Chapter 63: 0062 Swollen Gallbladder

During intraoperative exploration, the stomach and small intestine showed no abnormal changes. The liver was normal in size, surface smooth, without the nodular appearance seen in cirrhotic patients.

But the gallbladder was markedly congested and edematous, as large as half a grown man's fist.

The swollen gallbladder looked like an inflated balloon; one careless move and it would burst with a pop.

【Wow, how many stones must be in this gallbladder?】

【It might not be stones; it could be parasites.】

【If I touch it even a little, the gallbladder will rupture, flooding the peritoneal cavity with bile and contaminating the Shou Bing—it feels like that. I'm done; I can't watch anymore. If I keep watching, I'll probably have nightmares about doing a Shou Bing all night that never ends.】

The unnamed doctor who said he wasn't watching was honest with his body; no one left the livestream, and people kept joining late to watch the legendary big bull performing Shou Bing in Xinglin Yuan.

At a point 0.5 cm from the liver, Zheng Ren made a small incision with the tip of his knife and then began his signature move—Blunt Dissection.

Everyone watching the livestream was a professional doctor; those who had performed fewer than a hundred or so Shou Bing felt embarrassed to post comments in the livestream.

But no one could achieve Zheng Ren's Blunt Dissection.

After repeatedly watching Zheng Ren's performance of 49+1 Appendectomies, someone tried a broader Blunt Dissection, but the result was disheartening—they nearly caused a bowel tear, a medical accident.

During this period, a post appeared in Xinglin Yuan that gathered the statements of everyone who had watched the livestream and attempted Shou Bing, for everyone's Discussion.

Some people still thought it was their own lack of skill, but upon looking at the post, everyone was the same useless.

It seems to be a cognition issue; the big bull doesn't know how many actual operations he performed to develop this skill.

When Zheng Ren performed Blunt Dissection intermittently with the Hemostatic Forceps and his fingers, the livestream was dead silent.

Many people's fingers twitched slightly in sync with Zheng Ren's movements in the livestream.

But… that state of butchering an ox with ease, at a glance you could tell it was only to be watched, not learned.

The gallbladder was congested and swollen to half a grown man's fist, with extremely high surface tension; not to mention Blunt Dissection, even having everyone present do a simple open Gallbladder Removal Surgery required careful caution—any lapse and the gallbladder might burst.

But the operator in the livestream, without a second thought, inserted the curved forceps beneath the serosal layer of the gallbladder wall opened by the blade and quickly separated it.

This speed… is practically courting death.

But nobody would say that.

Why? Because anyone who had said that before got proven wrong, and busybodies took screenshots as proof, posting them in the Discussion post for posterity to vilify.

After a few seconds or several tens of seconds, the Blunt Dissection had reached the gallbladder neck. The operator began to free the gallbladder triangle, a mass of inflamed, tangled connective tissue.

His technique was proficient, his movements not fast, yet each step seemed instinctive, making many doctors present feel their hearts race.

This is literally walking a tightrope—normally, a professor at a top‑tier hospital… why a top‑tier hospital? Why a professor? Because hospitals below that level wouldn't dare perform this kind of Shou Bing; the risk of a medical accident is enormous.

Even in a top‑tier hospital, ordinary junior attending physicians and the Inpatient Chief wouldn't touch it.

At least a team‑leading professor is needed to have enough confidence to perform this difficult Shou Bing.

They would do it, but definitely with extreme caution; they would never be like that big bull in the livestream who, without a thought, just clamps down and does Blunt Dissection.

Actually, the operator's movements aren't particularly fast; they're just precise. The anatomical structure of the gallbladder triangle unfolds like a painting before everyone's eyes.

This guy has definitely dissected several cadaver teachers—no! A few definitely aren't enough; at least ten or twenty.

In China, the number of cadaver teachers is so low that some medical colleges have only one cadaver teacher per class for dissection.

Groups of eight or, legend has it, groups of four dissecting one cadaver teacher are privileges that only a few medical colleges enjoy.

For example, in a certain northern border stronghold, the school is still a medical college, but it has preserved countless corpses of the Kwantung Army from decades ago for dissection. Doctors graduating from that medical college have never known what a cadaver teacher is.

Such a title cannot be applied to the Kwantung Army, even if their bodies have been soaked in formalin for decades.

Because cadaver teachers are scarce, many clinical attending physicians and above don't mind taking on part‑time work as forensic medical examiners.

Of course, this special arrangement exists only for ambitious doctors in third‑ and fourth‑tier cities lacking dedicated forensic medical examiners.

This guy who does livestream Shou Bing has surely dissected many cadaver teachers; this becomes evident in the gallbladder triangle as it is gradually exposed, and once fully exposed, the doctors present all simultaneously think the same thing.

The cystic duct and cystic artery are clearly exposed, then ligated and cut, and the gallbladder is removed in a retrograde fashion.

Removing the gallbladder merely announces that the curtain on this Shou Bing has been raised.

【Laparoscopic Shou Bing would have been fine enough—I didn't expect an open Gallbladder Removal Surgery to reach this level.】

In Xinglin Yuan, a doctor posted a bewildered reflection.

Experts can tell at a glance whether it's done right; no need to look elsewhere—just seeing a gallbladder removal, everyone believes the operator will surely finish this Shou Bing beautifully.

As for how much one can learn from it, that depends on each person's talent.

【Are you stupid? You can't even do an open Shou Bing properly—where do you get off doing laparoscopic Shou Bing?】

【Not necessarily; nowadays many resident‑level doctors start practicing with laparoscopic Shou Bing. Those two just now have unintentionally revealed their age.】

【Once the gallbladder is removed, I feel there will be at least three to five stones three centimeters or larger inside.】

Zheng Ren's dissection was exceptionally clear; after the gallbladder was removed, the common bile duct and hepatic duct were clearly exposed in the Operating Field, and you could tell at a glance which was which.

Nevertheless, to rule out any mishap he reached for a 5 ml syringe, punctured and aspirated bile, confirming it was the common bile duct.

He made a traction line, stretched the common bile duct, Zheng Ren reached out and the sheathed Suction Device was lightly tapped into his hand.

The instant the common bile duct was cut, the Suction Device was shoved inside.

Without a gap, the large amount of bile pooled in the common bile duct, which hadn't yet been forced out by tremendous pressure, was sucked away by the Suction Device.

This detail attracted the attention of doctors in Xinglin Yuan.

In ordinary Shou Bing, some protection around the common bile duct is usually done, because some bile leakage is inevitable.

But the operator in the livestream did no protection; the opening made in the cystic duct and the sheathed Suction Device were about the same size, so not a drop of bile could leak out.

Everything was just right, appearing simple and effortless to the extreme; only someone who has actually performed this kind of Shou Bing would know its difficulty.

【Suddenly I feel a bit sad—I once performed an open drainage procedure for acute obstructive suppurative cholangitis a few years ago; bile leaked during the Shou Bing, triggering a postoperative infection that was first bacterial then fungal, and it took a month to recover.】

【Same feeling—the operator's handling is truly steady; that incision is the same size as the Suction Device—is this tactile sense and eyesight trained?】

【That's talent—don't even dream about it.】