Back in 2002 as a doctor

"..."

"Focus on it." Zhou Congwen lowered his head and continued the operation, "The umbilical cord and IQ were cut together at birth? How stupid."

No one has ever used this kind of tone to yin and yang face to face, and Director Zhao almost ran away on the spot.

But wandering on the verge of going berserk, Director Zhao calmed down instantly.

A thought arose in his mind - he must have some real skills to dare to pick and choose so strongly, otherwise how would he step down in a while?

Or he knew that the operation would not be successful, so he found the fault at the beginning, and then blamed himself after he went berserk.

No, not even an intern would have such a naive idea.

No matter how you think about it, there is no possibility, Director Zhao is a little confused.

He kept pondering, but Zhou Congwen's movements did not stop, and the operation was going on step by step.

Director Zhao couldn't figure it out, but he didn't want to be scolded either. He held his breath and concentrated, and instantly entered the state.

Zhou Congwen must not be given any chance to be sarcastic, and he is unwilling to let the big tweezers or wire scissors hit his radial styloid again.

Concentrate on pulling the hook to expose the surgical field.

Sure enough, as Director Zhao entered the state, Zhou Congwen didn't say much, and started to investigate step by step.

The color of the donor liver was poor, and it was obviously in an ischemic state.

Zhou Congwen used blunt scissors to expose the operative field, and saw that the anastomosis of the portal vein was unobstructed and the blood flow was normal.However, the donor and recipient arteries on both sides of the arterial anastomotic stoma had no pulse.

This was expected. Zhou Congwen held the blunt scissors in his palm, reached in and touched them.

Then when he stretched out his hand, the equipment nurse was stunned, not knowing what Zhou Congwen wanted.

She was about to cry when she saw Zhou Congwen's hand. Zhou Congwen scolding Director Zhao is like scolding his own dog. If she can't cooperate, will the next second be...

When the equipment nurse was at a loss, she suddenly heard Zhou Congwen say, "Sharp knife."

sharp knife?What do you need a sharp knife for at this time?

However, the equipment nurse did not question it, but quickly picked up the sharp knife blade with the hemostat, installed it as quickly as possible, and then slapped it in Zhou Congwen's palm.

Zhou Congwen used a sharp knife to open the anastomotic line on the hepatic artery, and then cut open the anastomosis.

The action is extremely firm.

A newly formed thrombus in the hepatic artery was subsequently seen.

The thrombus is dark purple in color and fills the blood vessel.

It is the culprit, the culprit!

"Prepare 50 U of urokinase." Zhou Congwen instructed lightly, and began to insert the tweezers along the reopened anastomosis.

What is he going to do? !

Director Zhao was dumbfounded.

Zhou Congwen's movements are very simple, and there is only one thing he can do - "clamp" the thrombus out with tweezers.

Can!

The thrombus formed for up to three days. Although it was tangible and qualitative, it was as tender as tofu. In Director Zhao's view, the thrombus couldn't be pinched at all.

Such a fresh and tender thing will break with a little effort.

Was he going to break up the thrombus first and then withdraw it with a syringe?

Director Zhao was beaten and scolded twice by Zhou Congwen, and he was in such a good state that he instantly "understood" what he meant.

"Syringe, 10ml." Director Zhao stretched out his hand and said.

"What do you need a syringe for?" Zhou Congwen asked suddenly.

"what?!"

Director Zhao was taken aback, is Zhou Congwen looking for trouble?

But the next second he was stunned.

The tweezers in Zhou Congwen's hand came out of the anastomosis of the hepatic artery with the tweezers like soft tofu. The thrombus was trembling and would break at any time, but it just "persisted" and was taken out intact.

What the hell!

Countless exclamation marks rose above Director Zhao's head.

Professor Wen was also dumbfounded. Zhou Congwen's movements are very simple, but to do this step requires a deep control of power.

How did he do that?

"Director Jiang, let's start taking the radial artery." Zhou Congwen clamped out the thrombus, put it in the tray and glanced at it again.

"Professor Zhou, what do you want the radial artery for?" Director Zhao hesitated for a moment, but still asked.

"The liver transplant operation is a bit rough."

Zhou Congwen said directly.

Invisibly, Director Zhao's face was slapped with a slap.

Director Zhao burst into tears, so there is no need to slap someone in the face.

Chapter 0761 Liver Transplantation as Coronary Artery Bypass Surgery

"There is a bile fistula at the anastomosis of the common bile duct, and the arterial anastomosis provides an obvious inflammatory response in the blood vessel wall about 1 cm long in the side artery of the recipient."

Zhou Congwen didn't say anything else, but what he said after the investigation was more difficult for Director Zhao to accept than the cynicism just now.

But with the facts in front of him, Director Zhao couldn't even utter a single rebuttal.

Common bile duct anastomosis... Isn't it normal to have a fistula...

"Urokinase." Zhou Congwen briefly explained, and then asked for urokinase.

He took the syringe and slowly injected 50 U of urokinase into the stump of the grafted hepatic artery for thrombolysis until venous blood flow back from the grafted hepatic artery stump could be seen.

After the thrombus was removed from the gastroduodenal artery on the recipient side, the amount of bleeding was large and the pulsation was obvious.

But the transplanted liver still didn't change.

"Professor Zhou, are you going to have a bypass operation?" Director Han appeared behind Zhou Congwen at some point.

"Well, there is no artificial blood vessel, the radial artery is more suitable. Director Jiang, it is about 5cm, is there any difficulty?"

Director Jiang, who was opening the skin, raised his head, "Xiao Zhou, why don't you come? I'll help you."

Zhou Congwen was not polite, and he didn't disagree with Director Jiang's words. Instead, he raised his hands in front of his chest, turned and moved, and stood side by side with Director Jiang.

Could it be that Zhou Congwen said that the right radial artery should be taken before the operation because it is convenient for Zhou Congwen to change the operating table?

A strange idea appeared in everyone's minds - before the operation, Zhou Congwen had already prepared himself from beginning to end.

Zhou Congwen stood in front of the patient's right arm, and the equipment nurse next to the equipment table was crying and under great pressure.

Just now I was glad that this young master was in the abdominal operation area, otherwise I would be scolded for a mistake in cooperation.Even the daring Director Zhao was scolded like a grandson, and he definitely couldn't hide from it.

Who would have thought that he would just change his position and stand in front of him.

The equipment nurse didn't have time to have any more thoughts, so she concentrated on it and must...no, try...to try not to give this young master a chance to get mad.

This operation is really stressful.It can't be said that joking and laughing don't count, the operator still has a straight face, like a powder keg that will explode anytime and anywhere.

Zhou Congwen stretched out his hand, and immediately slapped the scalpel on his hand.

An incision was made on the left forearm of the recipient, and the incision was made layer by layer. Zhou Congwen found that the outer diameter of the radial artery was similar to that of the transplanted hepatic artery, about 4mm, and nodded with satisfaction.

With the assistance of director Jiang, he began to free the radial artery with a length of about 6cm.

After blocking the blood flow, Zhou Congwen was not in a hurry, but waited for a few minutes to confirm that the peripheral circulation of the finger had not changed, and the arterial pulse could still be touched in the nasopharyngeal pot, and then decided to cut the artery.

The removed radial artery graft was about 5 cm long, and there were 3 small branches in it, all of which were sutured with 8-0 Prolene suture.

"Prepare papaverine saline." Zhou Congwen said.

Papaverine is a routine medicine in vascular department, which can prevent vasospasm and is often used in interventional surgery.

The equipment nurse let out a sigh of relief. This young master didn't want anything special, and it was fine if he didn't have any special requirements.

However, the operation was really fast. Within ten minutes, the radial artery was removed, and the operation took off.

Seeing that Zhou Congwen was about to turn around and go back to the abdominal operation area, the equipment nurse in the right arm operation area let out a sigh of relief, "Professor Zhou, you performed the operation really fast."

"Oh, it's very simple. If you want to take a slow stroll," Zhou Congwen replied casually.

"Huh? Have you done vascular surgery before?" asked the equipment nurse.

"Heart bypass surgery involves harvesting the internal mammary artery. The principle is similar. If you do more, you will naturally become more proficient. And young patients will also go to the radial artery. This is one of our extracardiac surgeries. How can you not be proficient?" Zhou Congwen said indifferently. Said.

Director Jiang from the Department of Vascular Surgery and Director Zhao from the Department of Hepatobiliary Surgery who stood opposite Zhou Congwen were stunned when they heard what he said.

It turned out that Zhou Congwen performed the repair surgery after liver transplantation as a heart bypass.

No wonder you are so proficient!

But is it really okay to do so?

Heart and liver... Coronary atherosclerosis and liver transplant, can that be the same!

Although the principle... the principle is different, okay?

However, the operations with different principles turned out to be exactly the same under Zhou Congwen's hands. While assisting Zhou Congwen in the "bypass" operation, Director Zhao of the Department of Hepatobiliary Surgery wondered if he had made a mistake.

Zhou Congwen treated the second uterine repair operation after liver transplantation as coronary artery bypass surgery, and it turned out to be so harmonious that there was no problem.

Both ends of the autologous radial artery graft were intermittently anastomosed with the transplanted proper hepatic artery and the recipient's gastroduodenal artery. Zhou Congwen used 8-0 Prolene line.

The anastomosis was extremely proficient, and both Director Jiang and Director Zhao were silent.

Why are you so proficient?

According to Zhang You, Zhou Congwen was able to do bridges with a beating heart, and he did it without an octopus to fix the heart.

One is a quiet vascular anastomosis, and the other is an anastomosis completed under the interference of the beating heart, can it be the same?

This operation has already gone in a strange direction.

The chief directors of the two specialties watched Zhou Congwen anastomose the transplanted radial artery end-to-end with heart bypass surgery, and their minds were spinning a thousand times.

Zhou Congwen not only did it quickly, but also did it very well.

After the completion of the anastomosis, the blood flow was opened, the anastomosis was unobstructed, and the pulsation of the radial artery and the graft proper artery was obvious.

After waiting for 10 minutes, Director Zhao stared intently, and saw that the color of the patient's liver had improved significantly.

The operation was a success?

Director Zhao was a little confused.

Hepatic artery thrombosis after liver transplantation is an extremely serious and dangerous complication. I didn't expect it to be solved by a cardiothoracic surgeon in this way.

Zhou Congwen let out a sigh of relief when he saw that the color of his liver had improved. He raised his head and twisted his cervical spine, his eyes narrowed, as if he was smiling.

In an instant, spring blossoms bloomed in the operating room, and everyone could feel the change in the painting style.The sense of urgency that was calm and stern and with a sharp knife hanging above his head was gone.

"Blunt scissors." Zhou Congwen stretched out his hand and said gently.

"Hey." The equipment nurse quickly slapped the blunt scissors on Zhou Congwen's palm.

"Professor Zhou, are you going to end it?"

"Not yet." Zhou Congwen began to look for the omentum, "but soon, repair the fistula of the common bile duct anastomosis, and then you can step down."

"So fast! I thought it would take five or six hours."

The equipment nurse sensed the change in the atmosphere and talked more.

The depressive environment and atmosphere before were easy to overwhelm people's emotions.Say a few words, soothe the spirit is the top priority.

"It won't take that long." Zhou Congwen said while cutting a piece of omentum, "There are only so many surgeries. If it takes more than one and a half hours, we can only find another donor liver. There is no need to continue on the operating table. "

"..." Director Zhao was speechless.

What Zhou Congwen said was so confident that he had deep doubts about his own skills.

Chapter 0762 Silence After Successful Surgery