[Mr. Zhang recovers well after surgery]
The whole body is weak and the skin is yellow. A middle-aged man suffers from the "king of cancer"
Mr. Zhang (pseudonym) from Yiyang, Hunan Province is 52 years old. He has a history of mental illness and has been treated with long-term medication. He is obese.
Recently, Mr. Zhang developed general fatigue, loss of appetite, nausea and vomiting, and yellowing of skin throughout his body. He was sent to the local hospital for examination and found abnormal liver function, increased aminotransferase and bilirubin, and multiple lymph nodes after the peritoneum.
Local doctors said that Mr. Zhang's condition was serious and recommended to be transferred to a provincial-level hospital for diagnosis and treatment.
After several twists and turns, the family sent the patient to the Department of Gastroenterology of Hunan Second People's Hospital for treatment. The department director, Professor Zhou Yan, , , was invited to consult Professor He Hengzheng, director of minimally invasive surgery.
After improving gastroenteroscopes, CT, magnetic resonance and other auxiliary examinations for patients, it was initially diagnosed with obstructive jaundice caused by pancreatic cancer. Conservative treatment cannot relieve it. There are definite surgical indications.
is diagnosed with clear diagnosis. At this time, the most fundamental and effective method is to perform pancreatic and duodenectomy on the patient.
This surgery is one of the largest surgery in abdominal surgery. The surgery steps are complex and tedious, and three anastomosis of the gallbladder, pancreatic intestine and gastrointestinal; there are many organs removed, including the pancreatic head, duodenum, bile duct, part of the stomach and small intestine; the operation time is long, which is a serious challenge to the operator's technology, brain and physical strength.
is also prone to complications such as gastrointestinal fistula, biliary fistula, lung infection , pancreatic fistula, and lung infection after surgery. Any of these complications are fatal to the patient, and the operation is extremely difficult and risky.
plus Mr. Zhang also has obesity, sleep apnea syndrome, poor cardiopulmonary function; he also suffers from mental illness, has no self-awareness, does not cooperate with or comply with treatment, but will resist treatment, and may remove drainage tube at any time, resulting in the failure of the entire treatment process, which brings huge challenges to surgery and postoperative treatment and care.
Doctors are kind-hearted, life first, and multidisciplinary collaboration to fight the "difficult"
Professor He Hengzheng has successfully performed surgical treatment for many difficult and severe patients whom the industry peers believe are difficult and risky, all of which can meet good expectations. In recent years, there have been successful experiences in many cases of full-laparoscopic pancreatic duodenectomy.
Therefore, after evaluating the condition in detail, Professor He Hengzheng believed that as long as the patient is fully prepared before the operation, the operation is meticulous during the operation, and the treatment and care after the operation are carefully, the patient still has a chance to operate.
After fully communicating with Mr. Zhang’s family, Mr. Zhang was transferred to minimally invasive surgical treatment.
Minimally invasive surgical medical and nursing team invited relevant experts from the hospital's psychiatry, gastroenterology, anesthesia and surgery department, Critical Care Medicine department, , endocrinology, respiratory and critical care medicine department and other related experts to conduct multi-disciplinary discussions, and formulated a thorough perioperative treatment, nursing measures and postoperative rehabilitation plan for Mr. Zhang. A difficult operation to fight the "king of cancer" is ready.
[Professor He Hengzheng’s team checked]
On the day of the operation, with the support of the anesthesia and surgery experts to perform general anesthesia and surgery on patients and their life support, Professor He Hengzheng led Zhou Xiaobing and Tan Lipeng to operate teams to properly protect the surrounding organs according to the initial plan, followed the principle of "discern, debris and discernment", and gradually progressed in an orderly manner, achieving the anastomosis of the pancreatic intestine, gallbladder intestine and gastrointestinal tract, and completely removed the lesion tissue and thoroughly cleared the regional lymph nodes.
After more than three hours, after abdominal cleaning and incision suture, the operation was a complete success. Mr. Zhang was pushed out of the operating room and entered the intensive care unit to continue observation and treatment.
overcomes many difficulties and successfully treats the patient successfully, and the patient recovers successfully and is discharged from the hospital
While busy with diagnosis and treatment, Professor He Hengzheng goes to rounds every day to check Mr. Zhang’s postoperative situation. With the close observation and joint efforts of experts in critical care medicine, Mr. Zhang's postoperative condition was good and he was transferred back to the minimally invasive surgical ward.
According to the rehabilitation treatment plan formulated before surgery, Professor He Hengzheng and head nurse of minimally invasive surgery led the medical team to conduct close observation and safety protection of patients on the one hand to prevent them from undergoing unplanned extubation without self-awareness and leading to serious consequences.
On the one hand, it strengthens care, closely observes the characteristics and amount of drainage fluid, regularly turn over and pats the back to prevent lung infection, strengthen nutritional support to reduce anastomotic edema, and prevent the occurrence of anastomotic fistula, and reasonably give oxygen and respiratory function exercise to improve cardiopulmonary function and correct hypoxemia .
continuous anti-psychiatric disease treatment and other series of meticulous treatments and cares. Mr. Zhang recovered smoothly and was able to get out of bed with the help of doctors and nurses.
did not have any complications such as gastrointestinal fistula, biliary fistula, pancreatic fistula, etc., and no unplanned extubation occurred. The mental state also improved significantly compared with the previous one. The surgical treatment and postoperative care were successful, and Mr. Zhang recovered successfully.
[Recovery soon]
Professor He Hengzheng introduced that pancreatic duodenectomy is currently the most effective method to treat diseases such as pancreatic head cancer , duodenal malignant tumors, lower common bile duct malignant tumors, and peripheral ampulla cancers.
surgical resection has a wide range of surgical resection, great changes in the physiological structure of the patient, high difficulty and complex operation. Moreover, if complications such as gastrointestinal fistula, biliary fistula, pancreatic fistula, and lung infection occur after the operation, any of these complications will be fatal to the patient, and the difficulty and risk of the operation are extremely high.
plus Mr. Zhang combined with obesity and mental illness, bringing greater challenges to surgical treatment and postoperative care.
It is understood that for patients with surgical problems of this type of mental illness, many hospitals cannot perform timely and effectively surgical treatment due to the difficulty and high risk.
Hunan Provincial Second People's Hospital is a large-scale Grade A hospital that combines comprehensive business and mental psychology. It has the advantages of MDT multidisciplinary collaborative diagnosis and treatment. Professor He Hengzheng has led the team to successfully perform surgical treatment for many patients like Mr. Zhang, accumulated rich experience, and achieved good social response.
(Editor Rainbow.)
Hunan Medical Chat Special Author: Hunan Second People's Hospital Liu Li
Follow @Hunan Medical Chat to get more popular health science information!
