Chapter 1036: Highlighted the key points in the textbook
Many doctors who have had experiences agree with the remarks made by this doctor.
Doctors from external hospitals, like experts showing off their martial skills, speak eloquently about issues, while our own hospital teachers don’t teach classes. dical students attending the lecture for the first ti are bound to be confused, just like the intern Fan Yunyun, who feels her brain is unable to discern all directions.
It’s not easy to learn under Senior Sister Xie, who has managed to assist in such crucial surgeries and make appearances in front of national peers, yet she still has not figured out what exactly this surgery entails.
Senior Sister Xie once told her that you must tackle the hard problems; learning from the teacher is not as effective as putting more effort into exploring by oneself. Only by thoroughly understanding anatomy, can you grasp all surgical issues.
Fan Yunyun quickly lowered her head and pulled out a thick anatomy atlas from her bag, flipping to the related pages.
Sitting beside her, Geng Lingfei surprisingly glanced at the large textbook in her hands, finally realizing why she brought such a big backpack to the lecture—she treated it as a school study session.
Watching her actions, Geng Lingfei frowned and turned his head back, muttering: Damn, this intern seems to intentionally compete with him for the teacher’s attention.
“You’re talking about the issue with Porta Hepatis?” Fan Yunyun seed to ask herself.
Geng Lingfei didn’t even give her a glance, unwilling to discuss anything with soone who competes for the teacher’s attention.
If Dai Nanhui found it amusing, he would look at their distinctly different expressions. He always felt it odd and unheard of for those two to be learning from an intern.
She found it; Fan Yunyun quietly read the key points to herself from the book: The hepatic veins are ford by the confluence of the liver’s portal vein system and hepatic artery system through the central veins and interlobular veins, generally converging at the second and third Porta Hepatis into the inferior vena cava.
When a patient has Budd-Chiari syndro, the outflow of the hepatic veins is obstructed, creating extensive collateral circulation between the patent and obstructed hepatic veins, between the subcapsular arch and the sinusoidal spaces of the liver, between diaphragmatic veins and hepatic veins, between hepatic veins and short hepatic veins, and between interlobular and perihepatic ligants, as ntioned by the external hospital doctor.
Moreover, at the third Porta Hepatis, many small to dium-sized veins are called short hepatic veins, numbering thirty to fifty. These factors contribute to significant risks during surgery if not managed properly by the doctor, leading to uncontrollable bleeding and potentially fatal consequences on the operating table.
The reason for establishing extracorporeal circulation in such surgeries lies here. The inferior vena cava is a major conduit for blood returning to the heart; once obstructed, it may cause congestion in the veins below. The severity of this issue can sotis lead to renal failure in the lower section. Furthermore, for patients with Budd-Chiari syndro, the collateral circulation ford mostly consists of small vessels; if the main channel is blocked, these small vessels may burst like a heavily mined area. When that happens, blood floods extensively, and the doctors, with only a few hands, cannot manage such a large area of bursting vessels.
This is exactly the daunting consequence of uncontrollable bleeding being discussed.
Understood, understood. Fan Yunyun nodded her head, impressed by Senior Sister Xie, indeed, understanding and comprehending anatomy well is most crucial.
Given all this, why do doctors hesitate to use extracorporeal circulation?
The reason is simple, unless absolutely necessary, performing deep hypothermic anesthesia and stopping circulation on a patient is definitely not a good thing.
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