Chinese medicine: from rural hospitals to top three hospitals in Kyoto

In the afternoon, after lunch, the second operation was performed, "radical resection of hilar cholangiocarcinoma combined with portal vein invasion" performed by Zhong Dongyang.

The patient was a man in his fifties. The tumor had invaded a very wide area. The main trunk of the portal vein and its left and right branches were almost completely occupied and wrapped by gray-white cancer thrombi. The situation was several points more serious than the images seen during the preoperative discussion.

In most medical institutions, such cases will be directly judged as "losing the opportunity for surgery" and can only receive palliative treatment.

The atmosphere in the operating room was more solemn than in the morning. The air seemed to carry weight, pressing down on everyone's heart. The experts who were living a simple life even stopped whispering to each other as they felt much more depressed.

Liver surgery is known for its high risk of bleeding, especially this type of surgery involving the main trunk of the portal vein, which requires "pulling teeth from the tiger's mouth." Once a blood vessel ruptures and heavy bleeding occurs, it can instantly turn into an irreversible disaster.

The difficulty of this operation is well known.

To everyone's surprise, Chen Yang was still not the main surgeon in this operation, but was still serving as the technical advisor.

How confident is this young Chinese doctor?

Zhong Dongyang stood at the main operating position, concentrating his mind, clearing all distracting thoughts from his brain, and began the delicate operation.

Freeing the liver, exposing the first hepatic portal, and skeletonizing the hepatic artery and bile duct like peeling off silk threads... Each step is clear and steady, showing the sophistication and composure of a national player.

However, when we really started to deal with the most core and dangerous portal vein cancer thrombus, the expected difficulties still arose.

The cancer thrombus was adhered extremely tightly to the vein wall. When trying to peel it off, the fragile portal vein wall immediately showed tiny tears, and dark red blood instantly gushed out like a fountain!

"Suction device! Blocking forceps!"

Zhong Dongyang remained calm in the face of danger, his voice as cool as ice, and the team members worked together in perfect harmony to quickly and accurately control the bleeding point.

But this thrilling scene also shows that conventional cancer thrombectomy is extremely risky and almost impossible to complete at this moment.

Inside the observation room, the hepatobiliary surgery experts from the R side looked extremely serious. Many of them shook their heads secretly, thinking that the operation might come to a standstill or even be forced to be terminated.

"Director Zhong..."

Chen Yang's voice was like a stabilizing force, ringing out again at the critical moment: "Abandon the strategy of complete dissection and try 'portal vein sleeve resection and anastomosis'."

"Sleeve excision?"

Zhong Dongyang paused slightly and was shocked.

This means decisively abandoning the section of the portal vein eroded by cancer cells and then performing a difficult end-to-end anastomosis.

Performing such delicate vascular reconstruction in the liver hilum, an extremely narrow and deep area surrounded by numerous important structures, requires extremely stringent technical requirements.

"Correct."

Chen Yang's tone was firm and his judgment was unquestionable.

"Based on the imaging and surgical field, the cancer thrombus is approximately 3 cm long. The remaining portal vein length you've freed is sufficient, and the anastomotic tension is within a controllable range. Prioritize ensuring complete radical resection, as this is the patient's only hope of survival. The technical difficulty of vascular reconstruction is..."

Chen Yang's voice was calm: "I believe Director Zhong can overcome it."

This heavy trust brought a warm feeling to Zhong Dongyang's heart, which then turned into great ambition and firm determination.

"Understood!" Zhong Dongyang no longer hesitated and decisively changed his tactics.

He knew that Chen Yang must be confident to say so. With Chen Yang's support, Zhong Dongyang became bolder.

Having someone to back you up and having no one to back you up are completely different situations. After being let go, Zhong Dongyang even performed at his best.

He carefully freed the invaded portal vein segment, fully freed the proximal and distal ends to reduce tension, and then decisively removed the diseased blood vessel with a sharp knife.

Afterwards, in a narrow space that seemed almost impossible for many experts around him, he concentrated and calmed his mind, and used vascular sutures thinner than a hair to begin the meticulous and artistic vascular anastomosis.

The control of every stitch length and the tightness of every knot reflect his profound skills and ultimate concentration gained from decades of hard training.

The viewing room was utterly silent, everyone held their breath, captivated by the robotic-like steadiness and millimeter-precision of the needle. It was more than just a technique; it was an art that combined strength and beauty.

"Pretty!"

When the last stitch was completed, the blocking clamp was released, the portal vein blood flow was restored, and the anastomosis was flawless without any leakage, some expert could not help but cheer in a low voice, breaking the silence at the scene.

Next, extended left hepatectomy and bile duct jejunostomy were performed... Zhong Donghua's team was in high spirits and completed the task in one go.

When the piece of liver tissue carrying the fatal cancer was completely removed, the new bile drainage channel was successfully established, and all monitoring indicators were stable, the operation was declared a complete success!

This means that a patient with advanced bile duct cancer who was almost sentenced to death was pulled back from the brink of death and was given the precious opportunity for radical resection and long-term survival!

The applause broke out again like thunder and lasted for a long time!

This time, it was no longer out of courtesy, but out of heartfelt admiration and praise for the pinnacle of skills!

No matter which country Chen Yang and others come from or what their purpose is, at this moment, this operation is worthy of praise.

When Zhong Dongyang walked out of the operating room, he saw Wen Haodong, Qu Haoran and others looking at him with smiles.

"Director Zhong, congratulations." He Yonghua said to Zhong Dongyang with a smile.

"Fortunately, I have fulfilled my mission." Zhong Dongyang also breathed a sigh of relief.

Chen Yang also smiled and praised: "Director Zhong's vascular anastomosis technology has reached perfection. Today it has opened everyone's eyes."

"Director Chen, please stop making fun of me." Zhong Dongyang was embarrassed.

Without Chen Yang's guidance, he would not have been able to complete the operation.

"Director Chen, Director Zhong, congratulations."

An expert from Country R also stepped forward and said sincerely, "Today's surgery was truly eye-opening. Director Chen, your previous analysis, put into clinical practice, is remarkable."

The complete success of two equally difficult operations in different fields really made Xiaoshi feel heavy-hearted.

However, from the perspective of a professional doctor, it is a rare honor to see such an operation.

"Dr. Chen, I wonder if I have the honor to participate in tomorrow's surgery?" Sakata Masakazu suddenly walked up to Chen Yang and said.

"It should be a great honor that Professor Sakata is willing to participate."

Chen Yang smiled and said, "However, this kind of difficult surgery requires more teamwork. I hope Professor Sakata understands."

This time, Chen Yang asked Zhong Dongyang and others to bring their team. On the one hand, it was for training, and on the other hand, he did not intend to give Xiao Rizi the opportunity to participate. It was already very good to be able to leave the images. After all, the patient was provided by Xiao Rizi. Participating in the operation?

Are you thinking too much?

"I understand." Sakata Masakazu nodded regretfully. He had no way to refute Chen Yang's statement.