Chapter 202 - 181: Jin Province’s Liver Tumor Heavyweights Gather at City No. 1 Hospital

Chapter 202: Chapter 181: Jin Province’s Liver Tumor Heavyweights Gather at City No. 1 Hospital

Inside the Emergency Department.

Yasui was on duty today.

In the afternoon, a patient was admitted with symptoms of biliary obstruction, including fever, jaundice, and upper abdominal pain.

Yasui’s initial assessment was that the patient had a biliary tract disease, most likely caused by gallstones.

After sending the patient for tests, he soon received the imaging department’s files, along with various other liver biochemical indicators.

After reviewing them, Yasui’s expression turned grim. The patient’s condition was more complicated than he had imagined.

The patient was sixty-eight years old with a weak constitution. Magnetic resonance cholangiopancreatography (MRCP), an abdominal CT scan, and an ultrasound all confirmed the diagnosis: a common bile duct stone!

Moreover, the patient had a long history of chronic hepatitis B, and this examination revealed that his entire liver had become cirrhotic.

His liver function was classified as Child-Pugh B-level.

The Child-Pugh score is one of the most common clinical indicators for assessing hepatic reserve capacity. This classification standard is simple, convenient, fast, and accurate.

The indicators included in this classification standard are mainly: serum bilirubin, plasma albumin, prothrombin time extension, ascites, and hepatic encephalopathy.

Clinically, the total score is divided into classes A through C.

A-level: good liver function.

B-level: poor liver function.

Class C: Patients with Class C liver function should avoid surgical treatment, as the postoperative mortality rate can reach 50-75%.

Surgery is relatively safest for patients with A-level liver function.

This patient, however, was B-level, already below the safety threshold.

For a patient with bile duct stones, the standard treatment is open surgery. But given this patient’s liver function classification, the risks of open surgery were far too great.

However, based on the patient’s current condition, conservative treatment definitely wouldn’t solve the problem. With the biliary obstruction, fever, and pain, if the stone wasn’t removed promptly, he would likely suffer liver failure, which would be life-threatening.

After reviewing everything, Yasui’s face was solemn. This problem was beyond his capabilities.

Yasui immediately called Director Cai Qi from Hepatobiliary Surgery and also reported the situation to the second-line on-call physician, Director Qin.

Before long, both Director Qin and Director Cai had rushed over.

After they reviewed the case, they too were hesitant to make a decision. To operate or not to operate—it was a true dilemma.

But the more time passed, the more dangerous the patient’s condition became.

"Director Qin, I have an idea. We could try an Endoscopic Sphincterotomy (EST)!"

"EST is minimally invasive, and its complications and risks are far lower than traditional open surgery."

Director Cai proposed his idea.

Qin Donglai thought it was an excellent idea, but the current Emergency Surgery department hadn’t even mastered basic ERCP. How could they possibly perform EST, a procedure derived from it?

"Director Zhang Heng can!"

Yasui reminded them from the side.

"That’s right! Director Zhang is very skilled at EST. It’s a routine surgical technique at Jin Province Tumor Hospital."

At this moment, Qin Donglai had to admit that Zhang Heng’s arrival had indeed brought new strength and more comprehensive capabilities to the City First Hospital’s Emergency Department.

"I’ll contact Director Zhang right away."

Qin Donglai immediately called Zhang Heng.

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「Jin Province Tumor Hospital.」

Zhang Heng was discussing an academic exchange visit to City First Hospital with Director Ma, Director Fu, and others.

He was just trying to think of a suitable reason. After all, they couldn’t just say they were coming to City First Hospital to see Dr. Wu Ting.

Just then, the call from Qin Donglai came through.

Zhang Heng was delighted when he heard. ’This couldn’t have come at a better time.’

Zhang Heng listened with a straight face as Qin Donglai explained the patient’s situation. He then pondered for a moment before slowly replying:

"Director Qin, I understand. I’m currently at my old workplace, Jin Province Tumor Hospital, for an academic exchange."

"How about this: I’ll bring a team over immediately. As it happens, Director Fu’s team from Haijin Port is also here at Jin Province Tumor Hospital for an exchange. I’ll invite Director Fu to come along, and I’ll also invite my former superior, Director Ma."

"After all, this patient’s liver function is B-level, and it’s cirrhosis caused by chronic hepatitis B, so the situation is very serious. I have no problem performing the surgery myself, but there are always risks."

"The patient is quite lucky that both Director Fu and Director Ma are available. With two of Jin Province’s top experts in hepatic tumors present, I’m confident this surgery can be performed safely."

Zhang Heng’s words were vague, but he gave the impression that he was specially inviting Director Fu and Director Ma to consult on the case.

What incredible influence and connections!

After hanging up, Zhang Heng described the case at City First Hospital—a patient with cirrhosis from hepatitis B complicated by a common bile duct stone.

Director Ma and Director Fu took it very seriously. It was indeed an excellent pretext.

"Director Zhang is always so thorough. We’ll use the consultation at City First Hospital as the reason for this impromptu inspection and exchange."

After all, Director Ma and Director Fu were renowned figures in Jin Province’s hepatobiliary surgery field. It would be far too undignified for them to visit Fan City First Hospital on a whim just for a junior doctor. It wouldn’t sound good if word got out.

But with Director Zhang’s framing of the situation—City First Hospital was in a bind, and two warm-hearted experts, undeterred by the hardship, were accompanying Zhang Heng to the City First Hospital Research Center to consult on a patient’s treatment—it sounded admirable enough to earn a thumbs-up from anyone who heard!

It had to be said, Zhang Heng was quick-witted. Effortlessly, he had won the approval and praise of both City First Hospital and the two directors, Fu and Ma.

’When I get back to City First Hospital, we’ll hold a consultation. I’ll make sure to invite Wu Ting.’

’Based on this patient’s condition, the best treatment plan is an Endoscopic Sphincterotomy (EST), a procedure I’m very proficient in.’

’Wu Ting may be experienced with transarterial chemoembolization, but young doctors inevitably have gaps in their skill sets. One can quickly accumulate experience in a single surgical technique, but to master multiple techniques and have them all blossom requires a vast amount of clinical experience. Wu Ting is still young, after all.’

Moreover, Zhang Heng knew very well that City First Hospital had never performed an Endoscopic Sphincterotomy (EST). They were still in the process of learning ERCP.

This was also why Director Huo had brought him in. He was brought to the City First Hospital Research Center to introduce these new surgical techniques and pave the way for the Emergency Surgery department to become a key specialty in laparoscopic diagnosis and treatment.

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"Director Qin, how did it go? Can Director Zhang perform the surgery?"

Cai Qi asked with some concern.

Qin Donglai nodded excitedly.

"Director Cai, you won’t believe this. Director Zhang is simply incredible."

"He happens to be at Jin Province Tumor Hospital today for an academic exchange. When he heard we admitted this patient, not only is he rushing back immediately, but he’s also inviting his department’s Director Ma, as well as Director Fu from the Hepatic Tumor Surgery department of Jinggang University Affiliated First Hospital, who’s there for an exchange."

"Director Ma Shengzhong and Director Fu Jinfen are the top luminaries in Jin Province’s hepatic tumor field! I never thought we’d be able to get them to come here."

"Even our Director Huo doesn’t have the clout to invite these two great figures over for a single patient."

"I can’t believe Director Zhang has this much influence."

Hearing Qin Donglai’s words, Cai Qi was also thrilled.

City First Hospital’s Hepatic Tumor Surgery department was at the bottom of the barrel in Jin Province, and he, Cai Qi, was unremarkable. To be able to consult with two such eminent figures was both an honor and an opportunity for him.

If he could build a friendly rapport and establish a connection with them, it would be a huge help to the future development of City First Hospital’s Hepatic Tumor Surgery department.

"In that case, I’ll go call over all the key physicians from my department to observe this surgery."

Cai Qi was ecstatic, and he felt a growing admiration for Zhang Heng. At the same time, he was envious of Director Huo. Having Wu Ting was already impressive, but to think this Zhang Heng was just as formidable, with such a deep background and powerful abilities!

While Cai Qi went to arrange for his department’s doctors, Qin Donglai also prepared to have the Emergency Department doctors participate in this rare, high-profile surgery.

Qin Donglai quickly reported the situation to Director Huo. He also called over Luo Ming, Wu Ting, and the others to take part in the consultation.

He specifically assigned Cheng Feng, who had studied photography in his spare time, to film the entire consultation and surgery. It would make for excellent promotional material later on.

Featuring two top experts from Jin Province Tumor Hospital and Jinggang University Affiliated First Hospital would have a lot of prestige.

This time, they were truly riding on Deputy Director Zhang Heng’s coattails. It instantly elevated the prestige of Fan City First Hospital’s academic exchange activities to the highest level!

When Huo Yun heard that Fu Jinfen and Ma Shengzhong were coming, he was also a bit surprised, but he was very satisfied with Qin Donglai’s arrangements.

Since his promotion to deputy director, Qin Donglai had changed a great deal. His presence in the department was growing stronger, and when Huo Yun wasn’t around, his arrangements were becoming more and more thorough.

Of course, Huo Yun had also been very satisfied with Zhang Heng these past few days.

This event, in particular, made him feel that the high price he paid was not in vain.

With Zhang Heng, City First Hospital could not only independently perform Endoscopic Sphincterotomy (EST) but could also easily invite such a powerful top-tier hepatobiliary surgery team for a consultation.

Compared to Wu Ting, Zhang Heng was, after all, more senior. Whether it was his versatile skills or his network of contacts in Jin Province, he was a "plug-and-play" elite physician.

The introduction of this new surgical technique by Zhang Heng laid a solid foundation for the future key specialty in laparoscopic diagnosis and treatment.

As the teams of Zhang Heng, Director Fu, and Director Ma arrived at City First Hospital, the team at City First Hospital had completed all preparations to welcome them. All the physicians were looking forward to the diagnosis and treatment of this patient.