After Chen Cang was ready, Ford and others also went to the operating room.


    Several doctors and assistants came, but they stood in the distance, looked at the operating table and didn''t speak.


    Ford looked at the operating room, suddenly looked at Chen Cang, and was stunned.


    What does that look mean?


    Kind of like... Encouragement?


    Ford was a little confused. It seemed that when he first entered the hospital, the teacher looked at him happily and said, "study hard!"


    At this time, Ford''s nurses brought in the instruments, as if... Ready to take over the operation at any time.


    Although pancreatoduodenectomy is an effective treatment for pancreatic cancer, its efficacy is still not satisfactory.


    Especially pancreatic head cancer is the worst!


    Other types of cancer are slightly better, but the total surgical resection rate is only 30%, and the surgical mortality and five-year cure rate are only about 10%.


    Therefore, this requires a high degree of precision of the operation, and do a good job in every link.


    Similarly, this is the confidence of Ford and others. They have enough clinical experience and coping strategies!


    Even in the field of digestive tract reconstruction, great progress has been made.


    Ford looked at Chen Cang and saw that he looked happy without any waves, which made him a little more curious.


    The young man doesn''t seem nervous at all. Doesn''t he know the difficulty of pancreaticoduodenectomy?


    Perhaps... The ignorant are fearless!


    Ford believes that he can find many shortcomings and mistakes of Chen Cang during the operation, and even he will write a paper and publish it in the Journal of the American Medical Association.


    The operation is about to begin!


    The anesthesiologist is the director of the anesthesiology department. He has had enough communication before. Open surgery.


    Continuous epidural anesthesia is selected, which has long maintenance time, small response, good abdominal muscle relaxation and easy exposure.


    When Ford saw this scene, he almost couldn''t help laughing: are you ready to open a pancreaticoduodenectomy?


    Now this kind of surgery, Mayo is basically all endoscopic surgery!


    Ford suddenly felt a sense of dimensionality reduction


    "Dr. Chen, do you want an open stomach?" Ford still couldn''t help asking.


    Chen Cang didn''t look back, but looked at the nurse and said, "scalpel!"


    Ford blushed at the sight.


    Chen Cang has discussed this matter with the anesthesiologist for a long time. Choosing open exploration is a necessary step to decide whether to remove it!


    Because the old man was very early and didn''t even have much metastasis, Chen Cang''s first intention was to retain some tissues and remove some tissues.


    This is also a surgical scheme he has been studying and exploring recently.


    If the traditional pancreatoduodenectomy is used, according to the physical quality of the elderly, plus long-term diabetes, Chen Cang assured that the survival period will not be too long.


    Even a perfect pancreaticoduodenectomy is useless!


    This is a defect of the operation itself.


    This is why Chen Cang strives for surgery, because he knows that if Ford does it, it must be completely removed. This is not very different from ordinary people. The only difference is that Ford can do better when reconstructing the digestive tract.


    This is the gap between Ford and Chen Cang.


    When Chen Cang''s pancreaticoduodenectomy was perfect, he cooperated with those quasi perfect biliary intestinal anastomosis... Perfect gastrointestinal anastomosis, etc., which made Chen Cang aware of one thing.


    That is the deformity of the operation itself.


    The more in-depth study, Chen cangyue found the deformity of the operation.


    There is no perfect operation, but the dwarf pulls out the general. When he has to, he can operate better, and the relative probability of complications is lower.


    Therefore, Chen canggen ignored Ford and needed to do an operation next.


    After taking the scalpel, Chen Cang made an incision near the middle of the old man''s right upper abdomen.


    The incision is not big, but this position is just convenient for up, down and extension to fully expose the whole digestive tract.


    When the abdominal cavity was exposed, Chen Cang began to examine.


    The gallbladder is normal in size, which is a good thing. Pancreatic head cancer will not compress the bile duct and cause gallbladder lesions.


    When Chen Cang touched the pancreatic head with both hands, he clearly felt a burst of information coming.


    [carcinoma of pancreatic head: very early, resection recommended!]


    After feeling the mass of the pancreatic head, Chen Cang''s next step is to open the duodenum for examination to clearly identify the development of pancreatic head cancer,


    This operation is dangerous. It is easy to spread the tumor or spread intestinal bacteria into the abdominal cavity. It should be avoided as far as possible when it is not particularly necessary.


    Sun Guangyu looked at Chen Cang with trepidation and dared not take a breath.


    Although he had talked about the operation plan, he was still a little nervous.


    Ford is also stupid!


    Chen Cang is dancing on the tip of a needle!


    After seeing the internal structure clearly, he finally breathed a sigh of relief.


    The next thing to decide is whether to perform radical resection.


    Check whether the cancer itself goes beyond the gland and invades important blood vessels such as portal vein, superior mesenteric artery and vein, abdominal aorta and inferior vena cava.


    At this time, Chen Cang directly cut the retroperitoneum outside the duodenum and turn the duodenum and pancreatic head inward!


    Then, carefully probe the dorsal side of the pancreatic head and the gap between the aorta and the ventral inferior vena cava with the left index finger.


    It is easy to put your fingers into this space, indicating that the cancer is still limited to the pancreas and has no metastasis.


    Fortunately, there was no transfer!


    This process requires three-step inspection, but Chen Cang did more than ten steps. He counted all the places he can consider.


    This... Can never be done by endoscopic surgery.


    Refinement and precision.


    As time went by, Chen Cang checked it carefully.


    Finally, the inspection is over!


    Chen Cang looked at the abdominal cavity. The four-dimensional model began to simulate constantly. After two minutes, Chen Cang began to move!


    Next, fully separate the organs to be removed.


    At such a key link, Chen Cang suddenly didn''t separate the stomach body, but began to free up the bile duct!


    Then... With hemostatic forceps, he took the lead in cutting the lower part of the common bile duct and the pancreas in a Y-shape.


    Then a clever separation was carried out. At this time, the pancreas suddenly dissociated!


    This inexplicable operation made everyone look silly!


    At this time, the pancreatic head cannot be touched, and ligation is required for the operation of duodenum, gastric body and even bile duct to prevent the proliferation of tumor cells.


    But Chen Cang now separates the bile duct directly from the pancreas, so that the bile duct is free!


    This operation directly fooled Ford behind him!


    What''s going on?


    Chen Cang took a deep breath. Just now, he was careful. He was afraid of adverse consequences. His eyes had already opened!


    Put your heart into it!


    All he has to do is not remove the bile duct, but skillfully separate it to achieve a removal effect.


    At present, the effect is good!


    At least for a while, the biliary intestinal anastomosis is less difficult.