This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 69: Somewhat Famous!
On Wednesday, August 26, the scorching sun turned Longxian County into a sauna once again.

At 8:30 a.m., after Lu Cheng finished his rounds, he went straight to the doctors' lounge. Du Daihua, who wanted to learn techniques from Lu Cheng, went to change the dressing and amend the doctor's orders very proactively.

Lu Cheng was not worried about Du Daihua's ability to follow medical orders; he was much better than Peng Kun. Du Daihua would carry out whatever Lu Cheng asked.

As long as the doctor's orders were suggested by Lu Cheng, the skill points would go to Lu Cheng, plus the skill points for changing the dressing, so Lu Cheng didn't bother to argue with Du Daihua about the small things.

Lu Cheng opened his thick, large notebook, wrote the date August 25th on the page, and meticulously prepared to write down a sentence.

It turned out the pen was out of ink. I wonder who the heartless person was who swapped the 'pen' in the lab coat...

Lu Cheng could only take another one from his backpack—

[In-situ spleen-preserving surgery for spleen injury; regular resection in partial splenectomy—get it!]

[Splenic lobe/segment resection: Dissect the splenic hilum vessels → Ligate the target lobe/segment artery → Resect along the ischemic line; Indication: Grade III (regional injury)]
Subtotal splenectomy: Preserving ≥30% of splenic tissue at the upper or lower pole (requiring preservation of at least two splenic segmental arteries); Indications: Multiple regular lacerations of grade IV.

[Irregular splenectomy, total splenectomy with autologous spleen transplantation, and vascularized spleen transplantation are all not mastered; ☆☆☆]

Lu Cheng drew three five-pointed stars in a row to remind himself that he must strictly control his ability range in order to avoid the patient dying from 'shock' due to spleen preservation surgery.

Compared to death, admitting one's inadequacy and undergoing spleen removal is not shameful.

Recognizing one's own limitations and clearly summarizing the diseases that exceed those limitations will be more beneficial to one's clinical work.

After all, once Professor Chen Song leaves, there will be no one to back me up...

Absolute contraindications for gallbladder-preserving surgery:
1. Loss of gallbladder function: gallbladder atrophy or disappearance of the gallbladder cavity, porcelain gallbladder (calcification of the gallbladder wall) combined with serious lesions;

2. High risk of gallbladder cancer: history of gallstones >10 years, gallbladder adenomyoma, or local wall thickening;

3. Acute complications: gallbladder perforation, suppurative cholangitis, biliary pancreatitis (cystic duct obstruction)

4. Gallbladder contraction rate <30%

“Gallbladder-preserving stone removal surgery is technically challenging, requiring strict equipment and operator experience, and necessitates rigorous patient screening. Domestic and international guidelines still prioritize cholecystectomy because gallbladder-preserving surgery does not address the underlying cause of the stones (gallbladder metabolic abnormalities),” Lu Cheng murmured.

"That's why surgery is relatively difficult to learn."

This is a combined surgical procedure. Guidelines recommend direct incision, but gallbladder-preserving surgery can be performed if the patient strongly requests it. The patient's strong request must outweigh the guidelines, unless the procedure is specifically targeted.

"Dr. Lu, there's a patient outside who specifically wants to see you. They said they were transferred from the Traditional Chinese Medicine Hospital." Nurse Li Guofang said gently as she opened the door.

Lu Cheng turned slightly, somewhat surprised, and looked at Li Guofang with a slightly conflicted expression: "Transferred from the Traditional Chinese Medicine Hospital? Are you looking for me?"

Li Guofang has bright, clear almond-shaped eyes. She has always been an honest girl with a very good personality. She is hardworking and conscientious, and has a pretty face. However, her A-level and junior college education make her a bit 'humble' and she often works on holidays.

"Yes, Dr. Lu, the patient had his wound bandaged at the Traditional Chinese Medicine Hospital. At the nurses' station, he said he only came to see you. It seems he was recommended by Dr. Luo from the emergency department of the Traditional Chinese Medicine Hospital."

"Dr. Zhang Tiesheng in the emergency room said he would take a look first and then call you, but the patient disagreed." Li Guofang had a delicate oval face with almost no blemishes, and looked pure and refined. Her voice was also quite delicate.

“Okay, let’s go take a look.” Lu Cheng put down his pen. He didn’t know Dr. Luo from the emergency department of the Traditional Chinese Medicine Hospital. He had spent most of his time in the orthopedics department, so he knew his colleagues there.

"Uncle, Dr. Lu, whom you're looking for, has arrived," Li Guofang said softly to the patient.

The visitors were two middle-aged men, around fifty years old.

When he turned his head, his eyelids immediately widened, thinking he had been tricked. But when Lu Cheng approached and the name and photo on the name tag matched the person, a middle-aged man spoke up.

“Hello Dr. Lu, we were referred by Dr. Luo Shanpei from the Traditional Chinese Medicine Hospital. He said that the Traditional Chinese Medicine Hospital could not handle my brother’s tendon injury, and that we should either go to the prefecture or come here to see you.”

“We were planning to slaughter a pig this morning, but when the knife fell, my brother inexplicably went to catch it. Look at the mess we’ve made…” The middle-aged man was extremely annoyed.

Lu Cheng could tell at a glance that this was a classic zone 2 flexor tendon injury.

Under normal circumstances, a knife will not damage the inner layer of the tendon, or at least not rupture it completely, but a pig-slaughtering knife is different.

Lu Cheng nodded slightly: "Did you register? If you didn't register, it wouldn't be proper for me to see you."

"Not yet. Dr. Luo specifically instructed us to make sure we find you before registering, to avoid... um, to avoid any misunderstandings. I'll go register. Dr. Lu, could you take my brother to see a doctor first?"

"If it can be treated, we'll have surgery; if not, we'll charter a car to Jilin City as soon as possible," the middle-aged man said cryptically.

Peng Kun is working on tendon suturing, and the Traditional Chinese Medicine Hospital may have heard about it, but since they are not in the same system, others might give Peng Kun face, but his "colleagues" at the Traditional Chinese Medicine Hospital certainly won't.

"Dr. Lu, thank you for your hard work..." The injured middle-aged man looked somewhat helpless.

“It’s alright. Come with me to the control room first. Whether I can operate it depends on whether you have damaged any blood vessels or nerves. If you have, then I can’t handle it,” Lu Cheng said.

Patients' conditions are generally not textbook-like. The butcher's knife is very sharp. If it damages nerves and blood vessels, it's not a tendon rupture, but a half-finger rupture, requiring finger replantation. This is beyond Lu Cheng's range.

Lu Cheng swiftly led the patient into the operating room, opened the gauze and sterile dressings, checked them over, and looked up to say, "The only good thing is that no blood vessels or nerves were damaged."

“Surgery is possible, but if you want to pursue better surgical quality, I suggest you go to the State People’s Hospital,” Lu Cheng replied conservatively.

The patient was burly and had a deep voice: "Dr. Lu, aren't you just treating us like laymen?"

"Luo Shanpei from the Traditional Chinese Medicine Hospital is my brother-in-law. He told me all about your background. It's better to come here than to go to the State People's Hospital."

"He would never lie to me. It's cheaper and the quality is better here.

Longxian is an impoverished county. In most families, if one member of the family gets a government job, they are considered a prominent figure in the family and have the trust of their relatives.

"Uncle, Dr. Luo is too kind. It's not as exaggerated as Dr. Luo said. I can do it, but I can't guarantee that I'll be better than others."

"We're all tech people, so I won't belittle you or flatter you. Of course, I also thank you for your trust. I will do my best to preserve your hand function."

"After the surgery, you will need to follow instructions and do functional exercises, which is also one of the key points." Lu Cheng was not overwhelmed by the patients who came because of his reputation, and explained all the key points clearly.

(End of this chapter)