient being able to recover and leave the hospital after the surgery was only 5-6%.

  This was practically dancing on the tip of a knife!

  "Boss, this surgery can't be done." Su Yun looked at the radiographic films for two minutes and finally came to a conclusion.

  Zheng Ren knew what Su Yun meant. In fact, he himself also thought the same.

  For patients who did not do this surgery, they would die. If they did it, they would still have about 5% hope of surviving. Most doctors would choose to give up.

  'It has nothing to do with me if I don't go on stage. If I go on stage, I'll be affected.'

  'Who would be confident with tackling such a difficult surgery?'

  'What about the patient's family members? The chances of success are so low. If it fails...'

  In Sea City General Hospital, Zheng Ren performed a bleeding stop operation on a pregnant woman. The surgery was successful, but the patient's family members still took the patient away and prepared to sue Zheng Ren and the doctors in the obstetrics department.

  However, since the medical administration division had already filed the case, it meant that the hospital would take responsibility for the matter. Zheng Ren looked at the radiographic films, and his mind was already thinking about how to perform the operation.

  To watch the patient die? Zheng Ren really could not do that.

  It was fine if it was a disease like triple-negative b.r.e.a.s.t cancer where even if Zheng Ren used up all the time for the operation, he would not be able to solve it.

  However, even though this patient looked severe, there was still a slight possibility.

  Although Zheng Ren had left Sea City General Hospital for a few months, he had first carried out a mission when he went for earthquake relief. He had not adapted to the situation of only performing interventional surgery.

  The first thing he did was habitually was put himself in the position of chief resident of the emergency department.

  He had to help with patient resuscitation no matter what, even if there would be endless trouble in the future.

  He would give it a try. Even if he had the time to train for the surgery, Zheng Ren still did not have the confidence.

  This kind of surgery was simply too damn difficult.

  "You are..." Zheng Ren was pondering when Professor Yang's voice came over. He had not recovered from his shock. He was panting heavily. He had just changed into his white clothes, his c.h.e.s.t drenched in sweat.

  "Hello, Professor Yang. I'm Zheng Ren from the interventional department."

  Professor Yang, who was leading the team, saw that Zheng Ren and Su Yun were looking at the radiographic films. But soon, professor Yang recalled what Zheng Ren had just said.

  "Are you Zheng Ren from the interventional department?"

  "Yes." Zheng Ren nodded. He did not smile. He was thinking about how to perform the surgery.

  Even if he went to the operating theater to train for the surgery, he still had to have some ideas.

  However, this patient's surgery...was a mess. How could he have any ideas?

  "Are you the same Boss Zheng who was nominated for the Nobel Prize?" Professor Yang asked in a low voice.

  "Yes." Zheng Ren grunted again.

  "Nice to meet you." Professor Yang extended his hand and shook Zheng Ren's hand. Then, he asked, "Can intervention solve the problem of the portal vein?"

  "If we wait for the liver source, we can try it. But the patient is currently in an acute shock stage. If we operate on him, the vascular department will need to carry out reconstruction surgery," Zheng Ren answered straightforwardly.

  Professor Yang was obviously a little disappointed.

  He had known about the patient's condition since a long time ago. Initially, he wanted to delay as much as possible and carry out the slow-motion liver transplant surgery with the authorization of the hospital. He did not expect that there would be a ruptured cyst at night.

  He thought that the Nobel Prize candidate would have some good methods... Although Zheng Ren was telling the truth, Professor Yang could not help but sigh.

  "Boss, what's with this small snake?" Su Yun looked at the radiographic films and suddenly asked.

  "It's the performance of the liver hydatid image. It's the sa
me as the gauze below. It's not real. The two doc.u.ments published in the European Journal of Radiology in 1990 and 1991 had a classic description of this characteristic image: the snake-like sign and the spinning sign that has diagnostic significance for acute abdomen due to rupture of the liver hydatid," Zheng Ren said.

  Su Yun took a deep breath, feeling very troubled.

  Confirming the gauze and the small snake was actually not important made all the difference.

  Professor Yang sighed and picked up his phone. While contacting the people, he asked Dong Jia to prepare to send the patient to the stage.

  This was a hot potato but if the surgery was not performed, the patient would die.

  No matter what, he had to report it and then go on stage to give it a try. As for the troublesome matters in the future... They could talk about it in the future.

  "Boss, this surgery can't be done. You're new here, so don't let others catch you. Not to mention Professor Zhao, the chiefs of each department and the leading professors are here. Don't show off." Su Yun shook his head and reminded Zheng Ren again.

  "Can you do the c.h.e.s.t?" Zheng Ren suddenly asked.

  "I can definitely do the c.h.e.s.t, but the abdomen..." As he spoke, Su Yun pointed at the portal vein and right kidney on the radiographic films and said, "I'm afraid you can't do these, either."

  ..

  ..

  At this moment, Professor Zhao of the intervention department was at home. He was sitting in the study and reading a foreign language journal.

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

  "The new Zheng Ren."

  "The junior doctor who asked for a bed from you?" Professor Zhao's wife raised her eyebrows. When she heard Zheng Ren's name, she became unhappy.

  Cutting off one's income was like killing one's parents.

  "What junior doctor? He's Department Chief Kong's treasure and a candidate for the Nobel Prize," Professor Zhao said with a smile.

  "Just pretend. Why did you call him when you had nothing to do?"

  "This is not the afternoon consultation for the whole hospital. There is a patient with liver hydatid disease. All the departments have gone to see him."

  "Does it have anything to do with you?"