Falling behind at the start, the first surgery shocked the world.

Inside the emergency room, Zhang Ming and Deputy Director Fang simultaneously performed resuscitation efforts on the patient.

"In the summer, immediately perform a complete blood count on the patient."

"Hurry!"

"good!"

The nurse drew blood, and Xia Tian immediately rushed to the laboratory with the blood sample.

"Miss, urgent!"

"quick!"

When an emergency room doctor requests an expedited case, the laboratory must immediately put aside all other tests to prioritize the expedited procedure.

Results that normally take 15 minutes can be obtained in less than 10 minutes with expedited service.

"Dr. Xia, report."

The moment I received the report in the summer, I focused on bilirubin and transaminase levels.

Bilirubin 70umol/L.

Transaminase 400 U/L.

Seeing these two numbers, Xia Tian's heart sank.

Back to the gastroenterology department.

The patient has been resuscitated, but is unconscious.

Zhang Ming is performing a CT scan on a patient.

Seeing Xia Tian come in, he asked.

"How are your bilirubin and transaminase levels?"

Summer's face was extremely pale as she replied.

"Bilirubin 70, transaminase 400."

Zhang Ming: "What about the day you were admitted to the hospital?"

Xia Tian: "On the day of admission, bilirubin was 50 and transaminase was 900."

Quiet!

Inside the emergency room, there were five doctors from the gastroenterology department, plus Xia Tian, ​​Zhang Ming, and a few nurses—more than a dozen people in total. The entire emergency room was as quiet as a chicken's nest.

There was silence for a full five seconds.

Zhang Ming spoke.

What are your thoughts on summer?

Xia Tian glanced at Deputy Director Fang and said calmly.

"The patient's condition deteriorated rapidly; he became delirious, which is likely hepatic encephalopathy."

When the liver is severely damaged, the body's metabolism is significantly disrupted, and the ammonia level in the blood will also rise significantly. High blood ammonia levels can lead to brain disorders, namely hepatic encephalopathy.

There is only one possible outcome for hepatic encephalopathy.

Liver failure!

It was detected by CT imaging.

The patient's liver had shrunk to one-third of its normal size, and on imaging, it looked more like the liver of a 7 or 8-year-old child.

Zhang Ming immediately replied.

"The patient was transferred to the ICU for artificial liver plasma exchange, blood filtration, endotracheal intubation, and mechanical ventilation."

"As for what happens next..."

"Deputy Director Fang, you can handle this."

Zhang Ming rolled his eyes and said to Xia Tian, ​​"Let's go back to the emergency room."

The patient is no longer in the emergency room.

For patients who are not classified as emergency patients, the emergency department can assist in case of an emergency, but the final decision rests with the gastroenterology department.

Zhang Ming had a cold expression.

You have to clean up your own mess.

After all, when they're scrambling for patients, they're all so arrogant and boastful, and we can't stop them.

"Director Zhang."

"etc!"

Deputy Director Fang chased after him, every wrinkle on his old face screaming "urgent!"

Zhang Ming glanced at him and said coldly.

"Is there anything else?"

Fang Yuan's face was grim, and his tone was pleading: "I watched this girl grow up."

"Her parents entrusted her to me. I ruined a perfectly good child. I feel so guilty towards them."

"I trust your medical skills."

"Please help me think of a solution."

Zhang Ming has worked in the emergency room for many years and his medical skills are superior to those of doctors in other departments. Moreover, because of his bold personality, he is also bold in his medical practice. Sometimes, his boldness has saved many lives.

He glanced at Deputy Director Fang.

He turned to look at Xia Tian and asked.

"Xia, tell me your thoughts."

"How should this patient be treated?"

Summer pushed up her glasses and said expressionlessly.

There are three ways to treat liver failure.

"First, medication."

"Maintained with drugs such as insulin, human serum albumin, prebiotics, N-acetylcysteine, and hepatocyte growth factor."

"Second, artificial liver therapy."

"A device manufactured outside the human body to remove harmful substances produced by metabolism and replenish bioactive substances produced by the liver, such as bile."

Third, liver transplantation.

"This is the best way to treat liver failure."

"Given the patient's current condition, neither the first nor the second method can cure the disease, and continuing treatment will only lead to one outcome."

"A liver transplant is the only option."

"Otherwise, the patient will die within half a month."

Deputy Director Fang shivered.

As the deputy director of a department, how could he not know the outcome?

But I'm afraid to face it.

He hoped Zhang Ming would give him a miracle.

Unfortunately... medical miracles are too few.

Two full minutes later, Deputy Director Fang let out a long sigh and said quietly.

"Okay... I'll inform the patient's parents."

"Let them prepare for a liver transplant."

Zhang Ming and Xia Tian turned and left.

The gastroenterology department's affairs are none of their business anymore.

"Old Zhang, wait a minute."

Deputy Director Fang called out, asking in a pleading tone.

"Can your emergency department follow up on this patient?"

"I'm a little worried..."

Before he could finish speaking, Zhang Ming nodded.

"Can."

"Xia, please follow up on this."

"Okay." Xia Tian nodded, and the deputy director said, "You can let me know if anything happens."

Deputy Director Fang looked at Xia Tian with a somewhat unpleasant expression.

Yesterday, Xia Tian reminded him to be careful about the patient's liver failure.

He didn't take it seriously at all and treated it as a normal case of jaundice.

If they had sent him to the ICU immediately, perhaps his condition wouldn't have deteriorated so quickly.

However, there are no "what ifs" in medicine.

What's done is done, so we can only grit our teeth and move on.

Notify the patient's family.

The family discussed it.

Blood type matching.

It took a whole day.

The next morning, Xia Tian received a call from the gastroenterology department.

Hepatobiliary medicine, gastroenterology, and emergency medicine.

Three-disciplinary consultation.

Inside the office.

Deputy Director Fang said, "The patient has acute liver failure, and the patient's brother is willing to donate part of his liver."

"Next, let's discuss the surgical plan."

"Xiao Ma, how confident are you about the liver transplant surgery?"

Xiao Ma is the deputy director of the hepatobiliary surgery department.

Because he is relatively young, just over 40, everyone calls him Little Ma instead of Old Ma.

Xiao Ma flipped through the medical records and frowned.

"75%."

"The patient's bilirubin level is too high. I'm worried about the possibility of brain death during surgery. The best-case scenario is only about 75%."

"If Director Zhang is willing to give me one assistant and Deputy Director Fang is willing to give me a second assistant, with the help of these two great generals, the success rate should be higher."

Everyone laughed.

Liver transplantation is a major surgery, and it is normal for two or three chief physicians to be involved in a single operation.

only……

A 75% probability is somewhat low.

With an acute liver failure survival rate of only 10%-30%, a 75% success rate has significantly improved the survival rate for patients.

But... these are the children I watched grow up.

Deputy Director Fang was still worried.

He looked at Zhang Ming and asked.

"Director Zhang, what is the success rate?"

Zhang Ming replied, "I'm not a hepatobiliary surgeon, and I haven't performed many liver transplants, so I wouldn't dare to say anything reckless."

Ok……

Deputy Director Fang was conflicted.

Zhang Ming turned to Xia Tian behind him and asked in a low voice.

"Are you capable of a liver transplant?"

Xia Tian nodded: "Yes."

What is your success rate?

Success rate?

Xia Tian has never had a liver transplant before. When asked about the success rate, he really didn't know how to answer. But a few days ago, he drew out two alternative surgeries from the Endeavour bottle.

One of the options is to study liver transplantation.

"Probably 95%."

The voice just fell.

Brush brush!

Inside the meeting room, everyone's eyes were on him.

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Author:

This is a real case: a 22-year-old girl suffered from drug-induced liver damage and liver failure due to an overdose of acetaminophen.

Acetaminophen tablets are commonly known as paracetamol. Overuse can cause liver damage; always follow the instructions on the package insert.

A few days ago, I had a toothache due to internal heat, and after reading this case, I didn't dare to take any medicine...

Please remember to take care of your health and avoid taking medication indiscriminately.

Finally: In the real case, the patient died due to liver failure and did not have time to receive a liver transplant.