Chapter 1459 Inoperable Patients

Zheng Ren, Su Yun and Director Kong separated and went directly to the hepatobiliary surgery.

"Boss, foreign friends have started asking me about TIPS surgery." Su Yun said.

"Huh? What does it mean?"

"There are rumors on their side that this year's Nobel Prize in Medicine has already been decided as our TIPS project." Su Yun smiled.

"It's not very likely. For this kind of thing, do your best and obey the destiny." Zheng Ren said here, and suddenly smiled: "Besides, even if the Nobel Prize is given to our medical team, it should be, what is an internal decision?"

"..." Su Yun looked at Zheng Ren with the eyes of a fool, was silent for a few seconds, and said, "Boss, I really appreciate your confidence."

"Second-phase students, when are you coming?" Zheng Ren asked casually.

"Can I trouble you to respect the experts, professors, and scholars from all over the world?" Su Yun said.

"It's already very respected. I think the respect for a medical staff should be reflected in the amount of operations they perform first." Zheng Ren said: "I only have one request, to be able to perform 100 TIPS operations within 2 months after returning home. Priority. You can't do surgery, and those who simply want to study will be ranked a little later."

"You will kill people."

"Otherwise they have learned TIPS surgery, what are they going to do?"

"Okay, then I'll write it down. It is estimated that people will be able to come in about a week. The daring arrangement of the imperial capital is still from Zhou Chunyong's side."

"Um."

"Zhu Liangchen, what are you going to do?" Su Yun asked.

Listening to Zheng Ren calling Director Kong the Director today, Zhu Liangchen became a hidden danger.

"There is nothing to do. If he wants to learn TIPS surgery, let him do it too. If he wants to find another way, whether it is gastric fundus artery embolization or liver cancer intervention combined with surgery, he can try it." Zheng Rendao.

Su Yun was also a little emotional.

It has only been a few months, and there are already so many projects that can be taken out.

In the past, there were no technical breakthroughs in interventional disciplines, and any new discoveries were treasured.

And now in the medical group... the cooperation between interventional therapy for liver cancer and surgery is not strictly a new technology, but it has great strategic significance for live broadcast of surgery.

Stomach fundus and left gastric artery embolization, but it is a big operation with a lot of money!

How many girls in the country are willing to lose weight?

It's better than eating those unreliable things randomly. After all, if Zheng Ren can study and understand it and be willing to operate it, the reliability is guaranteed.

Uh... When did you have such strong confidence in Zheng Ren?

Su Yun found this and was a little helpless.

It may be that there is no precedent for a failure in surgery, and over time, it has led to the formation of a mindset.

Silent all the way, each thinking about things, came to the hepatobiliary surgery.

Professor Yang didn't come on stage, he was sitting in the office, making something.

"Brother Yang, I didn't have surgery." Zheng Ren came in and greeted with a smile.

"I'm not looking for you today. I wanted to discuss something, but I didn't arrange an operation." Professor Yang stood up and said with a smile.

"I went to the hospital to report my work, I came a little late." Zheng Ren sat down and saw that Professor Yang was studying a film, so he leaned over.

"What kind of work?" Professor Yang asked casually while watching the film.

"Preliminary diagnosis and treatment of latent liver metastases."

"..." Professor Yang paused and looked at Zheng Ren in amazement.

As a professor of hepatobiliary surgery, how could he not know that the diagnosis of latent liver cancer is simply a fantasy?

Zheng Ren didn't notice the change in Professor Yang's mood, but after one glance at the film, he was attracted.

"Brother Yang, this patient is quite heavy!" Zheng Ren rubbed towards Professor Yang, squeezing to occupy a better position.

"The patient was admitted to the hospital due to liver injury locally, and the examination found that the liver had space-occupying lesions." Professor Yang saw Zheng Ren watching the film attentively, so he temporarily ignored the diagnosis of latent liver metastases and began to introduce the patient.

The introduction, which is just a sentence, is very simple, but it illustrates the essence of the problem.

This patient had no cirrhotic nodules on the liver, but had diffuse liver damage. Liver function is greatly affected.

According to Zheng Ren's rough judgment, the patient also has about 20% of the liver function.

The liver itself has a strong ability to regenerate. Even if the left or right half of the liver is removed, the remaining liver of many patients will rapidly proliferate.

Therefore, the preoperative evaluation should take into account the estimated ratio of the residual liver to the total liver capacity.

If the liver is normal, the ratio is less than 25%; the patients with liver disease, the ratio is less than 40%, are contraindicated for liver resection.

The patient has chronic liver damage, and the residual function of the liver is also about 20%.

Without surgery, the patient will live about 3 months.

But if you have to do surgery, you may die after a few days because of liver failure.

"How many years has the patient had a history of drinking with such a heavy alcoholic liver?" Zheng Ren asked.

"30 years ago, it was said that I still drank it last night." Professor Yang replied helplessly.

"last night?"

"Well, during the ward rounds in the morning, I smelled alcohol on the patient, so I asked the nurse on the night shift." Professor Yang said, "The nurse said that he found him drinking in the ward and stopped it on the spot. The patient also cooperated, saying that he did not drink. already."

Zheng Ren smiled wryly.

"Later, according to the clinical person, he went out to drink, a bag of peanuts and two bottles of Red Star Erguotou, and he drank it until more than 10 o'clock in the evening. However, the wine was still good. When he came back, it was quiet and there was no trouble."

"Su Yun, look, it's still necessary to drink less." Zheng Ren pointed to the MRI of his liver and said to Su Yun.

This is so disgusting.

"Don't talk nonsense, I have tested it, and the various enzyme spectra of the alcohol dehydrogenase oxidation system are more than 121 times that of normal people. I drink alcohol, and it will not cause alcoholic liver." Su Yun said expressionlessly.

"Brother Yang, do you know this patient?" Zheng Ren asked.

"Well, I know." Professor Yang sighed, "If you don't know each other, and you still don't cooperate with the treatment, you'll be discharged directly from the hospital."

"That's quite troublesome." Zheng Ren sighed.

At a minimum, the patient can be diagnosed with an alcohol dependence, an acute exacerbation of chronic liver injury, and a hepatic malignancy.

Not to mention malignant tumors, liver damage alone can be fatal, and this patient is still drinking alcohol, which is aggravating liver damage.

"He's my junior high school classmate." Professor Yang sighed deeply and said, "The liver function reserve is not enough to allow surgery, but I really can't bear to let him go home and die."

Professor Yang didn't say the rest, but Zheng Ren already knew what he wanted to say.

"It can be done." Zheng Ren said, "Do portal vein embolization first, and the liver will have enough reserves after 1 month. Whether you do surgical resection or I do liver cancer interventional embolization + radiofrequency ablation, it is all right."

...

...

Note: A liver cancer patient two years ago said that he was not afraid of death. When he heard that his liver cancer lesions had disappeared, he jumped with joy. Saying that he was afraid of death, he repeatedly warned him not to drink, but he still took a bottle of wine and drank it in the hospital ward.

Later, he passed away half a year after the operation, not because of liver cancer, but because of heavy drinking and liver failure.

It's a pity.