Chapter 779: with translation of chapter title

Whether it's liver hydatid or malignant tumor, once it invades the portal vein, it probably means the difficulty of the Shou Bing increases geometrically.

"The thoracic department opened four tables in the operating room; tonight something's gone wrong—the thoracic department can't even scrape together a person." Dong Jia complained, "Zhao Zong said, if there's something, have me find you; if something happens, he'll take responsibility. He hasn't even called you, yet you came."

Just as they were speaking, a figure rushed in, panting. His throat sounded like it was pulling a bellows, the hoarse voice making one feel his own breathing wasn't smooth either.

"Professor Yang!" Dong Jia shouted hurriedly.

"How's the rescue going?" the person gasped, apparently having run up.

"Temporarily stable, but…"

"I'll go change clothes." Professor Yang didn't even look at Zheng Ren and Su Yun, probably thinking they were just passersby.

"Any films?" Zheng Ren asked.

"Yes, the CT done this afternoon, covering chest and abdomen." Dong Jia immediately turned around, took the film bag from under the patient's bed, and handed it to Su Yun.

"You look first; I'll go attend to the patient—don't let anything else happen later." Dong Jia didn't forget to be polite at the end.

Su Yun grabbed the film bag, said nothing, turned and headed straight for the doctors' office.

After placing the film on the viewer, Su Yun was stunned.

The CT images of two levels appeared directly before his eyes. In one level, a small snake wound its way into the field of view—no bigger than 10 cm, but lifelike. In the other level, there was a mass of gauze.

Damn it, was this placed in as part of an experiment?

Zheng Ren remained in his usual pose, right hand supporting his chin, seriously examining the film.

No matter how talented Su Yun is, after all he's not from the General Surgery Department, so he doesn't know much about hepatic hydatid disease, which is rare even in Di Du.

Seeing Zheng Ren focused on the film, he took out the chest CT to look.

The imaging findings were shocking.

Hepatic hydatid disease has extensive involvement, affecting four abdominal and thoracic cavity organs as well as major blood vessels.

Looking at the images, they truly resemble cancer in several ways.

Calling it worm-cancer is quite fitting.

The hydatid invaded about 65% of the liver, forming a large, hard mass, and extended downward to invade the right kidney and renal vein.

Extending upward, it penetrated a large area of the diaphragm, then invaded the thoracic cavity and lower right lung, spreading all the way to near the pericardium.

The hydatid extensively invaded the abdomen's largest venous vessel and its branches, causing complete occlusion of the vena cava from the level of the right renal vein to the right atrium, spanning 17 cm; meanwhile, the four sets of vessels entering and exiting the liver—hepatic artery, portal vein, hepatic vein, and bile duct—were all severely damaged.

Similar to Budd-Chiari syndrome, but the portal vein invasion is so extensive that it cannot be treated via interventional surgery.

Looking at the thoracic involvement, the cyst wall is relatively thin; Zheng Ren estimates it should be a rupture of the right thoracic cyst, causing infectious shock.

But this surgery…

It's just too complex.

If it were done, the patient's chance of leaving the operating table alive isn't great—at most a 30% possibility.

Moreover, even if the patient leaves the table alive, the chance of surviving the critical period is no more than 20%.

All told, the patient's chance of postoperative recovery and discharge is only about 5–6%.

This is practically dancing on the tip of a knife!

"Boss, this Shou Bing can't be done." Su Yun looked at the films for two minutes, then reached a conclusion.

Zheng Ren understood Su Yun's meaning; in fact, he thought the same.

For patients who will die if not operated on, yet have only about a 5% hope of survival if operated, most doctors would choose to give up.

Not going up onto the table has nothing to do with me; going up, and I get implicated.

Who can be confident about such a complex surgery?

Moreover, if the family aren't present? Even if the surgery succeeds, there definitely won't be any issue. But if it fails…… At Haicheng Shi Yiyuan, Zheng Ren's hemostasis surgery for a parturient with massive postpartum hemorrhage was successful, yet the patient's family still took the patient away and prepared to sue Zheng Ren and the obstetrics doctors.

However, since the Medical Department has already filed it, that means any incident would be borne by the hospital. Zheng Ren stared at the films, already contemplating how to perform the surgery in his mind.

To watch the patient die helplessly? Zheng Ren truly can't do that.

Even if it were something like triple-negative breast cancer, Zheng Ren couldn't solve it even if he exhausted all his surgical time.

Yet this patient, though grave, still has a sliver of possibility.

Although Zheng Ren had left Haicheng Shi Yiyuan a few months ago—first on a mission, then to Earthquake Relief—he still hadn't adapted to doing only Intervention Department surgery.

At First Time, he habitually placed himself in the position of Inpatient Chief of the Emergency Department.

No matter what, we must attempt a rescue, even if it brings endless trouble later.

Let's give it a try; even with Surgical Training Time, Zheng Ren still lacks confidence.

This kind of surgery is damn difficult.

"Who are you…?" Zheng Ren was pondering when Professor Yang's voice came over. He hadn't caught his breath yet, panting, his freshly changed White Coat already soaked with sweat on the front.

"Professor Yang, Greeting, I'm Zheng Ren of the Intervention Department."

Professor Yang, leading the team, saw Zheng Ren and Su Yun looking at the films and casually asked a question. But soon Professor Yang recalled what Zheng Ren had just said.

"You're Zheng Ren of the Intervention Department?"

"Mm." Zheng Ren nodded, without a smile, he was pondering how to perform the Shou Bing.

Even if going to the System Operating Room to practice surgery, he'd still need a plan.

But this patient's Shou Bing… a tangled mess—where's the plan?

"Are you Zheng Lao Ban, the Nobel Prize Nominee?" Professor Yang asked softly.

"Mm." Zheng Ren hummed again.

"Pleasure to meet you." Professor Yang extended his hand, shook Zheng Ren's, then immediately asked: "Can Intervention resolve the portal vein issue?"

"If we wait for a liver source, we could try. But the patient is currently in acute shock; if we operate, the Blood Vessel Department would need to perform reconstructive surgery." Zheng Ren answered bluntly.

Professor Yang was visibly disappointed.

He had known the patient's condition all along; originally he wanted to delay as much as possible, and after hospital authorization perform an Outpatient Liver Transplant Surgery, but he didn't expect the cyst to rupture that evening.

I still thought the Nobel Prize nominee would have some good tricks...... Although Zheng Ren was telling the truth, Professor Yang still couldn't help but sigh.

Boss, what's going on with this little snake? Su Yun looked at the image and suddenly asked.

It's the manifestation of the hepatic hydatid image, same as the gauze below, not real. The two papers published in 1990 and 1991 in the European Radiology Journal gave a classic description of this characteristic image: the serpentine sign and the gauze sign, which have diagnostic significance for ruptured hepatic cyst acute abdomen. Zheng Ren said.

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

Determining the gauze and the little snake is actually not important; what matters is the surgery.

Sigh. Professor Yang sighed, picked up the phone, while contacting people and letting Dong Jia prepare to send the patient to the operating table.

This is a hot potato, but if we don't do the surgery, the patient will die.

No matter what, we have to report it first, then go up and give it a try.

As for future troubles...... we'll talk about them later.

Boss, this surgery can't be done; you've just arrived, don't give anyone a handle to hold against you. Not mentioning Professor Zhao, with the department heads and team-leading professors around, you'd better not show off. Su Yun shook her head and again warned Zheng Ren.

Can you do the chest? Zheng Ren suddenly asked.

I can definitely do the chest, but the abdomen...... As she spoke, Su Yun pointed with her finger at the portal vein and right kidney on the image, saying: These, I'm afraid you can't do either.

……

……

At that moment, Intervention Department Professor Zhao was at home, sitting in the study reading a foreign-language journal.

Who were you just calling? Professor Zhao's lover asked.

The newly arrived Zheng Ren.

Is that the little doctor who demanded a Bed Position from you? Professor Zhao's lover's eyebrows shot up, and upon hearing Zheng Ren's name, a murderous aura surged upward.

Cutting off someone's source of wealth is like killing their parents; this saying is truly reasonable.

What little doctor? He's Director Kong's treasure, a Nobel Prize nominee. Professor Zhao laughed and said.

Just pretend, why are you calling him for no reason?

This isn't the Afternoon hospital-wide consultation; there's a patient with hepatic hydatid disease, and all departments went to have a look.

Is it related to you?

No. If you insist on saying there is a relation, you could tack it on. When finally doing an autologous liver transplant, creating an image would be faster.

Then why did you call Zheng Ren?

I have no way, but that doesn't mean Zheng Lao Ban has no way either. Professor Zhao leaned back in the chair, closed his eyes, seeming to ponder something.

He……

The last time we did research, I heard he came from a general surgery background.

Then you let him go? This is giving him an Opportunity to show off in public? Professor Zhao's lover didn't understand.

Opportunity? I'm just afraid he won't dare to go up. Professor Zhao laughed and said: He came from Hai Cheng; I don't know why Director Kong took a liking to him. In Hai Cheng he was the Inpatient Chief of the Emergency Department, and I hope he'll get to perform surgery. You say, no matter who, who could let him get on? Which department's surgery would require an Intervention Department doctor to do it? This isn't showing off.

You're just overthinking.

If he dares to propose the demand to go up for surgery, afterward he won't be able to stand in 912. Professor Zhao laughed: If that's the case, it would truly be a relief.

Director Kong too, just a little doctor, fighting over a Bed Position from your hands?

He's a Nobel Prize nominee; if I were Director Kong, I'd do the same. Anyway, he's going to retire soon, so it doesn't matter. It's a pity—if it were two years later, I could vie for the position of department head, and if I met him again, how great that would be.

He's that capable? Professor Zhao's lover exclaimed in surprise.

I can't match him in surgery, especially TIPS Surgery—his technique is slick. But being young and full of vigor, having such great ability at this age, his ambition is surely high. Today I don't know what the situation is like over there; if he truly, unaware of the depths, wants to go up on stage, there will be fun to watch.

He won't really go up to perform the surgery as the lead surgeon, right?

How could that be possible! Emergency Rescue is just playing around? Besides, Gan Dan Wai Ke's Yang Rui, who stays at home, is that a penny-pincher? Over these years, I've never seen him yield to anyone. A few years back, he wasn't still locked in an irreconcilable feud with Lin Guo Dong, and in the end he literally squeezed Lin Guo Dong out. An Intervention Department doctor under thirty, what gives him the right to steal Yang Rui's stage? Saying that, I really do have some anticipation.