Chapter 473: Chapter 247: Does It Matter?!_3
"Do we really need to set up another one?" Nurse Chen Juan’s tone was a bit displeased.
Lu Cheng’s order was clear: "We must establish another set."
Then, with only a quick review of the abdominal vascular anatomy, Lu Cheng immediately ligated the splenic artery.
The largest branch supplying the pancreas is the splenic artery.
Of course, after dealing with the main flow, further exploration of the branches of the gastroduodenal artery and the pancreaticoduodenal artery is needed...
Lu Cheng quickly and skillfully cut along the splenocolic ligament, directly entering the lesser sac.
He moved towards the upper border of the pancreatic tail, where the splenic artery frequently resides!
Although Lu Cheng didn’t come here often, he had been enough times to feel almost like coming home.
At this moment, Lu Cheng also confirmed by feel that it was indeed the pancreatic tissue rupture causing the bleeding.
Lu Cheng quickly lifted the posterior peritoneum with a toothed forceps, bluntly separated the loose tissue above the pancreatic tail, and then clamped the main trunk of the splenic artery with a vascular clamp.
Of course, Lu Cheng soon saw that the bleeding site was at the uncinate process. The pancreatic uncinate process is a hook-like extension of the pancreatic head on the left side, and its major blood supply comes from the gastroduodenal artery and the superior mesenteric artery.
This patient’s preperitoneal hematoma is also from the superior mesenteric artery!
After clamping the splenic artery, Lu Cheng immediately pushed the intestines back, then, with Du Yali’s help retracting, pushed the transverse colon upward and moved the jejunum and ileum towards the lower left abdomen.
This exposed the pancreas neck, and below the junction of the horizontal part of the duodenum is the superior mesenteric artery.
After cutting the retroperitoneum, Lu Cheng sent the hemostatic forceps in again. It wasn’t the superior mesenteric artery that Lu Cheng clamped, but he precisely clamped the inferior pancreaticoduodenal artery.
Nevertheless, even after doing all this, it was still not finished.
Lu Cheng had to explore the gastroduodenal artery further!
After quickly locating the hepatoduodenal ligament, cutting the front cover, and exposing the common bile duct, proper hepatic artery, and other structures, he began searching for the proper hepatic artery pulsation on the left side of the common bile duct.
The origin of the gastroduodenal artery needs to be traced from the proper hepatic artery to the common hepatic artery, right gastric artery... gastroduodenal artery, right gastroepiploic artery... superior pancreaticoduodenal artery.
Lu Cheng accurately located it, and after clamping it, only then did he slowly let out a breath of relief.
He then began to clean the hematoma in the anterior abdomen and search for other bleeding points in the superior mesenteric artery...
As Lu Cheng’s operations slowed and became more meticulous, the rescue scene became less gruesome.
However, Lu Cheng’s operations went unappreciated, not even by the patient.
But the patient could silently affirm the significance of it all with their continued life.
"Lu Cheng, how’s it going on your side?" Long Chunbo asked.
"Director Long, the larger bleeding points have been handled. Let’s move the patient to the CT room and then to the operation room. Rush the blood bank to send blood over," Lu Cheng reported.
"The patient’s blood pressure is still low, but a little better than before. Just a little better," the nurse said.
"Send to the CT room, then to the operation room," Lu Cheng instructed.
The remaining procedures could definitely not be completed in the emergency room.
Long Chunbo, hearing Lu Cheng so positive, asked with a slightly conflicted tone, "Will it be meaningful?"
In Long Chunbo’s view, even after entering the operation room, such a patient was likely to end in death, as had been the case with many doctors he partnered with.
Long Chunbo only knew the approximate statistics from his experiences.
"It might be, Director Long!" Lu Cheng answered.
"Send to the CT room," Long Chunbo said.
Lu Cheng was an experienced attending physician with his own persistence. Long Chunbo couldn’t order him to stop the rescue, just thought that perhaps after many failures, Lu Cheng would gain more experience.
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