Chapter 947 The Heart Is Bleeding

Zheng Ren didn't say anything, just changed his clothes silently.

"Go, go and see the situation." Director Kong also took the time to change his clothes, put on a sterile cap, and walked in quickly.

First came to the operating table, Director Kong began to review the images of the operation process.

During the process of taking the stent, the angle was slightly deviated and touched the liver parenchyma, causing a small artery to rupture and bleed.

This is also the reason why only one stent was removed in the previous TIPS operation and never recovered.

It is indeed a perfect idea to install the second retractable stent and wait for the patient to adapt to the blood ammonia situation before taking it out. Expanding the outflow tract is indeed a perfect idea. However, there are many difficulties in the process of taking out the second recoverable stent.

Zheng Ren dared to do this only after he had reached the master level in the interventional surgery skill tree. But Zhu Liangchen tried to do many details by himself before teaching them to him.

this thing...

In fact, it cannot be said that Zhu Liangchen was completely wrong.

It's just that this kind of mistake is completely unnecessary.

He stood behind Director Kong, watching the video of Zhu Liangchen performing the operation, but he came to the system space and clicked on the operation training.

The system operating room rose from the ground, and Zheng Ren entered without hesitation.

His heart is bleeding.

Although there is still plenty of time for surgical training, this is completely unnecessary "consumption". This fellow Zhu Liangchen!

Zheng Ren thought bitterly in his heart.

His heart was already bleeding, and he didn't waste the training time for surgery, and started the operation directly.

In fact, with Zheng Ren's level of interventional surgery, he could go directly to the stage. But this was an unexpected situation after all. Taking over Zhu Liangchen's operation by himself and doing it by himself are two different concepts.

Zheng Ren still chose to purchase the surgical training time safely. If there is any problem, it is still in the system operating room and let the experimental subject bear it.

Zheng Ren had already done research on this complication. Embolization is undoubtedly the best choice.

He first let the stent deflate a little, angiography, and immediately saw blood flow.

Zhu Liangchen had finished the puncture work, and Zheng Ren began to super-select the artery.

In patients with advanced liver cirrhosis, the liver has shrunk, and the arteries have abnormal anatomical structures due to various reasons. Coupled with splenomegaly, the blood coagulation mechanism is not good, so one or two hours of compression with a covered stent to stop bleeding has no effect.

Angiographic results showed that the bleeding arteriole was a 4th and 5th degree junction artery. Very thin, the difficulty of super selection is not ordinary.

But for Zheng Ren, the difficulty of this kind of super-selection will not be more difficult than the interventional embolization of the prostate.

Zheng Renchao is very skillful and meticulous in the cross operation of left and right hands.

Because the liver function of patients with advanced liver cirrhosis is very poor, and the liver is shrunk, so there is less embolism, and less embolism, so as not to cause liver failure in patients.

The guide wire enters, is super-selected layer by layer, and finally enters the bleeding artery.

Almost embolizing the bleeding point, Zheng Ren was sure that even if he had reached the peak level of interventional surgery, he could only do this.

There is nothing special about the operation, it is just a test of the super-selection technique.

Embolization, re-radiography.

Zheng Ren was very confident, but the system only gave 85% of the completion of the operation.

Strange, why is this so?

After observing for a few minutes, Zheng Ren found that except for one small artery, the channel where the stent was punctured was continuously oozing blood.

This is the result of extensive contusion of the liver parenchyma after repeated friction.

Zheng Ren was also very helpless.

Zhu Liangchen's technique was wrong, causing even greater surgical side injuries.

What to do? Zheng Ren felt a little helpless for a while. Embolization of small arteries can solve big problems. It's okay for the patient to step down like this. The problem of bleeding may get better soon, but it may also continue to ooze, leading to deterioration of the state and eventually hemorrhagic shock.

We can't wait for patients to heal themselves, we must solve this problem! Zheng Ren immediately made his choice.

Don't do things that are by chance. Although Zheng Ren had the luck bonus, deep down in his heart he disliked it.

Then super-select, find several blood supply arteries at the oozing contusion position, super-select, and embolize.

Zheng Ren faced a difficult problem. The more detailed the super-selection, the smaller the range that can stop the bleeding. In this case, more superselection and embolization should be done.

How to obtain a point of maximum benefit and minimum damage is very difficult.

Fortunately, there is a lot of time for surgical training, so Zheng Ren simply tried to do it little by little.

Fortunately this is a system operating room and mistakes can be made.

As time went by, Zheng Ren gradually found a balance point. Where to embolize the 3rd and 4th grade arterioles can avoid causing greater damage to the patient, but can stop the bleeding smoothly.

It's just that Zheng Ren was a little distressed by the wasted time in surgery training.

Fifteen hours later, Zheng Ren finally saw that the operation was 97% complete.

That's it, no matter how much, it is estimated that it will be difficult to achieve.

After all, the patient's platelet count is more than half that of normal people. In this case, the completion rate of 97% of the operation has almost reached the limit.

He glanced at the experimental subject, feeling a little regretful.

Turn around and leave the operating room of the system, and return to reality.

After reviewing the procedure of the operation, Director Kong said in a deep voice, "Old Five, Boss Zheng and I are going to take a rest."

Zheng Ren hurriedly went to brush his hands.

Going on stage with Director Kong, he can't wait for the professor to finish his preparations like he did with Professor Rudolf Wagner before going on stage by himself.

To the old director, we still have to show respect.

Seeing Zheng Ren running to brush his hands and get ready, Director Kong took a deep look at Zhu Liangchen and shook his head slightly.

Zhu Liangchen felt dry mouthed, a little embarrassed, but also a little dissatisfied with Zheng Ren's arrival.

With all kinds of complicated emotions intertwined, he lowered his head and refused to look at Director Kong.

Director Kong was fine, brushed his hands and went to the stage.

"Boss Zheng, you do it." After Director Kong went up, he stood directly under Zheng Ren's subordinate and squeezed him into the operator's position.

Zheng Ren did not continue to be polite, and directly inserted the micro guide wire, and began to perform superselective arteriography + arterial embolization.

In the operating room, Zhu Liangchen stared blankly at the old and the young on the operating table through the leaded glass.

Did I do something wrong? He doesn't think so.

It must be a problem with the surgical design, two stent-grafts should not have been installed in the first place!

The second-stage surgery is very difficult, and it completely violates the principles of TIPS surgery for so many years.

Zhu Liangchen tried for a long time, and did not do anything too violent. They are all old doctors, and they are all people who have done hundreds of TIPS operations. They all know in their hearts that violence will definitely not solve the problem.

It may be possible to violently remove the stent graft, but it will definitely be accompanied by massive bleeding. It wasn't until the end that Zhu Liangchen called Director Kong helplessly and asked for help.

He can stop the bleeding successfully, Zhu Liangchen began to look forward to it.

As for the future, TIPS surgery is better not to touch it. Even if it is improved, the risk is too great.