Many doctors who have had experience with this situation agree with what the doctor said.
Doctors from other hospitals are like martial arts masters who show their faces. They speak eloquently about problems, while teachers from our own hospital do not give lectures. Medical students who come to listen to lectures for the first time will be confused. For example, intern Fan Yunyun feels that she can no longer tell east from west.
It is not easy to learn from Senior Sister Xie. Senior Sister Xie was able to participate in such an important operation and help in front of her peers across the country, but she has not yet figured out how this operation was performed.
Senior Sister Xie told her that she had to tackle a tough problem. The teacher said it would be better for her to put more energy into exploring on her own, as only by thoroughly understanding anatomy could she understand all surgical problems.
Fan Yunyun quickly lowered her head, took out a thick anatomy atlas from her schoolbag and opened the relevant page.
Geng Lingfei, who was sitting next to her, looked at the big textbook in her hand in surprise, and finally realized why she had to bring a big schoolbag to attend the lecture. People treated the lecture as a self-study class at school.
Looking at her actions, Geng Lingfei frowned and turned back: Damn, all the actions of this intern seem to be intentionally or unintentionally trying to steal the teacher position from him.
"You said they were talking about a problem at the liver gate." Fan Yunyun seemed to be asking and answering herself.
Geng Lingfei didn't even look at her and refused to discuss with someone like her who was trying to steal the teacher's name.
...
...
Dai Nanhui was amused by the different expressions on their faces. He felt that it was unheard of and strange that these two people were learning from an intern.
After turning the page, Fan Yunyun recited the key points of the book in her mind: The hepatic vein is formed by the confluence of the liver's portal vein system and hepatic artery system through the central vein and sublobular vein, and mostly merges into the inferior vena cava at the second and third portals.
When a patient suffers from Budd-Chiari syndrome, the outflow of the hepatic vein is partially obstructed. Therefore, the collateral circulation mentioned by the doctor from the external hospital can be widely formed between the unobstructed hepatic vein and the blocked hepatic vein, between the subcapsular arch of the liver and the sinusoidal space of the liver parenchyma, between the phrenic vein and the hepatic vein, between the hepatic vein and the short hepatic veins, between the lobules and the perihepatic adhesion zones, and in the perihepatic ligaments, etc.
In addition, there are a large number of small and medium veins at the third hepatic portal, which are called short hepatic veins, with as many as thirty or fifty of them. The above factors constitute a huge risk of uncontrolled bleeding and death of the patient on the operating table if the doctor does not handle them properly during the operation.
The significance of establishing extracorporeal circulation in this type of surgery lies here. The inferior vena cava is a large channel for blood to flow back to the heart. Once blocked, venous congestion in the lower segment may occur. How serious this problem is, sometimes it can cause renal failure in the lower segment. In addition to this, the collateral circulation formed in the course of the disease in patients with Budd-Chiari syndrome is mostly small blood vessels. Once the large channel is blocked, these small blood vessels will be detonated like a large minefield. By then, the blood will flood into the sea, and the doctors will only have a few hands. How can they deal with such a large minefield with exploded blood vessels?
Uncontrollable bleeding refers to this terrible consequence.
I understand. Fan Yunyun nodded. Thank you, Senior Sister. It is really important to study and understand anatomy well.
If this is the case, why do doctors hesitate to use extracorporeal circulation?
The reason is very simple. It is definitely not a good thing to do things like deep hypothermia anesthesia and circulatory arrest on patients unless it is necessary.
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