"So, did you decide who it will be?" Liu Banxia asked during lunch.
"Let's have Liu Yiqing and Xu Yino go first. Ladies first," Huang Bo said.
"Alright, a little pre-op quiz then. You two, tell us about this patient's situation. Don't tell you've chosen soone but haven't even reviewed the dical records," Liu Banxia said.
"The patient has been ill for about a month. When admitted to the local hospital, the patient's jaundice was severe. After so adjustnts there, the patient ca to our hospital for further treatnt," Xu Yino said. "Based on the imaging, it's likely that the gallbladder cannot be saved. Plus, the bile duct has infiltrated the right hepatic artery. Multiple samples should be taken during surgery for frozen section analysis."
"Liu Yiqing, your additions," Liu Banxia said after taking a sip of soup.
"If the situation is ideal, we can perform a cholecystectomy, right hemihepatectomy, regional lymph node dissection, and biliary-enteric anastomosis. If the situation isn't ideal, we'll have to do our best with what we find," Liu Yiqing said.
"What will be the challenge in this operation? Tell us, Huang Bo," Liu Banxia continued.
"The intraoperative frozen section sampling and clearing the lymph nodes around the hepatic hilum will be quite laborious, based on the patient's imaging," Huang Bo quickly replied. "However, I believe Dr. Liu has no problem performing such dissection. What we need to pay attention to now is the high difficulty involved in repairing the left and right hepatic ducts, assuming the surgery goes smoothly."
Liu Banxia nodded. "That's decent. You haven't completely ignored this patient just because you're not on the surgical team for this one. The description you've given is quite comprehensive. Different surgical thods will be adopted depending on the patient's specific condition discovered during the operation."
"There's also a possibility that extensive tumor spread is found during the exploration. In that case, what would be your choices, or your recomndations to the patient's family?"
Everyone looked at each other; nobody spoke.
"Let ask then. Who's for continuing the surgery and removing the tumor? Raise your hands," Liu Banxia said with a smile.
No one raised their hand; they all continued eating quietly.
"To be honest, I don't have a definite answer to this question either," Liu Banxia said after a mont's thought. "One important aspect we need to consider is the patient's age; they're only 42 years old, still very young. If we can achieve a thorough clearance of the tumor, and if the patient responds well to postoperative chemotherapy, there might be a chance to extend their survival by more than two years."
"Of course, this is just a possibility, and it's quite slim. But we're dealing with a life here. Even though we have contingency plans, we hesitate every ti we confront such a situation."
"So, there's no single correct or appropriate answer to this. Ultimately, the decision must be left to the patient's family."
"I'm not joking; this was sothing I just thought of. It's like the cardiac myxoma surgery Old Chen and I perford. We didn't feel much at the ti, but now, looking back, we're both sowhat frightened."
"While it's true that taking such a gamble could potentially add many years to a patient's life, the risk is also incredibly high. The next ti I encounter a similar patient, I don't know what I'll think or what I'll suggest."
"This is indeed a tough call. As surgeons, we often face these situations. However, there's no past experience that can truly guide us in these specific instances."
The interns nodded and started eating quietly.
Liu Yiqing and Xu Yino would be assisting this afternoon. Starting tomorrow, everyone would have to take turns, and it would be a continuous rotation.
Even though each intern had chosen their own surgical patient, Demon Liu could quiz them at any ti. Therefore, it was crucial for them to have an accurate understanding and clear judgnt of these patients. They also needed to be familiar with the surgical plan, even if they weren't directly assisting in a particular operation.
After lunch, Liu Banxia led Xu Yino and Liu Yiqing straight to the patient's ward.
"Are you prepared?" Liu Banxia asked with a smile.
"We're already prepared, Dr. Liu. Will you tell us if anything changes or if there are any developnts?" the patient's family mber asked.
Liu Banxia nodded. "Although we've discussed many possibilities, we can only make an accurate assessnt after the exploratory laparotomy. Then we'll inform you of the patient's condition and discuss the surgical options. I know having a nasogastric tube is uncomfortable, but please hang in there."
"Dr. Liu, thank you. Director Zhou said you're quick in surgery and your patients recover well," the patient's family mber said.
"It also depends on the circumstances. This operation is expected to be quite long, conservatively estimated at over five hours. You should be ntally prepared," Liu Banxia said.
"Dr. Liu is good and fast. I had rectal cancer, and he saved my anus," chid in the patient in the next bed.
"Your praise won't change anything. Your indicators don't et the discharge standards yet, so you can't leave," Liu Banxia said. "Do you think I don't want to discharge you quickly so we can admit new patients? Just hang in there for three more days."
"Actually, I really feel fine now. How about we do another blood test?" the patient insisted.
"Blood tests don't lie. Your white blood cell count is still a bit high, so I can't let you go yet. Try to move around a little; don't just lie in bed all the ti. However, no strenuous exercise. That's all." Liu Banxia waved her hand.
"Xu Yino, have soone take the patient to the operating room. It's almost ti. I'll give so final instructions and then head to the OR as well. You two go ahead and start the preliminary preparations."
"Okay, Teacher Liu," Xu Yino responded.
These preoperative preparations were very straightforward for them; they could practically do them with their eyes closed.
When Liu Banxia reached the main hall, Wei Yuan ca over.
"Good heavens, are you trying to drive us all crazy too?"
"What's wrong? Wasn't the surgery this morning successful?" Liu Banxia asked.
"Don't play coy. If you keep up this insane pace, what are we supposed to do?" Wei Yuan said helplessly.
"Just have to deal with it, I guess. It's not a big deal, really. It's just that the director has a backlog of surgeries these few days, so we need to help share so of his burden," Liu Banxia said, laughing. "I had the interns each pick another surgery. See if any of them interest you, and you can go observe. Do you have anything going on this afternoon? If not, you can join in the OR."
Wei Yuan shook his head. "I have to be on duty tonight. This one surgery could easily take five, six, or even seven hours. I need to preserve this old life of mine; I can't keep up with your pace."
"I'll see later. I think there are still two liver tumor surgeries. If I have ti, I'll join you for one. Sigh... having to compete with the youngsters for cases, it's a bit embarrassing."
"What nonsense are you talking about? Don't overthink it. If you want to do it, just do it," Liu Banxia said, laughing. "If you're not scrubbing in this afternoon, please take the lead in monitoring this patient closely. We don't know this patient's actual condition yet, and it's conservatively estimated to take over five hours."
"Alright, go. Leave it to us," Wei Yuan said. "Anyway, it's in the teaching operating room, so we can watch on the screen. The view is more or less the sa. Open surgery or laparoscopy?"
"Open surgery. With laparoscopy, the operation would be more difficult. We also don't know the extent of the lesion. It's quite possible that we would have to switch to open surgery after creating the ports," Liu Banxia said.
"Alright, you should get going. Then you can co back earlier. If there's anything I don't understand, I can ask you. Go on then. Since you're determined to go on this surgical spree, at least make it a spectacular one," Wei Yuan said.
Liu Banxia didn't know what to say. Her primary intention really was to help alleviate Director Zhou's workload. Of course, there were so other minor thoughts mixed in, but she wasn't overly focused on using this to angle for the deputy director position.
With matters on the ward settled, Liu Banxia headed to the operating room to scrub in.
"Teacher Liu, we've verified the patient's information and completed the preparations," Liu Yiqing reported.
"Alright, Doctor Wang, please proceed with anesthesia," Liu Banxia said.
Wang Lei didn't hesitate and began the procedure.
"Liu Yiqing, you'll perform the exploratory laparotomy, with Xu Yino as first assistant. Then, Xu Yino, you'll do the cholecystectomy, with Liu Yiqing as first assistant," Liu Banxia instructed after the patient was successfully anesthetized.
"Who's assisting you with the distal subtotal gastrectomy tomorrow?" Wang Lei asked.
"I haven't actually asked. I let them choose themselves. I'll just go to the operating room, and I'll find out who it is when I get there," Liu Banxia said. "Life should reserve so surprises, but I can make an educated guess, though. It's probably either Li Hao or Miao Rui. There's also a unilateral thyroidectomy this afternoon, so it'll be a bit tiring."
"Well, you asked for it. Alright everyone, listen up! We'll try to arrange for everyone to have the sa day off for compensatory leave. Then, we can all go to Jinbao for a big al!" Wang Lei announced.
The mood in the operating room lightened; hard work deserved so reward, after all.
Assisting Liu Banxia in a single surgery was usually quite pleasant. After all, Liu Banxia operated quickly, which saved everyone ti. But when she went on one of her 'surgery sprees,' life beca decidedly less pleasant. Those weeks were a grind, and several people had painful mories of them.
This current spree was still better than the last one, though. At least there were breaks. The previous ti, they were barely out of one operating room before having to prepare for the next. Who could endure that?
Zhou Shuwen, watching from the observation room, couldn't help but sigh and shake his head. That rascal Liu Banxia, can't she exercise a little restraint? Saying sothing like that with so many people watching... is that really appropriate? Still, he also felt a asure of reassurance. Liu Banxia had a good rapport with everyone, and quite a few people were observing this surgery. A large audience for a surgery was, in itself, a testant to skill. If you weren't good, who would waste their ti watching? Once Liu Banxia finished her term as chief resident, it seed he could indeed schedule more surgeries for her.
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