When the Doctor Uses A Hack

The atmosphere in the operating room was tense and oppressive.

The heads of the Emergency Department, Ji Qu, and the Hepatobiliary Surgery Department, Shen Xiuyuan, as well as the General Surgery Department Chief, Qi Xiao, were all gathered in the operating room, their eyes meticulously fixated on the situation within the abdominal cavity, not daring to be careless in the slightest!

It was at this very moment that Chen Cang realized just how reckless his previous actions had been…

Thinking back on his earlier laparotomy, a wave of fear washed over him, and cold sweat seeped out, already soaking the clothes underneath.

If his movements had been any larger just now, the situation might have been completely uncontrollable…

But the abdomen was already open, and even though they could see the sharp wooden fork piercing into the abdominal cavity, no one dared to make any rash movements.

Even the sound of breathing in the operating room began to seem noisy.

Ji Qu, the head of the Emergency Department, frowned deeply. Through the shadowless lamp, one could clearly see the sharp wood entering the intestines, and the feculent secretions, which had not seeped out, were completely blocked by the sharp wood that had penetrated the intestinal wound!

Exploration within the abdominal cavity needed to continue; the operation couldn’t be halted because of this.

Ji qu said in a grave tone, "No bile-like fluid found in the abdomen!"

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"No damage to the major blood vessels has been detected."

"The liver has a clear penetrative wound, but the bleeding isn’t too obvious."

…

The exploration was cautious and step by step, and at that moment, the head of the Hepatobiliary Surgery Department, Yang Ziming, suddenly said, "Old Ji, don’t move!"

That statement made Ji Qu freeze, and even Qi Xiao, the head of the General Surgery Department beside him, looked towards Yang Ziming.

Yang Ziming swallowed hard, "There are remnants of twigs broken off inside the hepatic artery, and there is a clear puncture wound near the hepatic vein. If you move recklessly now, you could easily cause massive bleeding!"

That pronouncement made Ji Qu involuntarily stop his work.

A moment later, Ji Qu couldn’t help but ask, "Wouldn’t stopping the bleeding be enough? If we don’t deal with it now and the intestines fully rupture, spreading feces, we won’t be able to control an infection across the entire abdominal cavity."

Indeed, there was logic to that reasoning, as feces have a strong infectious potential. The abdominal cavity was already compromised due to the entry of foreign bodies, and if the intestinal contents were to leak out, managing an abdominal infection would be very troublesome!

Generally speaking, visceral injuries aren’t necessarily fatal; slow and steady hemostasis followed by repair should suffice according to the principle of "hemostasis first, repair later."

Yang Ziming said sternly, "If there is an infection, we can manage it with anti-infection measures, but if the hepatic vein is ruptured, no one here can save him!"

The voice was not loud, but to everyone’s ears, it struck like thunder!

Damages to the hepatic vein are not just a single vein injury, but rather damage to the main hepatic veins and the inferior vena cava below the liver.

Due to the special anatomical location behind the liver and the difficulty in treatment, injuries to the hepatic vein remain one of the most challenging problems in the field of hepatobiliary surgery to this day.

Yang Ziming was not trying to be alarmist, but rather he took a deep breath and with a grave expression said, "Let me put it this way, the average mortality rate for hepatic vein injuries is as high as 83%, and that’s the mortality rate in the operating room, do you understand?"

Ji Qu was taken aback; he could comprehend a mortality rate of 83% being high, but… the concept of an operating room mortality rate somewhat stunned him!

After all, it was an extremely specialized case, and even as the head of the Emergency Surgery Department, Ji Qu wasn’t completely familiar with it.

"Can’t you do it?"

Yang Ziming’s face flushed red, and he chuckled self-deprecatingly, "Don’t mention me, there are no more than three people in Dongyang who can do it, and moreover... this is just being able to do it, not necessarily willing to do it."

"I’m not joking. Injury to the hepatic veins can cause fatal hemorrhages. These large veins have thin walls, and some parts are enwrapped by liver tissue, so... both surgery and repair are very difficult!

Moreover, the most important thing is their anatomical position behind the liver, which is difficult to expose, and if surgery is conducted under direct vision, it could lead to even more severe bleeding, and there is the risk of air embolism;

and... if hemostasis is attempted blindly, it could worsen the injury!"

Yang Ziming said all this in one breath, sighed, and slowly added, "So, do you think it’s dangerous or not?"

A single sentence silenced everyone!

They dared not explore further.

Yang Ziming glanced at Shen Xiuyuan and asked, "Has the critical condition notification been signed?"

Shen Xiuyuan nodded: "It has been signed!"

Yang Ziming hummed: "Since the condition has changed, go and get another signed, and also, the risk notification, tell the patient about the risk..."

"Right, you go in person."

The critical condition notification is not only signed once, but also if other new, more dangerous diseases are discovered, it must be signed again to inform the patient!

Shen Xiuyuan promptly removed his gloves, picked up the medical record, tore off two signature forms from the outside, wrote a few sentences, and then hurriedly walked outside!

At this time, Chen Cang and his party were sitting outside the operating room, constantly comforting He’s wife, who had been truly frightened by the previous critical condition notification.

Only then did Chen Cang console her: "Auntie, for any surgery with risks, the hospital will have you sign a consent form. You must understand that surgery itself carries risks. It’s just procedure, don’t worry, it’ll be okay!"

But no matter how Chen Cang consoled her, she couldn’t help but shiver with fear.

At that moment, the door to the operating room opened again, and Shen Xiuyuan rushed out, saying to He’s wife, "Hello, the patient’s condition has changed, and we’ve found a splinter entering near the hepatic vein. The patient’s condition is very critical now, and we need your signature."

A single sentence instantly devastated the already trembling woman, the words "very critical" breaking down her psychological defenses.

It had only been a few days since her son and daughter had started their own families, and just as the good times began, this happened.

The woman was suddenly at a loss.

And Shen Xiuyuan, somewhat helplessly, tried to comfort her all over again.

Chen Cang was taken aback and asked, "Can the hospital perform the surgery?"

It was then that Shen Xiuyuan remembered Chen Cang, who seemed to be a doctor, and shook his head: "We can’t guarantee it, but... if you’re not reassured..."

At that moment, Yang Ziming himself came out and said to He’s wife, "Here’s the thing, the patient’s condition is very critical right now, and although we can ensure safety for the moment, there could be accidents at any time. Our hospital does not have the capability to perform this kind of surgery."

"If we transfer hospitals, I’m worried the patient might not tolerate it. There could also be accidents in the ambulance, so it’s best to bring in an outside expert."

He’s wife took a deep breath, trying to calm herself down: "Doctor, you must save our He, I... I’m just a farmer, I don’t know any experts."

Yang Ziming sighed: "Our hospital has always been in touch with the Hepatobiliary Surgery Department of Dong University Second Hospital in An Yang. We can invite them to perform the surgery, but... it might require you to pay the expert fee, because in this situation..."