Chapter 451: Chapter 330: Surgery Successful, Life Saved

The patient’s duodenum has two injuries, one cut in the middle of the duodenum and one cut at the head of the pancreas.

If it needs to be removed, it would involve completely excising the entire duodenum along with the head of the pancreas.

And a pancreaticoduodenectomy is a complex and high-risk surgery.

The pancreaticoduodenectomy includes three main steps: exploration, resection, and reconstruction of the digestive tract.

Exploration is the necessary step to determine whether resection is possible, resection involves removing the head of the pancreas, pyloric antrum, entire duodenum, the lower part of the common bile duct, and regional lymph nodes.

Reconstruction is anastomosing the common bile duct, pancreatic duct, and stomach with the jejunum.

However, once the duodenum is removed, it greatly impacts the patient’s postoperative recovery.

Or rather, the patient might have to live with a bag, leading to a poor quality of life.

"Director Qin, does it need to be removed?"

Zhang Qingquan observed the situation, looking complex, couldn’t help but ask.

Qin Feng pondered for a moment, did not answer, and then began to move to free the duodenum.

He wanted to save the patient’s duodenum!

The patient is still young, only in their twenties, and is also a police officer.

If without a duodenum, life in the future would likely be very difficult.

The road ahead is still long~~~

But it’s not the right time yet, because the physiological indicators have not yet met the standards.

...

The surgery was still ongoing, and Yu Shuang had completed the liver repair.

The surgery time exceeded 5 hours!

This was also one of Qin Feng’s longest single surgeries, Yu Shuang’s clothes inside the sterile suit were long soaked.

Beside her, Lu Mingming sat on a stool resting, such surgery is mentally exhausting.

And the first assistant Zhang Qingquan was also on edge, but fortunately, Qin Feng’s surgical ability was so formidable that it barely required him to operate much.

Because he couldn’t keep up, many operations were done first by Qin Feng.

This left him quite frustrated!

The young vice-director he had once underestimated and envied, despite completing many difficult surgeries before, he had thought was just due to being on stage with critically ill department doctors.

But now, Qin Feng’s ability completely convinced him, a master of surgery from neurosurgery to thoracic, urology, and obstetrics.

Unprecedented strength!

Zhang Qingquan even felt a tinge of emptiness, perhaps he would never reach such a level and height in his lifetime.

Monster!

Utter monster!

Qin Feng seemed born for surgery, born for medicine.

No matter how brilliant a genius, next to him they couldn’t lift their head or catch their breath.

Too terrifying~~~

The surgery continued, Qin Feng swiftly freed the duodenum and pancreatic head.

Clang~

"I’m done over here."

Yu Shuang put down the needle holder, exhaling deeply.

The liver and gallbladder were all sutured, venous vessels completed anastomosis.

"Alright, thank you both."

Qin Feng nodded to him and Lu Mingming upon hearing this.

Aside from the pancreaticoduodenectomy, other parts were fully sutured.

The physiological indicators also recovered considerably, reaching the critical value for surgical safety standards.

According to the current situation, it should hold until the pancreaticoduodenectomy repair.

"Then Director Qin, we’ll be heading out first."

Yu Shuang removed his sterile gloves, nodded with a smile.

"Well... Director Qin."

At this moment, Lu Mingming walked over, stumbling a bit with his words.

"How can it be possible Dr. Lu?"

Qin Feng looked at him puzzled.

"You are proceeding with the pancreaticoduodenectomy next, right?"

Lu Mingming asked with an awkward smile, seeing Qin Feng nod,

"Well... Director Qin, may I stay and observe?"

Hearing this, Qin Feng and Zhang Qingquan were both stunned for a moment, then exchanged smiles.

"Sure, if you’re free, stay until the surgery ends."

Qin Feng agreed to his request, giving Zhang Qingquan a glance.

Zhang Qingquan also understood, stepped back from the first assistant position, and moved to the second assistant.

Since Dr. Lu Mingming from the gastrointestinal department wanted to observe, whether out of courtesy or technical demand, it was more fitting for him.

Besides, he was not very familiar with gastrointestinal surgery, Lu Mingming being first assistant was also more confident for the surgery.

"Thank you, Director Qin."

Seeing this, Lu Mingming’s eyes showed joy, quickly thanked, then stepped into the first assistant position.

"Scalpel."

"Richardson."

Qin Feng picked up the scalpel, separating the liver lobes, the retractor pulling the gallbladder and right liver lobe towards the head, the second retracting the left liver lobe.

Previously using Kocher’s maneuver, he freed the duodenum and pancreatic head; in this process, the soft tissue and lymph nodes from the vena cava and aorta were not routinely removed.

When the duodenum is freed distally, it must be separated from the hepatic flexure of the colon, fully exposing the colonic mesentery.

A retractor placed here would be very helpful, pulling the hepatic flexure and right half of the colon towards the tail.

At this moment, Qin Feng deftly turned to the anterior pancreatic head and adhered transverse colonic mesentery, further separating them to expose the superior mesenteric vein.

The smoothness of the whole process was impeccable!

Beside him, as the first assistant, Lu Mingming was absolutely amazed at his technique.

Such beautiful technique he had only seen in the operating rooms of department heads and vice directors, like watching a performative art. 𝗳𝗿𝐞𝕖𝘄𝗲𝕓𝗻𝚘𝚟𝕖𝐥.𝚌𝕠𝕞

Preserving the pancreaticoduodenectomy is more difficult than excision, its difficulty level is at least a step higher.

Excision surgeries in gastrointestinal surgery are high-difficulty level 4 surgeries, outside of directors and vice directors, only one serving vice-senior can be on stage.

This year at 36 years old, entering the Peking Union Medical College Hospital’s gastrointestinal department at 27, Lu Mingming still hadn’t fully led a pancreaticoduodenectomy.

Let alone preservative surgeries under severe injury!

Before Qin Feng at 28 years old, achieving the coveted Peking Union Medical College Hospital’s department vice director position, and it’s one of the most prestigious departments!

This news, to this day, resonates deeply in the Beijing medical community, some even reported and complained to the medical committee.

Peking Union Medical College Hospital, as a national leading top-tier hospital, is allowing a young graduate student who hasn’t completed his doctorate to lead an immensely important and substantial emergency department.

This is serious non-compliance and an irresponsible act towards patients.

Even some related departments jointly wrote to higher-ups, requesting Peking Union Medical College Hospital to revoke this appointment and decision.

Even though Qin Feng’s achievements and the operating room are right here, they don’t care.

Because Qin Feng has already become a disruptor of the rules.

He has surpassed cognition!

But unfortunately...

There are quite a few people who support Qin Feng, among them the biggest supporter is critical care medicine.

Both Meng Dawei and Yuan Bin are leading figures and pioneers in critical care clinical practice and academia nationwide, and their teachers are the founding fathers of critical care in Jiuzhou.

Over 80% of the top experts in critical care nationwide come from the same line!

This alone can almost shake the medical community in Beijing!

And when the name Qin Feng appears, Beijing 302 Military Hospital, Beijing Fuwai Hospital, and the First Affiliated Hospital of Peking University, these institutions that had previous interactions with Qin Feng, all expressed unanimous support.

This is a test for young people, and as a leader in Jiuzhou and Beijing, Peking Union Medical College Hospital should have a pioneering spirit.

Moreover, Qin Feng is not yet the administrative director of the emergency department; he is currently only the deputy director of the office, mainly leading clinical work.

Jinling First People’s Hospital, Suzhou First Affiliated Hospital, and other top-tier hospitals in Su Province also expressed their support.

In addition, Qin Feng’s top-tier surgical cases over the short span of three to four years, enough to fill a book, have not failed once.

Ultimately, the administration of Peking Union Medical College Hospital decided to withstand the pressure and granted Qin Feng a one-year trial period.

If any issues arise or negative impacts occur during this trial period, the administration will revoke his deputy director position, and he will not be eligible for promotion for three years.

However, at the same time, the administration will counter the negatives by confirming his position if he successfully passes the trial after one year.

Once Qin Feng graduates with his doctorate from Peking Union Medical College, he will be exempt from the two-year working requirement and will be exceptionally promoted in his professional title.

At 30 years old, with associate senior professional title!

Qin Feng will become the youngest deputy chief physician at Peking Union Medical College Hospital, in Beijing, and throughout Jiuzhou Country’s top-tier hospitals!

After all, this is Peking Union Medical College Hospital!

Of course, this news is limited to the upper echelons and is still in the confidential stage.

"Number 0 surgical line."

In the operating room, Qin Feng has begun wound suturing.

For the severely damaged areas of the bile duct and the lower pylorus, part was resected and then re-approximated to reconstruct gastrointestinal continuity.

First, an end-to-side anastomosis of the pancreas to the jejunum was performed, typically placing the jejunum behind the SMA and SMV, similar to the location of the initial retroperitoneal duodenum.

The speed of suturing was incredibly fast, and the accuracy was so high that there wasn’t a single error in needle placement.

The knotting was perfect, with two fingers moving like fluttering butterflies.

Then he freed the pancreatic stump from the retroperitoneal tissue by 2-3 cm, necessitating the ligation and cutting of some splenic vein tributaries.

He examined the pancreatic duct, ensuring its patency past the site previously tied off with polypropylene hemostatic sutures along the superior pancreatic margin.

"Pancreatic duct."

Qin Feng extended his hand to receive a pancreatic duct.

He carefully inserted an 8Fr pediatric feeding tube into the pancreatic duct to ensure that it could easily be seen during the anastomosis, continuing the anastomosis, and then removed the tube just before completing the anastomosis.

Clink~

The anastomosis was successful, and the pancreatic duct was removed.

"Gauze, suction."

"3-0 suture with needle."

Dr. Lu Mingming held the suction device to quickly clear the surgical field, greatly astonished.

Qin Feng took up the needle holder again, initiating a two-layer anastomosis from the pancreas to the intestine using a posterior horizontal mattress suture.

"Come, hold it."

After finishing the suturing, Qin Feng said softly.

Dr. Lu Mingming carefully pulled the intestine to the pancreas and tied the suture to minimize the chance of pancreatic parenchyma tearing.

Clink~

"Electrocautery."

Qin Feng put down the forceps and extended his hand.

He received the electrocautery knife and made an incision in the jejunum approximately 1 cm in front of the row of mattress sutures tied with silk sutures by electrocautery.

Two 3-0 or 4-0 polydioxanone (PDS) sutures were passed through the posterior superior edge of the anastomotic opening for suturing...

After completing the intestinal anastomosis, he started the bile duct anastomosis...

Finally, the duodenal anastomosis...

Time passed minute by minute, and the surgery had been underway for nearly 7 hours.

Clink~

It’s unknown how many times the needle holder was put down; in Qin Feng’s eyes, there was only constant anastomosis.

And throughout the night, the patient’s physiological signs clung to the safety line, struggling.

It was as if the patient knew someone was saving him, persistently holding on without flatlining.

"Phew~"

Qin Feng let out a long breath, gazing at the sutured duodenum.

Finally, it ended smoothly.

Only the final steps remained, drainage and closure.

He placed a Jackson Pratt drainage tube near the hepatic duct and pancreatic duct anastomosis to start suturing.

The drainage tube tip was positioned after the hepatic duct-jejunum anastomosis and guided behind the stomach (between the pancreas-jejunum anastomosis and the left lobe of the liver), finally exiting from the left abdomen.

Lastly, a T-tube exited from the right abdomen, and both the drainage tube and T-tube were sutured to the skin.

He flushed the abdomen and closed it.

Clink~

At the moment the needle holder dropped into the basin, everyone’s hearts resonated with the sound.

The surgery was over!

"Alright, send to ICU for 24-hour intensive observation."

Qin Feng’s tense heart relaxed slightly as he spoke.

"Okay."

Zhang Qingquan nodded in response.

Meanwhile, Lu Mingming, the first assistant, was still immersed in the recent surgery, unable to extricate himself.

Such a beautiful surgery, truly a once-in-a-lifetime experience~~~

"Alright, Dr. Lu, we’re finished."

Qin Feng noticed him still dazed and couldn’t help but remind him.

"Ah? Oh! Alright, Director Qin, thank you! Thank you so much!"

Lu Mingming came back to his senses, his face full of excitement and gratitude.

This kind of surgery is simply textbook-worthy.

Learned so much today!

Immediately, he diligently took off his gloves, walked out of the operating room, and began to clean and disinfect.

Meanwhile, outside the operating room, a few people in police uniforms had been waiting for a long, long time...