novel for you Chapter 934 A Difficult Surgery
Chapter 934 A Difficult Surgery
"Xiao Chen, have you really undergone a liver transplant operation? Or did you cooperate with Zhong Dongyang in Shen City?" Yuan Zhengmin confirmed again.
He really couldn't believe it.
Yuan Zhengmin’s thoughts were the same as most people’s. It was already incredible that Chen Yang could achieve such success in traditional Chinese medicine at such a young age. How could he even have such high attainments in the field of hepatobiliary surgery?
This is too hard to believe.
Jiang Yan smiled and nodded, with admiration for Chen Yang: "Director Yuan, it is absolutely true. The situation of the operation was very critical, and the liver supply blood vessels were in very poor condition. Director Zhong's team was at a loss for a while. It was Dr. Chen who remained calm in the face of danger and implemented an extremely sophisticated vascular anastomosis and reconstruction plan, which ultimately turned the tide and made the operation a success."
"Director Zhong later spoke highly of Dr. Chen, saying that his vascular anastomosis technique had reached perfection."
Borg also added seriously: "Director Yuan, what Miss Jiang said is true."
"I also know Professor Zhong Dongyang of Kyoto Hospital. He is also very famous in the field of international hepatobiliary surgery."
"The video recording of that operation was later circulated in a small circle. Dr. Chen's operation was a textbook example, especially in dealing with complex vascular variations and fine anastomosis, showing amazing skills and stability beyond his age. This is also the most important reason why I came to Huaxia this time and was eager to see Dr. Chen."
Chen Yang was a little embarrassed by the compliment and smiled modestly: "Doctor Borg is overpraising me. Director Zhong is the key. I just provided some ideas at the key link. That time, the situation was special and it was a coincidence."
"No...no...no...Chen..."
Borg leaned forward slightly, his blue eyes filled with seriousness and earnestness. "In the field of top surgery, there is no such thing as 'luck' or 'coincidence'. That is a testament to your strength. This time, in addition to wanting to exchange medical ideas with you, I also have an unwelcome request. It is a...very difficult clinical problem. I hope to get your help."
The atmosphere in the reception room suddenly became solemn.
Yuan Zhengmin also held his breath. The difficulty of this case, which even Borg, the world's top hepatobiliary surgery expert, called "difficult" and sought help across the ocean, can be imagined.
Chen Yang's expression also became serious: "Doctor Borg, please speak."
Borg took a deep breath, took out a tablet from his briefcase, quickly called up several high-resolution medical images, and handed them to Chen Yang.
"The patient's name is Thomas Wilson, he is 52 years old and a famous American financier. Three months ago, he was diagnosed with hilar cholangiocarcinoma with portal vein invasion, also known as Klatskin tumor."
Borg pointed to an irregularly shaped, unclearly defined shadow in the liver hilum area on the image.
"The tumor was in a very tricky location, right where the left and right hepatic ducts met, and it was growing in an invasive manner. What was even more troublesome was..."
As he spoke, Borg slid the picture and called up the vascular imaging results.
"The tumor has encapsulated and severely invaded the proximal end of the left branch of the portal vein by about 2.5 centimeters, while compressing the left branch of the hepatic artery, causing the left liver lobe to show obvious signs of atrophy. The right hepatic duct has also been invaded, but to a lesser extent."
“Hilar cholangiocarcinoma?”
Yuan Zhengmin couldn't help but take a breath.
Although Yuan Zhengmin is not a Western doctor, he knows how difficult this disease is.
Hilar cholangiocarcinoma with portal vein invasion?
In reality, the mortality rate of this type of surgery is as high as 40%. It is characterized by deep location, hidden early symptoms, and difficulty in surgical resection due to its complex anatomical structure, and it is easy to invade surrounding blood vessels and liver tissue.
No wonder Borg came all the way to find Chen Yang.
Does Chen Yang really have such ability?
Chen Yang examined each picture carefully, frowning slightly.
Hilar cholangiocarcinoma is one of the most complex and challenging operations in the field of hepatobiliary surgery and is known as the "Mount Everest of hepatobiliary surgery."
In the current case, the tumor invaded the vital main branch of the portal vein, which directly increased the difficulty of the operation to hell level.
“We have evaluated…”
Borg's voice was heavy. "According to the conventional Bismuth-Corlette classification, this is at least type IIIb, and even close to type IV (the tumor invades the confluence of the left and right hepatic ducts and extends to the bilateral secondary bile ducts). Radical resection (R0 resection) is the patient's only hope for long-term survival."
"But the difficulty lies in how to completely remove the tumor without damaging or safely reconstructing the portal vein invaded by the tumor? The portal vein is the 'lifeline' of the liver. If it is not handled properly, massive bleeding during surgery or portal vein thrombosis after surgery are both fatal."
Bog paused and continued, "We organized a multidisciplinary consultation at Mayo and tried various preoperative downstaging treatments, including high-intensity radiotherapy and chemotherapy and the latest targeted drugs, but the results were... not ideal. The tumor was slow to respond to treatment, and the size and scope of invasion had hardly shrunk significantly. Surgery became the last and only option. But the risks of surgery are... extremely high."
Borg looked at Chen Yang, his eyes full of hope. "Chen, I have studied the technical details of your treatment of complex blood vessels in the operation in Shen City, especially your ability to perform tension-free and high-patency anastomosis of small and variant blood vessels under extreme conditions. It is one of the best levels I know of so far."
"The core difficulty of this operation lies in the severance and reconstruction of the left branch of the portal vein that is wrapped by the tumor."
Borg continued, "We need to safely free up both ends of the healthy portal vein of sufficient length in the extremely narrow space infiltrated by the tumor, and perform end-to-end anastomosis, or, if necessary, use artificial blood vessels or autologous blood vessels (such as the great saphenous vein) for interposition and transplantation. This requires the surgeon to have extraordinary microsurgical skills, stable psychological qualities, and... an almost intuitive grasp of space... I think you are the most suitable person."
"Chen, on behalf of the Mayo Clinic and Mr. Wilson and his family, I formally invite you to join this surgical team as my first assistant, mainly responsible for the most core and dangerous part of portal vein reconstruction! The surgery is tentatively scheduled to be performed in three weeks at Mayo. We will arrange all the itinerary, procedures, and remuneration."
There was silence in the reception room. Yuan Zhengmin was frightened by what he heard. Although he was not an expert in surgery, he understood the importance of the operation and the huge risks involved.
If successful, Chen Yang's name will be resounding throughout the international hepatobiliary surgery community; if failed, not only will a life be lost, but it may also deal a heavy blow to Chen Yang's nascent international reputation.
Chen Yang's eyes were still fixed on the image on the tablet computer. His fingers tapped the table unconsciously as he fell into deep thought.
Yuan Zhengmin tried hard to wink at Chen Yang...