Chapter 788: 776 Intraoperative Cholangiography and Capillary Bile Duct Anastomosis

"Boss, go slow, I'm feeling dizzy." Su Yun stood to Zheng Ren's right, unconsciously blew a breath, and said.

"It's fine, not too fast." Zheng Ren removed the left liver, a pathology specimen basin appeared on his left side.

The left liver full of parasites was placed in the basin; just one look would trigger trypophobia in sufferers.

Xie Yiren called the circulating nurse, carefully throwing both the basin and the left liver into a yellow trash bag to avoid contaminating the sterile area.

Only after the parasite-filled left liver disappeared did Xie Yiren finally exhale.

Taking this kind of liver…… is really frightening.

At the same time, Zheng Ren removed the diseased liver and quickly infused UW solution into the portal vein.

UW solution is the fluid used to preserve donor organs during organ transplantation; it mainly contains lactobionic acid, is a major non‑penetrating anion, and has a relatively large molecular weight.

It reduces cell swelling during cold storage and also contains maltose, hydroxyethyl starch, and adenosine.

On that side, portal vein resection and artificial conduit repair have already begun.

Zheng Ren devoted half of his attention to monitoring the vascular surgery; seeing that the occlusion, resection, and suturing were going smoothly, he relaxed.

Su Yun, after all, is a doctor who has performed heart transplants; this is no joke.

Heart transplantation in mice is absolutely more difficult than in humans; because the vessel diameter is small, suturing requires a microscope.

Yet resecting the portal‑vein segment containing the parasite‑laden thrombus and replacing it with an artificial vessel is far more difficult than a heart transplant; the portal vein is relatively hard, making suturing comparatively easier.

Zheng Ren knew Su Yun could definitely do it, but in the System Operating Room the relevant steps had not been thoroughly trained.

He originally intended to act as a backup just in case, but Su Yun didn't give him that chance, and he worked especially smoothly with Director Bao.

After removing the liver invaded by the liver fluke, the patient's remaining liver was pitifully small.

"There will be prolonged liver failure after the operation," a doctor in the gallery blurted out, unable to hold back.

"The liver volume is only one‑third of the original; liver failure is likely to occur."

"Then what is the significance of this operation?"

Yeah, what's the point of this surgery? After stepping down, liver failure is inevitable, and the patient's chance of survival is less than 5%.

Is the surgery still necessary?

Even a normal person would probably not tolerate losing that much liver tissue; moreover, this patient had resection of a right kidney segment, lung segment, part of the pericardium, and the superior vena cava was cut and rerouted…

This series of surgeries inflicts enormous trauma.

Adding to that, the patient already had infectious shock before the operation…

Even 912, many surgical professors felt their hearts go cold facing this situation.

Professor Yang shared the same thought as his colleagues whispering behind him, but he simply couldn't stop.

The assistant opposite was as calm as an AI; I couldn't keep up with my full concentration, let alone discuss postoperative issues with others.

Most importantly—although the surgery had already lasted several hours, it had not yet reached the most critical step.

Autologous liver transplantation could answer the colleagues' doubts, but autologous liver transplantation is also the most difficult!

If we disregard rejection and consider only surgical difficulty, the difficulty of autologous liver transplantation far exceeds that of ordinary liver transplantation.

Ordinary liver transplantation only requires anastomosing the major blood vessels and bile ducts; the surgical difficulty is actually considerable. However, Professor Yang, having performed liver transplants before, could handle it completely.

When the patient arrived, he first considered liver transplantation—but who would have thought the patient would present in emergency with a ruptured hydatid cyst wall, causing infectious shock?

There was no time to wait for a donor liver; only an autologous liver transplant could be done.

Just thinking about an autologous liver transplant made Professor Yang feel despair welling up.

Big and small bile ducts, blood vessels…

He had attempted this high‑difficulty surgery before; although it succeeded, he was dissatisfied with his own performance. He had originally planned to hone his skills and then launch another assault on the final bastion of hepatobiliary surgery, but unexpectedly a case of extremely high‑difficulty autologous liver transplantation fell from the sky, forcing him onto the operating table.

"Professor Yang, what do you think about resecting liver segment eight?" Zheng Ren, while lending Su Yun a hand, said politely during the break.

Professor Yang's hand was numb.

Resecting liver segment eight is indeed the best option now. According to the condition, segment eight liver is intact but not the most important part of the liver. If a successful autologous transplant could be made, becoming the left lobe of the liver, the operation could be called a great success.

However……

Because the liver left is scarce, liver function is severely impaired, and the operation time must be kept under two hours.

This differs from ordinary autologous liver transplantation; its difficulty is greater, to an unimaginable degree.

Professor Yang moved his hand a little, sighed, and asked: "Boss Zheng, do you have any confidence? To be honest, I have none."

Hearing Professor Yang say that, the operating room fell silent once again.

The surgical difficulty is evident to all; no one would say Professor Yang lacks skill because of it. The patient's condition is too grave, and human strength has its limits.

Is all we can do just sigh?

Such a splendid operation—if it ultimately fails, that would be terribly disappointing.

"Eighty percent confidence." Zheng Ren, seeing that Su Yun's side had already begun occluding the superior vena cava, preparing to excise and reroute it, said calmly.

Eighty percent…… is that high?

Professor Yang was somewhat puzzled.

He raised his head; from maintaining the same posture for a long time, his cervical vertebrae emitted a grating sound that made one's teeth ache.

Without taking time to move his neck, Professor Yang stared into Zheng Ren's eyes, trying to see whether this was a joke.

"In a moment we'll do an intraoperative cholangiogram; anastomosing the bile ducts is no problem. Even the fine capillary bile ducts can be anastomosed." Zheng Ren's sentence completely stunned Professor Yang.

Generally, in autologous liver transplantation only the large bile ducts are anastomosed; the remaining capillary bile ducts close on their own. Postoperatively drainage is needed to avoid infection and other complications.

But what did I just hear?

Intraoperative cholangiography? Then we have to anastomose the capillary bile ducts?!

This…… this kind of procedure Professor Yang has heard of, but only a grandmaster‑level figure would attempt it once to prove they can do it.

In theory it's feasible. But under these circumstances, could anyone actually pull it off?

"Zheng…… Boss Zheng, you're not joking, are you?" Professor Yang's words began to stutter.

In his view, this is a joke.

"Cut the liver into eight sections, prepare for transplantation, the patient's vital signs are not very stable, we have no time." Zheng Ren glanced at the ECG monitor, said.

"You come to my side?" Professor Yang said again.

"You go first, after a while do the imaging, then I will assist you in doing an autologous liver transplant." Zheng Ren narrowed his eyes slightly, as if smiling.

On the operating table, to have the surgeon's position snatched away is a great disgrace!

However, Professor Yang, hearing Zheng Ren say that, felt his heart suddenly relax.

He dares to say that, likely the possibility of being able to do it is high. If it were an ordinary young doctor, Professor Yang would have already coaxed him down.

But standing opposite him is a Nobel Prize-nominated doctor, the halo of the Nobel Prize enveloping him, and facing this situation, Professor Yang could only choose to believe.

"Good!" Professor Yang said through gritted teeth.