Chapter 1314: Little Stone, Big Trouble

Chapter 1314: Chapter 1314: Little Stone, Big Trouble

(Thanks to reader 75185340 for the monthly ticket encouragement)

"The exterior of the small intestine doesn’t appear to have any issues."

After making space, Liu Banxia carefully observed and stated.

The crew also stared intently at the screen, hoping to catch some clue from the exterior of the small intestine.

However, it was still in vain, and it looked just like the typical condition seen during surgeries for patients.

"OK, let’s prepare to clamp and make a puncture. Close to the pancreatic duct end, let’s take a look."

After inspecting it further, Liu Banxia said.

"We will soon understand the situation more specifically." Li Liwei was somewhat eager.

After all, he has been a doctor for many years and has witnessed many surgeries, but has never seen bleeding in the pancreatic duct; intestinal perforation is much more common.

And even in cases of digestive tract bleeding, gastric bleeding has a higher incidence.

It’s likely due to irregular lifestyles and unhealthy eating habits. Many people suffer from gastritis and gastric ulcers, eventually leading to gastric bleeding.

The probe was inserted, and everyone’s spirits lifted.

Although the source of bleeding hasn’t been found yet, blood is now visible inside the small intestine.

"Teacher Liu, should we head straight for the duodenum?" Xu Yino asked excitedly.

"Absolutely, don’t forget to irrigate. The issue might be within the small intestine, so we must conduct a thorough examination. The patient has endured enough; we cannot afford to miss anything," Liu Banxia said.

Though feeling excited, Liu Banxia’s actions remained cautious.

The entire small intestine is relatively long, consisting of the duodenum, jejunum, and ileum, playing a crucial role in the body’s digestion and absorption.

The area where the pancreatic duct connects to the small intestine is located on the posterior medial wall of the descending part of the duodenum, opening alongside the common bile duct.

In fact, pancreatitis due to pancreatic duct stones is extremely rare because of the strong digestive ability of pancreatic fluid. But rare doesn’t mean nonexistent; this patient indeed has a small stone.

As irrigation and suction were performed, the view gradually became much clearer. So far, no abnormalities have been seen on the inner side of the washed intestinal walls.

Expressions turned tense because they knew if it was indeed pancreatic duct bleeding, the surgery’s difficulty and the patient’s suffering are on entirely different scales from small intestine bleeding.

Liu Banxia’s actions remained slow; it was his first time handling such delicate work, worried that quick movements might damage the intestinal walls.

"Should we skip probing below? Bloodstains are still visible at the outlet and are extending inward."

Finally at the entry point, Liu Banxia spoke.

"Oh... such a tiny stone, how did it wear through the blood vessels?" Xu Yino asked.

"We’ll only be able to see clearly after making an incision; next steps will be meticulous. I’ll go talk to the patient’s family," Liu Banxia said.

"Everyone should brace for hard work; today, we’ll certainly finish late. Adjust your schedules if needed, and let’s celebrate together after the surgery."

"Really got a large case before clocking out," Li Liwei remarked.

Even if Liu Banxia was quick with his hands, laparoscopic surgery of this nature takes time that cannot be easily curtailed.

With luck, they can finish before midnight; if unexpected situations arise, they might not finish until the early hours.

Estimating surgery time truthfully is quite challenging.

Moreover, the patient’s condition isn’t entirely clear yet, only the indications were sufficient.

"Dr. Liu, is the examination finished?"

Seeing Liu Banxia stepping outside, the waiting patient’s wife hurried over.

"We’ve completed the preliminary examination; traces of blood were seen at the pancreatic duct and duodenum exit area, so we can basically conclude it’s bleeding within the pancreatic duct," Liu Banxia said.

"CT scan shows the stone is very small and hasn’t affected the pancreas in other ways. I suspect performing a pancreatic duct incision and stone removal will suffice."

"However, specifics can only be determined once opened up. If the stone has severely impacted the side of the pancreatic head, we’ll have to adjust the procedure to perform a pancreaticoduodenectomy."

"Due to the risky nature of pancreatic fluid, without adequate preparation this won’t be a successful surgery and will leave him with residual concerns."

"Dr. Liu, I don’t fully grasp everything you said, but I do understand that the bleeding needs to be taken care of, right?" the patient’s wife asked.

Liu Banxia nodded, "This is actually quite timely; if the pancreatic fluid continues to erode the bleeding point completely, the consequences won’t be just this minor complication."

"Go ahead, since we’re already in this situation," the patient’s wife nodded firmly.

This settles it, Liu Banxia can conduct the surgery with peace of mind.

He appeared hesitant before the exploratory procedure, but when things actually happened, he was quite decisive.

Returning to the operating room, Liu Banxia waved to the people in the observation room, "Today is probably going to be a long haul, anyone ready to battle till dawn?"

Wang Chao was quite speechless and replied through the intercom, "Actually, we just want to see how the stone caused the bleeding, nothing else matters. Hurry up, we still need to go for dinner after this."

"Sigh... We have no idea when we’ll get to eat. Do me a favor and let Manager Zhou know we’ll be a bit late tonight. We need at least one hot meal," Liu Banxia said.

"Absolutely, I might join you for a night snack too," Wang Chao agreed readily.

People around also cracked a smile.

That’s Liu Banxia for you, performing such a big surgery with such ease, anyone else would probably have a headache.

"Do I need to say more about separating tissue? Two warriors, who wants to face the dark side of life?" Liu Banxia looked again at Xu Yino and Su Wenhao.

"Comrade Old Su, the separation at the front isn’t that complex, I’ll start first, then you can follow," Xu Yino said.

"Settled, the first warrior is out. Any other partners who want to try can prepare while they’re separating tissue," Liu Banxia said.

"Actually, it’s not that complicated. Although we haven’t done many such big surgeries, each one leaves a deep impression. It’s just about evoking the major gastric bend and exposing the pancreatic head."

"From the CT, you can see the patient’s pancreas doesn’t have signs of enlargement, nor is the pancreatic duct visibly expanded, so finding the pancreatic duct is quite simple."

"The work you can do probably ends here, isn’t it simple enough, explaining it in a few words? Everyone can eagerly sign up, there aren’t many chances."

While he spoke with ease, Su Wenhao’s face was also quite tense now.

For them, it is an opportunity as well, but it came too suddenly, and they feel somewhat unprepared.

The surgery, although not as difficult as pancreaticoduodenectomy, is still not easy.

Because the pancreas is too important yet fragile, and there are many surrounding structures like the hepatic and bile ducts, and many blood vessels, making it all the more complex.

Liu Banxia spoke lightly because he only explained the result, not the detailed process. Actually doing it is not that simple.

It is considered some buffer time for Su Wenhao, with Xu Yino handling the small bowel perforation, and Cui Jia assisting.

"I must say, haven’t seen Xu Yino’s surgery for some days, the skill is indeed impressive, I need to work harder," Wang Chao remarked.

"Let’s encourage each other, their progress speed isn’t as incredibly fast as our beloved Director Liu, but it’s not slow either," Wei Yuan said with a bitter smile.

"You all are a bunch of pitiable ones. Encountering these six, even with prior knowledge, you must have felt a lot of pressure."

The interns nodded with wry smiles.

Working in this field, who doesn’t want to master the skills quickly and become successful?

But it’s genuinely tough; medical skills aren’t like other tasks, talent is truly important.

The six are famous, and among their batch and the following batch, their reputation even eclipses Liu Banxia’s.

Because Liu Banxia is somewhat distant, they have already put him on a pedestal, not part of their concern. The six are different, they were once partners in large lectures.

As for the current interns, many are from the Second Hospital, and have heard a lot about the flair of the six.

Being from the same hospital, if the standards vary too much, wouldn’t that be a bit awkward?

The surgery wasn’t easy, don’t be misled by Liu Banxia’s initial calmness. Once Su Wenhao started separating, Liu was closely watching.

They can be allowed to operate, but must not harm the patient more, can’t joke around. If things go wrong, Liu must intervene promptly.

Luckily, though they seemed a bit timid, their actual performance was steady, albeit slower, yet they were precise and orderly.

"Alright, the next part is mine."

After the pancreatic head was exposed, Liu Banxia commented with a smile.

"This pancreas is very good, the parenchyma isn’t atrophied or thinned, hence finding the pancreatic duct is relatively harder. But no worries, there are subtle differences."

"After determining an approximate position, we can use a fine needle to verify. I’ve pretty much got it, so cutting longitudinally will be okay."

People are now staring intently at the screen, eager to see why this small stone is causing such a big issue.

The patient’s blood loss was indeed considerable, not a minor condition.

When Liu Banxia opened the pancreatic duct, the small stone was revealed to everyone. A small corner at the tip was pressing tightly against the duct wall.