(Thanks to sincostgctg and Shoes No Evil for the encouragent from the monthly ticket)
"Alright, the suturing is done, let’s check the blood circulation."
After finishing the kidney repair suturing, Liu Banxia said.
Qi Wentai carefully released the hemostatic forceps and watched the kidney’s color together with Liu Banxia.
"The kidney’s blood flow is normal, there’s no bleeding at the suture site, beautiful."
After observing for a while, Qi Wentai said.
"I just broke out in a cold sweat, hesitating whether I should remind you. In the end, I decided against it; if you’re daring enough to do it, then it should be fine."
"I took a gamble here. But we can’t be too happy yet; the patient’s liver still has bleeding after such a long ti, and that’s a big problem," Liu Banxia said.
"So I need to correct what I just said, out of three challenges, we’ve only truly solved one. Or perhaps there are actually four challenges, which is quite troubling."
Liu Banxia’s words pulled everyone back from the joy.
Indeed, the surgery has only just begun.
For other chief surgeons, finishing kidney laceration repair in such a short ti is incredible. It’s a kidney, not as fragile as the spleen, and very easy to injure.
Though the human body can live with one kidney, it does affect the quality of life. Otherwise, why are there two as a standard?
The injuries of this patient are too complicated; severe kidney damage seems trivial compared to these compound injuries.
"Doctor Xu, has the blood pressure gone up?" Liu Banxia asked again.
"No, I’ve been observing closely. Although the blood pressure hasn’t increased, the heart rate is stable, and the indicators are still good," Xu Jie replied.
"This counts as our first piece of good news so far. The second good news is that a simple observation shows there seems to be no problem with the intestines," Liu Banxia said.
"The next task is also straightforward: quickly check the liver’s specific injury condition. Free the vessels, clamp to stop bleeding. If we control the liver injury, we’ll have a significant chance."
"Director Liu, I can only say I’ll cooperate with you as fast as I can," Qi Wentai said sowhat helplessly.
Liu Banxia’s intent is too clear; next is going to handle the liver laceration at the fastest speed. From the current state, the damaged liver lobe definitely needs to be removed due to the extent of the injury.
But Liu Banxia operates very quickly, and it’s been a long ti since he last collaborated with Liu Banxia, he isn’t sure if he can keep up.
His worry isn’t unfounded. Despite having much more experience than Li Hao, surgery isn’t judged solely by experience.
"Be mindful, Li Hao has persisted for quite so ti now; soon, you’ll be able to free your hand. You’ll need to resu surgery after a brief recovery; the laceration is quite large," Liu Banxia reminded again.
Li Hao nodded, feeling indeed sowhat fatigued.
"Begin."
After Liu Banxia called out, he quickly removed the gauze packed inside the abdominal cavity.
With the gauze removed, the site of the liver laceration was exposed, and blood began to flow out from the tear.
"Increase the blood transfusion volu, collect blood for coagulation analysis and hemophilia screening, see if there’s any new change," Liu Banxia said while freeing the vessels.
He felt tense, judging from the bleeding situation at the laceration site; surely, the coagulation function is problematic.
With such prolonged compression and packing, even if there’s bleeding, it wouldn’t be this amount. Liver partial removal, no matter how fast the technique, still requires enough ti to free the vessels.
There’s no mont of ease throughout the surgery.
During kidney repair earlier, he had to seize ti, as there would be a period of increased bleeding, and the patient’s blood pressure wasn’t high.
Now, liver partial removal is the sa, but involves greater bleeding.
The liver’s vascularization is too rich, with abundant blood supply; he must use the fastest speed to free and clamp the vessels.
Usually, Liu Banxia performs surgery quite calmly because he’s very confident. But not today—the safety net system temporarily rested; he must carry everything himself.
Performing ergency surgery already brings pressure, and his personal pressure adds even more.
Despite the pressure, his operations weren’t affected, remaining fast and steady as always.
This made the collaborating Qi Wentai sowhat strained, but he could only go along, ensuring the completion of the surgery.
"Director Liu, the blood pressure dropped a bit," Xu Jie reminded at this point.
"OK, I’ll try to be even faster," Liu Banxia responded, not stopping the work on hand.
The atmosphere in the operating room grew more tense as those nearby began helping to knead the blood bags. Now hypertension drugs were used, but the effect isn’t very pronounced.
This surgery is not just a test for Liu Banxia, it’s equally challenging for Xu Jie.
In his previous work experience, he has also encountered similar patients. But at that ti, the choice was simple: pack the bleeding area and send directly to ICU.
It was unavoidable because the hospital he worked for didn’t have a surgeon as skilled as Liu Banxia.
If it were a singular bleeding organ, it might be controllable, but a case like this patient’s really isn’t manageable by just anyone.
"Vascular clamps are complete, how’s the blood pressure?"
After a while, Liu Banxia asked, with a hint of urgency in his voice.
"Not very high yet, but it’s stabilized, and now it has elevated sowhat," Xu Jie said.
Liu Banxia furrowed his brow and carefully scanned the patient’s abdominal cavity, but did not find any new bleeding sites.
"Next, we will proceed with partial liver resection. We’ve worked this hard, we ought to try. Then, we shall search for other causes, to see if there might be other bleeding points," Liu Banxia said.
He was already feeling sowhat helpless; why is the patient’s blood pressure so low? Clearly, he’s clamped all the liver vessels, and the torn liver area no longer bleeds.
Initially, seeing Liu Banxia quickly isolate and clamp the vessels for hemostasis, he felt sowhat excited. But after seeing the patient’s blood pressure not significantly rise, he also felt a bit troubled.
Every life sign has its own indicative standard, Liu Banxia has done everything possible, yet the blood pressure hasn’t risen, indicating unresolved issues.
Liu Banxia continued his work silently, focusing solely on the operation.
He wasn’t worried about potential criticism from the patient’s family; judging from the current situation, his decisions today were very appropriate.
But now the patient still has unidentified conditions causing low blood pressure, which feels wrong.
"Director Liu, the laboratory report shows no hemophilia, coagulation ti unchanged," the circulating nurse reported.
"It seems the patient still has other conditions; no rush, let’s first resolve his liver problems," Liu Banxia said.
"Director Liu, the patient’s blood oxygen level dropped to 92, heart rate increased to 110."
As Liu Banxia finished speaking, Xu Jie provided a prompt.
"Understood, I’m on it," Liu Banxia said.
"The patient might have heart issues, Li Hao, please go out and inquire further with the patient’s wife. Try to calm her emotions, mainly ask about recent symptoms."
"Alright."
Li Hao responded and quickly ran out.
If the patient has heart-related causes, they could also affect the blood pressure. Especially given this massive bleeding, with so much blood and saline used so far.
"Should we call in the cardiothoracic specialists?" Qi Wentai asked.
"Monitor changes in blood oxygen and heart rate; if they stabilize, there’s no need to call them," Liu Banxia said.
"This guy, doing surgery under such pressure is indeed tiring. Usually, it doesn’t feel this way; today’s shift is particularly high-stakes. Luckily, the toughest phase has passed, now it’s about gradually investigating."
"Doctor Xu, we still need to maintain the patient’s vital signs. Otherwise, our previous efforts will be in vain; we need to create more ti for the patient, and later examine the causes."
"Director Liu, rest assured, I’m already trying my best," Xu Jie said.
Feeling sowhat helpless indeed, he had never encountered such a challenging patient. Usually, tasks like these were managed by Wang Lei and Li Liwei; this was his first ti.
"Relax, I believe this patient’s issues are not too severe. In terms of completion, we’ve reached at least 65%. Once I finish handling the liver, it could reach 90%," Liu Banxia said.
"Although my technique was a bit rough when isolating, it achieved the goal. Having perford so many liver surgeries, it’s the first ti I feel this tense."
It’s sowhat reassuring for everyone; the entire operating room needs a morale boost.
"Teacher Liu, I just confird with the patient’s wife, she reported no recent abnormalities in life."
After waiting a while, Li Hao returned.
"Moreover, the patient does not smoke, rarely drinks alcohol, usually just so beer. He exercises regularly, and the company provides health checks without noticing abnormalities."
"Alright, let’s get back to work," Liu Banxia said.
"Prepare ntally, everyone. If the liver treatnt ends, and the patient’s blood pressure still won’t elevate, we need to observe for a while longer, and not hastily send him to ICU."
"Because there might be unresolved issues we haven’t identified yet; sending to ICU is reasonable, but sowhat irresponsible. The platelet count is low, and currently, there’s evidence of impaired cardiac function needing our attention."
Nobody spoke, simply nodding firmly.
Liu Banxia was the backbone in the operating room; his calmness ensured steadiness among the team.
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