Chapter 804: 792 Reluctant Surrender

Throughout the process, Zheng Ren understood all the disclosed details.

Therefore, after seeing this image, Zheng Ren's first impression was late-stage pancreatic cancer with liver metastasis.

But he did not rule out a pancreatic neuroendocrine tumor.

Zheng Ren heard Yang Rui say that, nodded, and said: "Let's take a closer look; if it's a pancreatic neuroendocrine tumor, perhaps there is a way."

The patient's family seemed to have lost the ability to make independent judgments, standing to one side with a particularly grim expression.

The local diagnosis was advanced pancreatic cancer; he came to the capital with the idea of giving it a try. But hearing the professor here also think it was advanced pancreatic cancer, the patient's family at that moment thought of giving up treatment.

As for what a pancreatic neuroendocrine tumor is, no matter how, it's still a tumor, right?

What's the difference?

Zheng Ren removed the abdominal CT and inserted the contrast-enhanced MRI.

The contrast-enhanced scan appeared to be able to provide more information.

Although Zheng Ren had the ability to reconstruct, more images could provide more details, which also helped the reconstruction. But reconstruction is merely morphological; it cannot provide pathological basis, and for the current patient's diagnosis, it does not offer much help.

From the perspective of hemodynamic image changes, Zheng Ren strove to differentiate between malignant pancreatic tumor and pancreatic neuroendocrine tumor.

"Has the chromogranin A immunostaining been done?" Zheng Ren asked.

"No."

"Let's check and see; the arterial phase on the image looks problematic, or rather it leans toward a pancreatic neuroendocrine tumor." Zheng Ren said: "If possible, do an endoscopic examination to take a pathological tissue biopsy."

"Okay." Professor Yang nodded.

Having Zheng Ren's preliminary judgment is enough. At this point, no one can determine the stage, so there's no basis for discussing the next step of treatment.

If it were G3 stage, Professor Yang would advise the patient's family to give up; but if it were G1-2 stage, treatment could certainly be carried out.

"By the way, Boss Zheng, if surgery is possible, do you have a way on your end?"

"Radiofrequency ablation can be done." Zheng Ren said.

"Being able to do it is fine," Professor Yang smiled.

The lesion in the pancreatic area can be surgically removed, but the lesion in the liver is difficult for general surgery to excise; the best approach is to accept interventional treatment.

If Boss Zheng can do it and dares to do it, that means the patient's survival time will be prolonged.

After packing up the images, Professor Yang's movements became slower and slower, and he sensed a change in the patient's family.

Nevertheless, he still handed the film bag to the patient's family, saying: "Come as soon as possible, do a needle biopsy, pathology will determine the nature of the lesion. It's not necessarily pancreatic cancer; if it isn't, after treatment, survival can reach about ten years."

"Oh, okay, okay, thank you, thank you." The patient's family said a few polite words, bowed, and left.

Watching the patient's family's back disappear, Professor Yang shook his head.

"Alas." He then sighed.

Zheng Ren, too, being an experienced doctor, could also judge from the family's words and actions that something was likely to happen.

The patient's family had no strong desire for surgery or treatment; they merely came seeking a certainty, so that their reason for giving up treatment would be more solid.

But on this side, Zheng Ren and Professor Yang gave a seemingly plausible conclusion, calling for further examination.

Both sensed that beneath the patient's family's polite tone lay some kind of disappointment.

Even... perhaps some anger?

Actually, the malignancy of neuroendocrine tumors is far lower than that of pancreatic cancer. Although there is distant metastasis, that is merely a characteristic of neuroendocrine tumors.

If confirmed, surgical treatment is possible; Zheng Ren is confident that he can raise the patient's survival to over ten years.

Jobs's death, according to the latest WikiLeaks, was due to having a neuroendocrine tumor together with AIDS. After all, when he was young he was a hippie, so having AIDS is not surprising.

But looking at the patient's family's emotions, it's estimated they will give up once they go back.

Whether it's family reasons or economic reasons, these have nothing to do with the doctors. Speaking purely of the condition, if they give up, it truly is a pity.

However, doctors can only offer advice to the patient's family; as for whether to treat or not, doctors cannot make the decision.

Professor Yang patted Zheng Ren on the shoulder, quickly adjusted his mood, and said with a smile: "Little Zheng, the postoperative recovery of patients with hepatic hydatid disease is especially good; all test values are gradually returning to normal, your surgical skill is truly not bad. When I find another patient, you can teach me."

"Brother Yang, you're too polite." Zheng Ren smiled and said: "If there is, we'll discuss it."

This counts as agreed upon, and Professor Yang became a bit happier.

Autologous liver transplantation, with instruction or without, are two different concepts.

In the hepatobiliary surgery department of 912, the director has performed autologous liver transplantation, but the number is small. Professor Yang has also seen the director operate; his level… is truly not as good as Zheng Ren's.

Actually, he is quite curious: at Zheng Ren's age, how exactly did he hone his surgical skills?

General surgery doctors doing interventional work also have precedents. TIPS surgery, at least half of it is performed jointly by general surgery doctors and interventional medicine doctors.

But Boss Zheng, being able to handle both sides with skill, is rather amazing.

The patient's family left, the images were also finished viewing, Zheng Ren then said his goodbyes. Professor Yang saw Zheng Ren to the door and watched him depart.

Zheng Ren walked to the elevator, still feeling some regret in his heart.

This disease is still treatable; giving up is indeed a pity. But there's nothing to be done, Zheng Ren sighed.

Su Yun hadn't returned yet, and Zheng Ren wasn't in a hurry either; he went back to the ward and glanced at the postoperative patient.

Chang Yue and Xiao Oliver also weren't that busy; plus Dr. Shen, there were three people doing preoperative work, making Zheng Ren's team strong and capable.

Professor Rudolf Wagner was busy with statistical work and data organization.

The Nobel Prize reviewers' examination of the relevant data from surgical patients is very strict. These trivial matters, Zheng Ren basically has no intention of doing them.

Leaving it to the professor and Su Yun to do is much better than me meddling aimlessly.

However, the problem still lies in the number of patients; with several thousand surgeries, postoperative follow-ups, as the surgical volume increases, it will become a major issue.

To win the Nobel Prize, it's not enough to just have skill, nor can it be achieved merely by enthusiasm.

Zheng Ren saw that there was nothing else going on in the department, and prepared to go out for lunch with Xiao Yi Ren.

These past few days, Zheng Ren has visited the heads of all relevant departments in the hospital. Most were just courteous; if he wanted to point at these directors and have them bow their heads in submission, Zheng Ren felt it impossible.

Having come this far, it's already not easy.

He took out his phone, just about to send a WeChat to Xie Yiren, when suddenly a call came in—it was from Su Yun.

Zheng Ren answered right away.

"Boss, answer quick!" Su Yun said on the other end: "Pediatric emergency, come fast!"

What's wrong?

Making trouble!