Chapter 1007 New Ideas (Add 10 for Qingyan Xiaoguan)

After Chen Cang was ready, Ford and others also went to the operating room.

Several doctors and assistants came, but they stood in the distance and looked at the operating table without speaking.

Ford looked at the operating room, and suddenly met Chen Cang's gaze, and was stunned for a moment.

What does this look mean?

Kind of like... encouragement?

Ford was a little confused. This seemed to be the same as when he first entered the hospital. The teacher looked at him with relief and said, "Study hard!"

At this time, Ford's nurses brought in the equipment, and it seemed... ready to take over the operation at any time.

Although pancreaticoduodenectomy is an effective therapy for pancreatic cancer, its curative effect is still unsatisfactory.

Especially pancreatic head cancer is the worst!

Several other types of cancer are slightly better, but the total surgical resection rate is only 30%, and the operative mortality and five-year cure rate after resection are only about 10%.

Therefore, this requires a high degree of precision in the operation, and every link must be done well.

Similarly, this is also the confidence of Ford et al. They have enough clinical experience and coping strategies!

Even in the field of digestive tract reconstruction there has been considerable development.

Ford looked at Chen Cang and saw that he was in a relaxed manner without the slightest wave, which made him a little more curious.

This young man doesn't seem nervous at all, doesn't he know the difficulty of pancreaticoduodenectomy?

Perhaps...the ignorant are fearless!

Ford believes that he can find many shortcomings and mistakes in Chen Cang during the operation, and even he will write a special paper and publish it in the journal of the American Medical Association.

Surgery is about to begin!

The anesthesiologist is the director of the anesthesiology department, and has communicated enough before, open surgery.

The choice is continuous epidural anesthesia, which lasts for a long time, the reaction is small, and the abdominal muscles relax well for easy exposure.

Seeing this scene, Ford almost couldn't help laughing: Could it be... Are you going to open the abdomen for a pancreaticoduodenectomy?

Now this kind of surgery, Mayo has basically all done endoscopic surgery!

Ford suddenly felt a sense of dimensionality reduction...

"Doctor Chen, do you want to open your abdomen?" Ford still couldn't help asking.

Chen Cang didn't look back, but looked at the nurse beside him and said, "Scalpel!"

Seeing this, Ford blushed.

Chen Cang had discussed this matter with the anesthesiologist for a long time, and choosing laparotomy is a necessary step to decide whether or not to remove it!

Because the old man was very early, and there was not even much transfer, Chen Cang's initial plan was to keep some tissues and remove some tissues.

This is also a surgical option that he has been researching and exploring recently.

If the traditional pancreaticoduodenectomy is used, according to the physical quality of the elderly, plus long-term diabetes, Chen Cang can guarantee that the survival period will not be too long.

Not even a perfect pancreaticoduodenectomy!

This is a flaw in the surgery itself.

This is why Chen Cang fought for surgery, because he knew that if Ford did it, he would definitely have to remove it completely. This is not much different from ordinary people. The only difference is that when the digestive tract is reconstructed, Ford can do it. Relatively better.

This is the difference between Ford and Chen Cang.

When Chen Cang's pancreatoduodenectomy was perfect, he cooperated with those quasi-perfect biliary-enteric anastomosis...perfect gastrointestinal anastomosis, etc. This made Chen Cang realize one thing.

That is the disability of the surgery itself.

The more in-depth research, the more Chen Cang discovered the incompleteness of the operation.

There's no such thing as a perfect operation, but it's just a general out of the dwarf. When it's absolutely necessary, he can operate better, and the chance of complications is relatively lower.

Therefore, Chen Cang ignored Ford at all, and he needed to do an operation next.

Taking the scalpel, Chen Cang made an incision in the middle of the old man's right upper abdomen.

The incision is not large, but the position is just right for the upper, lower, and extension to fully expose the entire digestive tract.

When the abdominal cavity was exposed, Chen Cang began to check.

The size of the gallbladder is normal, which is a good thing. Cancer of the head of the pancreas will not compress the bile duct and cause the lesions of the gallbladder.

When Chen Cang touched the head of the pancreas with both hands, he clearly felt a burst of information.

[Carcinoma of the head of the pancreas: very early stage, resection is recommended! 】

After feeling the mass in the head of the pancreas, the next thing Chen Cang had to do was to open the duodenum for examination to clearly identify the development of cancer in the head of the pancreas.

This operation is dangerous, and it is easy to spread the tumor or the intestinal bacteria into the abdominal cavity, and it should be avoided as much as possible unless it is specially necessary.

Sun Guangyu looked at Chen Cang nervously, not daring to take a breath.

Although he had already talked about the surgical plan, he was still a little nervous.

Ford was equally dumbfounded!

Chen Cang is dancing on the tip of a needle!

After seeing the internal structure clearly, he finally breathed a sigh of relief.

The next thing to decide is whether to resection, can pay for radical resection.

Check whether the cancer itself has gone beyond the gland and invaded important blood vessels such as portal vein, superior mesenteric artery and vein, abdominal aorta, inferior vena cava.

At this time, Chen Cang directly incised the retroperitoneum on the outside of the duodenum, and turned the duodenum and the head of the pancreas inward!

Then, carefully probe the dorsal side of the head of the pancreas and the ventral side of the aorta and inferior vena cava with the index finger of the left hand.

It is easy to put a finger into this gap, indicating that the cancer is still limited to the pancreas and has no metastasis.

Luckily, there was no transfer!

This process requires three-step inspection, but Chen Cang has done more than ten steps, and he counts everything he can consider.

This... is something that laparoscopic surgery will never be able to do.

Refinement and precision.

Time passed by, and Chen Cang checked very carefully.

Finally, the inspection is over!

Chen Cang looked at the abdominal cavity, and the four-dimensional model began to simulate continuously. After two minutes, Chen Cang began to move!

The next step is to fully separate the organs to be removed.

And at such a critical link, Chen Cang suddenly did not separate the stomach body, but began to dissociate the biliary tract!

Then... under the hemostatic forceps, he took the lead in making a Y-shaped incision under the common bile duct and the pancreas.

Then a clever separation was performed, and at this time, the pancreas suddenly became free!

This inexplicable operation stunned everyone!

At this time, the head of the pancreas cannot be touched, and the operation of the duodenum, gastric body or even the bile duct needs to be ligated before removal to prevent the spread of tumor cells.

But Chen Cang has now separated the bile duct directly from the pancreas, so that the bile duct is free!

This operation directly blinded Ford behind him!

How is this going?

Chen Cang took a deep breath. Just now, he was very careful about this step, for fear of causing adverse consequences, his eyes have long been opened!

Put your whole heart into it!

What he has to do is not to remove the bile duct, but to subtly use separation to achieve a resection effect.

So far, it looks good!

At least for a while, the difficulty of biliary anastomosis is small.