Zheng Ren didn't say anything, just changed his clothes in silence.
"Let's go check out the situation." Director Kong also took the time to change clothes, put on a sterile cap, and walked in quickly.
First, he came to the operating table and Director Kong began to read the images of the surgical process.
During the process of removing the stent, the angle was slightly off and hit the liver parenchyma, causing a small artery to rupture and bleed.
This is also the reason why in the past tip surgery only one stent was removed and never recovered.
It is indeed a perfect idea to remove the second retrievable stent, wait for the patient to adapt to the blood ammonia situation, and then remove it to expand the outflow tract. But there are many difficulties in the process of removing the second recyclable stent.
Zheng Ren only dared to do this because his interventional surgery skill tree had reached the master level. But Zhu Liangchen tried to do many details himself before he could teach them.
This matter...
In fact, it cannot be said that Zhu Liangchen was completely wrong.
However, this kind of mistake is completely unnecessary.
He stood behind Director Kong, watching the video of Zhu Liangchen performing surgery, but he came to the system space and clicked on surgical training.
The system operating room rose from the ground, and Zheng Ren entered without hesitation.
His heart was bleeding.
Although there is still plenty of time for surgical training, this is completely unnecessary "consumption". This guy Zhu Liangchen!
Zheng Ren thought bitterly in his heart.
His heart was already bleeding, so he started the operation directly without wasting any surgical training time.
In fact, with Zheng Ren's level of interventional surgery, he can go on stage directly. But this is an unexpected situation after all. Taking over Zhu Liangchen's surgery by himself and doing it by himself are two different concepts.
Zheng Ren still chose to buy surgical training time safely. If there were any problems, let the experimental subjects bear it in the system operating room.
Zheng Ren has already done research on this complication. Embolization is undoubtedly the best option.
He first let the stent deflate a little, then took an image, and immediately saw blood flow.
Zhu Liangchen had finished the puncture work, and Zheng Ren began to super-select the artery.
Patients with advanced cirrhosis have liver atrophy and arteries with anatomical abnormalities due to various reasons. Coupled with the splenomegaly and poor coagulation mechanism, one or two hours of pressure with a covered stent to stop the bleeding had no effect.
The angiography results showed that the bleeding arteriole was an artery at the junction of the fourth and fifth levels. Very detailed, the difficulty of super selection is not ordinary.
But for Zheng Ren, the difficulty of this kind of super-selection is no more difficult than prostate interventional embolization.
Zheng Renchao was very skillful and meticulous in the cross-operation of his left and right hands.
Because the liver function of patients with advanced cirrhosis is very poor and the liver is atrophic, the best way to reduce embolism is to avoid causing liver failure.
The guide wire enters, super-selected layer by layer, and finally reaches the bleeding artery.
He was almost embolizing the bleeding point. Zheng Ren was sure that even if his interventional surgery skills reached the peak level, he could only do this step.
There's nothing special about the surgery, it's just a test of super-selected techniques.
Embolization, re-imaging.
Zheng Ren was very confident, but the system only gave an 85% completion rate for the operation.
Strange, why is this
After observing for a few minutes, Zheng Ren discovered that except for one small artery, the passage where the stent was punctured and placed was constantly bleeding.
This is the result of extensive contusion of the liver parenchyma after repeated friction.
Zheng Ren was also helpless.
Zhu Liangchen's technique was incorrect, which caused greater side-effects of the surgery.
What to do? Zheng Ren felt helpless for a moment. Embolizing small arteries can solve a big problem. It would be fine if the patient just stepped down. The problem of bleeding may get better quickly, but it may also continue to bleed, causing the condition to worsen and eventually lead to hemorrhagic shock.
We cannot wait for patients to recover on their own, we must solve this problem! Zheng Ren immediately made his choice.
It's better not to do things that take a chance. Although Zheng Ren had a lucky bonus, deep down he resented this.
Then super-select, find several blood-feeding arteries at the location of the oozing contusion, super-select, and embolize.
Zheng Ren faced a problem. The more detailed the super selection, the smaller the range that could stop the bleeding. In this case, more super selection and embolization will be done.
How to achieve the point of maximum benefit and minimum damage is difficult.
Fortunately, he had a lot of surgical training time, so Zheng Ren simply tried it out bit by bit and did it bit by bit.
Fortunately this is a systems operating room and mistakes are allowed.
As time went by, Zheng Ren gradually found a balance point. Embolizing the 3rd and 4th-level arterioles at any location can avoid causing greater damage to the patient, but can stop the bleeding smoothly.
It's just that the time spent on surgical training was wasted, which makes Zheng Ren feel a little sad.
Fifteen hours later, Zheng Ren finally saw that the completion rate of the operation reached 97%.
That's it. No matter how much it is, it's probably very difficult to achieve.
After all, the patient's platelet count is more than half that of a normal person. Under such circumstances, achieving 97% completion of the operation is almost to the limit.
He glanced at the experimental subject with some regret.
He turned around and left the system operating room, returning to reality.
Director Kong finished reading the operation process and said in a deep voice: "Lao Wu, Boss Zheng and I are going in. You have a rest."
Zheng Ren quickly went to wash his hands.
When he went on stage with Director Kong, he couldn't wait for the professor to finish his preparations before going on stage like he did with Professor Rudolf Wagner.
You still need to show respect to the old director.
Seeing Zheng Ren running to wash his hands and make preparations, Director Kong took a deep look at Zhu Liangchen and shook his head slightly.
Zhu Liangchen felt dry and a little embarrassed, but he was also a little dissatisfied with Zheng Ren's arrival.
With all kinds of complicated emotions intertwined, he lowered his head and did not look at Director Kong.
Director Kong was fine, just brushed his hands and went on stage.
"Boss Zheng, you do it." After Director Kong went up, he stood directly under Zheng Ren and squeezed him into the position of the surgeon.
Zheng Ren did not continue to be polite and directly inserted the microguidewire and started super-selective arteriography + arterial embolization.
In the operating room, Zhu Liangchen stared blankly at the old man and the young man on the operating table through the leaded glass.
Did you do something wrong? He doesn't think so.
It must be a problem with the surgical design. Two covered stents should not have been placed in the first place!
The second-stage surgery was very difficult and completely violated the rules of doing tip surgeries over the years.
Zhu Liangchen tried for a long time without doing anything too violent. They are all old doctors and have undergone hundreds of tip surgeries. They all know in their hearts that violence will definitely not solve the problem.
It may be possible to violently remove the covered stent, but it will definitely be accompanied by massive bleeding. It was not until the end that Zhu Liangchen had no choice but to call Director Kong and ask for help.
He could successfully stop the bleeding, Zhu Liangchen began to hope in his heart.
As for the future, tips surgery, it’s better not to touch it. Even if it is improved, the risk is too great.