"Suck in, faster." Ling Ran's command was clear and precise.

Removing the right lobe of the liver is an absolutely major operation in any hospital of any quality. Everyone in the operating room was excited and nervous.

Comrade Huo Congjun, who was still brushing his hands outside the door, was nervous but not excited.

But he didn't wash his hands, so it was useless to go in. He could only ask loudly: "What's going on now?"

"The pringle technique has been used to block the blood flow." Ling Ran replied.

The pringle maneuver is the most commonly used hepatic blood flow blocking method in surgical operations, and it is also the simplest method. The breakpoints are at the hepatic portal and liver pedicle, but it cannot completely control the bleeding at the cross-section.

Considering the warm ischemia damage to the liver, the pringle technique is the limit for blocking blood flow for an hour. In county hospitals, doctors in the emergency department do not dare to use this method even if they see the patient losing blood continuously. Because there is no follow-up.

, using the pringle technique can only cause greater damage.

Huo Congjun was also full of doubts.

However, he could not convey his worries to Ling Ran outside the door.

In emergency surgery, sometimes the worst decision is better than no decision at all. Huo Congjun could only raise his voice to release his worries: "What now?"

"The amount of bleeding is decreasing." Ling Ran paused, and then said: "The liver is in very bad condition, and there is no time to perform an ordinary right hemihepatectomy."

Huo Congjun's heart skipped a beat and asked, "How bad is it?"

"Hemoglobin is 16, blood pressure is 45, and it's still falling." Ling Ran answered very quickly. He was also looking at the monitor and thinking.

A few seconds, if used to answer questions, is a very short time, but on the operating table, in emergency surgery, a few seconds is enough to make everyone doubtful.

Lu Wenbin, Yu Yuan and Zuo Cidian looked at Ling Ran in unison, with the same sentence in their eyes: What should we do now?

For them, the chief surgeon is the backbone.

Everyone knows how to sew, how to cut, and how to use instruments. However, where to suture, where to incise, and where to use instruments all require guidance from the surgeon.

Ling Ran's brain was spinning rapidly.

He was thinking about one plan after another.

There is no need to consider ordinary right hemihepatectomy. Normal regular liver resection takes one and a half hours. This patient may not be able to wait even 15 minutes.

So, what about simple repair and then resection?

Ling Ran looked at the exposed field of vision and didn't think there was any plan that could be implemented within a few minutes.

"How's the situation?" The person who spoke this time was a hepatobiliary surgery chief who hurried over.

"Where is He Yuanzheng?" Huo Congjun asked the director of hepatobiliary surgery.

The young chief surgeon took the time to brush his hands and added: "A patient had a sudden biliary tract bleeding and was admitted to the uterus for the second time. Director He performed the surgery, and several other directors were also performing surgeries."

The prognosis of liver surgery has always been a difficult problem, and it must be treated urgently when encountered.

Director Huo curled his lips and glanced at the little chief physician whom he didn't know very well. He felt that it was really not as good as his own Ling Ran.

"Hemoglobin is 14...12." Su Jiafu shouted loudly as a reminder.

Ling Ran's expression was still unclear, but Huo Congjun outside the door was already worried: "Why did it fall so fast?"

"The liver injury is very serious, and the gauze packed with it will not work." Ling Ran replied.

"Then why are you in such a hurry to remove the stuffing gauze?" The face of the young doctor outside the door also changed. The value is so low, if not done properly, someone will die.

Huo Congjun glanced over from the corner of his eyes: "The packing has not worked to stop the bleeding. If the gauze is not removed, the inside will be opened. Now it is a race against time. The blood loss is 11,000 ml. Are you confident?"

"Ten thousand?" The little doctor stopped brushing his paws.

"Eleven thousand, it is estimated that the blood loss is close to twelve thousand." Huo Congjun snorted and asked, "Are you sure?"

"Director Huo, I've already had two rounds of blood transfusions all over my body. I..." How can the young chief dare to say anything confident?

"I'm now starting to separate the right liver." Ling Ran shouted loudly. This was a notification. He is now the chief surgeon in the operating room and has the greatest clinical power. He can't see the situation outside, and inside

The patient's condition becomes more serious the longer they wait, and the probability of survival becomes lower the longer they wait.

Huo Congjun didn't even put on surgical clothes. Looking at the cowering look of the junior surgeon at the hepatobiliary surgery department next to him, he became angry. What he despised most was this kind of irresponsible doctor.

The doctor stood on the operating table and returned from the Palace of Yama to take his life. If he was afraid of wolves in front and tigers in the back, what could he accomplish?

Recalling the liver surgery that Ling Ran had just done with him, Huo Congjun shouted outside the door: "First determine whether there is damage to the hepatic vein, and then cut off the round ligament and falciform ligament..."

Ling Ran didn't mind Huo Congjun's explanation. If a newbie were in the operating room now, he would probably be extremely grateful.

Of course, if it were a newbie, I would probably not be able to find the round ligament of the liver and the falciform ligament anywhere.

Huo Congjun had taught countless novices, and he was worried that Ling Ran would be nervous and make novice mistakes, so he continued: "You first look for the falciform ligament, and then follow the portal vein..."

The junior surgeon at the Department of Hepatobiliary Surgery looked down and brushed his hands. He was indeed timid. Therefore, after listening to Huo Congjun's words, he did not say anything even though he knew that Huo Congjun was asking Ling Ran to perform the surgery.

He is also not happy to have one more death case under his command.

By then, just talking about death can kill people.

However, the junior surgeon at the Department of Hepatobiliary Surgery is not optimistic about Ling Ran either. He does know Ling Ran. Doctor Yun probably knows everyone about him, but the bleeding volume of 11,000 ml is no joke. Doctor Yun’s current record for the highest blood transfusion volume is

A pregnant woman with amniotic fluid embolism received a blood transfusion of more than 18,000 milliliters. However, the director of the gynecology department mobilized the entire department to save the blood, and even used personal relationships to obtain blood. It was a feat that was only accomplished by a stroke of luck. Later, another pregnant woman with amniotic fluid embolism appeared.

Not so lucky.

The junior surgeon at the Department of Hepatobiliary Surgery had many malicious conjectures. The patient in front of him was sent from another county. It was probably because the blood bank of the local blood station was in a hurry...

"The round ligament and falciform ligament are severed." Ling Ran's voice came from inside the door.

"Untied?" The young chief was surprised.

Before he could think any more, Ling Ran's voice came again: "The perihepatic ligament is separated."

"The upper and lower veins will not be dissociated."

"Dissection of inactive liver tissue."

The voice came from within, sentence by sentence, with a calming momentum.

Huo Congjun finally washed his hands, stepped on the air-tight door and entered. He saw Ling Ran on the operating table, holding the patient's ruptured liver in his hand. He used his fingers and the handle of the knife to remove the inactivated and bloody liver along the edge of the laceration.

The poorly transported liver tissue is stuck in pieces.

To an outsider, such an action would be considered crude. However, Huo Congjun and the junior surgeon at the Department of Hepatobiliary Surgery were dumbfounded.
Chapter completed!