"Exploration reveals a 2x3cm tumor in the middle section of the bile duct, which is firm. The tumor has infiltrated the bile duct and the right hepatic artery, resulting in severe adhesions," reported Liu Yiqing.
"The gallbladder is irregularly shaped, likely due to a large accumulation of stones. No fluid accumulation is seen in the abdominal cavity, and an initial examination of the liver revealed no signs of tumor tastasis or spread. It is feasible to perform a cholecystectomy, a hemihepatectomy, regional lymph node dissection, and a biliary-intestinal drainage procedure."
"Okay, the rooftop incision is very well done. The overall exploration process was very efficient. Although the examination was thorough, the speed was sowhat slow. Xu Yino will be performing the cholecystectomy. Is she confident in handling the adhesions there?" Liu Banxia asked.
"Teacher Liu, no problem. The adhesions are not too severe. The concern now is whether the tumor has severely infiltrated the upper and lower segnts of the bile duct," replied Xu Yino.
"That will be sothing to consider when taking intraoperative biopsy samples. The quality of your dissection now will directly impact the success of my subsequent steps," Liu Banxia said.
"There are many people in the operating room and many more watching from outside. If you perform well, you'll save ti, shortening the entire operation. Reducing the patient's anesthesia ti will also improve their future prognosis."
"Most importantly, if you do well, many people will praise you. Xu Yino from the Ergency Center of the Second Hospital is quite remarkable, very impressive."
"That incision was a bit conservative; no need to be so cautious. It shows a lack of confidence in your skills. Feeling the pressure? Maybe I should take over."
As Liu Banxia chattered on, comnting on Xu Yino's every move, the onlookers outside felt their scalps tingle. Is he so kind of nagging monk?
If we were operating with soone like that constantly nagging, we might make a critical error with a single slip of the scalpel.
So this was the famous Liu Banxia? Wasn't he a bit too arrogant?
Many people wanted to discuss this, but seeing Zhou Shuwen there, it didn't feel right to gossip about his disciple in his presence.
But then they noticed that not only was Zhou Shuwen's expression unchanged, but several other people's expressions also remained unchanged.
It was then that they realized, while they were feeling irritated outside, Xu Yino, who was operating, seed unaffected, focused only on dissecting the triangle of Calot.
They were all professionals who had only heard that Liu Banxia was going to perform the surgery for Zhou Shuwen, so they ca to observe. They wanted to see what this rising star Liu Banxia was truly capable of.
Now it was clear: this "special surgical atmosphere" was habitual. In other words, these interns had been trained to this level.
Never mind Liu Banxia's two interns; even the operating room nurses showed no change in expression, simply carrying on with their duties.
Because they were all professionals, they naturally knew that while chatting during surgery could help ease tension and stress, no one would deliberately create pressure and make sarcastic remarks like Liu Banxia.
This indicated Liu Banxia's teaching style: bold and risky, but highly effective.
Because they are ergency physicians, the conditions in the field are often far worse than in an operating room. Even in the ergency room itself, the ambient noise can be significant.
In such situations, ergency physicians must remain calm to make rational judgnts and administer optimal dical treatnt.
They had only heard that the six interns from the Ergency Center's General Surgery Departnt were excellent. Today, they saw it firsthand. ntally, at least, they were already very strong, even surpassing many seasoned doctors.
Now they all found Liu Banxia a bit frightening. If we had to endure this type of teaching each ti we perford surgery, wouldn't it drive us crazy?
No wonder they called Liu Banxia the 'Big Demon King.' He's more than a Big Demon King; he's utterly ruthless!
Regardless of the onlookers' thoughts, Xu Yino and her colleagues had truly grown accustod to Liu Banxia's teaching style. During his instructional surgeries, the challenges were constant, demanding unwavering focus; there was no room to slack off, not even for a few seconds.
"The gallbladder has been successfully removed," Xu Yino announced cheerfully.
"Sigh... next cos the major part. The infiltration is severe, so dissection is proving sowhat difficult. Then there are so many lymph nodes to clear, and I also need to make crucial judgnts. It's quite worrying," Liu Banxia muttered.
"Teacher Liu, you've got this. I have a feeling there hasn't been any spread. We'll know for sure from the biopsies of the upper and lower common bile duct. If those are clear too, that would be ideal," said Xu Yino, having stepped aside.
"Teacher Liu, aren't you curious about who picked tomorrow's surgery? You seed to guess wrong earlier. But I can't just tell you; you have to let enjoy the surprise."
Even though this was a major surgery, the atmosphere both inside and outside the operating room remained relaxed.
Xu Yino had perford beautifully, not only with the clean and efficient gallbladder removal but also with her witty counterattack against Liu Banxia.
He deserved to be tornted like this. After his incessant chattering, it was ti he felt so pressure too.
Even if Xu Yino's current behavior bordered on insubordination, everyone present found it quite satisfying.
"No need to guess; that's all simple stuff. Surprise, do you even know what a surprise is? Tsk tsk, look how precise my dissection is now. A fraction more would be too deep, a fraction less too shallow. This cut is just right," Liu Banxia chid in delightedly.
"Right, after the frozen section results are back, if they're mostly negative and the impact isn't significant, Liu Yiqing will inform the patient's family. If not, well, that heavy burden can only fall to Doctor Xu."
Hearing his words, many people took a sharp intake of breath. This guy is so petty!
Zhou Shuwen felt he shouldn't watch anymore; my blood pressure might rise.
I've ended up with such an unconventional disciple, and the interns he's trained have also gone off the rails.
It's a simple truth: everyone wants to deliver good news to the patient's family. Just because there are no visible signs of tumor spread in the liver doesn't an all problems are gone.
The biopsy results are what matter. Cancer cells might have slipped past, invisible to the naked eye.
Although Liu Banxia was a bit talkative and petty, it had to be said that his surgical skills were truly formidable.
He didn't appear to be moving exceptionally fast, yet his dissection was remarkably swift. Just as he'd claid, every incision seed perfectly placed.
This was skill, extraordinary skill, especially given the patient's complex adhesions and infiltration.
Xu Yino had perford very well just now, but the prowess Liu Banxia was currently demonstrating was clearly on another level.
"Clearing these lymph nodes is quite tiring. Liu Yiqing, interested in clearing a couple? We still need to skeletonize the common bile duct, hepatic artery, and main portal vein within the hepatoduodenal ligant," Liu Banxia spoke again.
"So much to do; being the chief surgeon is genuinely exhausting. Aren't there any eager young colleagues? Anyone brave enough to step up and shout, 'I can do it'?"
"Based on my observations so far, I'm inclined to agree with a certain young colleague's assessnt: it's highly probable this patient has no tastasis. It's a gut feeling, so let's leverage that in our approach."
"This surgery might not be as complicated as we thought. It could just be a standard radical resection for hilar cholangiocarcinoma. Co on, any takers?"
"Xu Yino, you go first. Teacher Liu will be your first assistant. When you get tired, I'll take over. Teacher Liu has already cleared the most difficult part, so what follows shouldn't be too complex," Liu Yiqing spoke up.
"What do you think you're doing? I'm the chief surgeon. How are you two already assigning tasks?" Liu Banxia interjected.
"Teacher Liu, I'll take lymph nodes 9, 12, and 13. I think I can handle it," Xu Yino also chid in.
"Then Liu Yiqing can try the rest; I don't think she's done this many tis. Honestly, it's not often we get a case like this. Can I handle the transection of the bile duct?"
"Alright, then I'll gladly be the first assistant," Liu Banxia replied.
"The remaining steps will depend on the biopsy results after transection. If the results are good, the rest is routine. You two can manage it; it'll be easier than a laparoscopic procedure anyway."
"The only critical part is the suturing for the biliary-enteric anastomosis. I'll take over then and show you how it's done. Joking aside, the rest is pretty much routine. Stay steady. Old Wang is treating us to dinner tonight."
"Seriously... why am I always the one catching stray bullets?" Wang Lei said helplessly.
"The surgery is going smoothly. Based on my current estimates and their usual performance, five hours should be no problem," Liu Banxia said with a smile.
Many among the observers outside felt a mixture of envy and complex emotions. This Liu Banxia certainly has guts.
Letting interns participate so much in such a major, complex surgery, and treating it like routine... Do they really do this often?
Another reason for their envy was that opportunities to actively participate in such major surgeries were genuinely scarce. Most of the ti, they were observing from the sidelines or, like now, from the gallery.
The reason for their complex feelings was also simple: to earn such opportunities, one first had to endure Liu Banxia's grueling, almost inhuman, training.
We really don't know how these interns survived the year. If we had to go through that kind of internship again, we probably wouldn't last...
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