The liver, whether it is its location in the human body or its functions, is a link between up and down, and a balance between left and right. If the brain is the king, then the liver is the prime minister.
From a macro perspective, the liver is like a snail lying next to the stomach, like a snail eating hot pot, and the stomach is the hot pot.
The head of the snail is next to the stomach, which is the left lobe of the liver, and the back of the snail is the right lobe of the liver. In this way, the liver can be roughly divided into two lobes.
From a microscopic perspective, what does the liver look like? It looks like a honeycomb or a large office building. The central vein of the liver is the elevator in the middle of the office building.
Then various structures surround the central vein to form hepatic lobules. The hepatic lobules are like the floors of an office building, with many offices in it.
These offices are the liver cells, and the fire escapes surrounding the office buildings are the interlobular arteries of the liver.
Then the liver building is composed of countless floors of such liver lobules.
Venous blood from the stomach, large intestine, small intestine, pancreas and spleen is collected into the liver.
After various foods absorbed by the human body are absorbed in the stomach, small intestine, and large intestine, various substances, including nutrients, enter the liver through blood vessels. The liver breaks it down and combines it before transporting it out.
How to decompose the combination is very simple and vulgar. For protein, one had the sweet and sour pork. It is rich in protein, but these are the proteins that make up pigs. The liver is like a dismantler, breaking the proteins into parts and then reassembling them into the proteins that make up the human body.
If there is no liver, how will the protein be when eaten and absorbed? This is a bad thing. After eating pork for a few years, I realized why it started to look like a pig?
Keep eating for five or six years, well, you will become a pig! Although it is a bit exaggerated, this is one of the functions of the liver.
Various venous blood in the digestive tract not only contains nutrients, but also toxins, such as pesticides and harmful substances that are decomposed and absorbed by various substances.
All these will be eliminated by the liver and detoxified by detoxification. Without this prime minister, it would be very troublesome for these harmful substances to enter the brain, not to mention entering other organs.
For example, when you eat an egg, the ammonia molecules produced after the protein is broken down directly enter the brain. Well, people started talking nonsense, all kinds of weird things, and even streaking.
Therefore, the liver is very important. Where do liver tumors come from? To be honest, many of them haven’t been studied clearly yet. However, current research is relatively clear.
For example, for a person who loves to eat fatty meat or a person who drinks a lot of alcohol for a long time, how much is too much? 80g of liquor per day is considered too much.
Let’s not talk about other related diseases. But in just one liver, fatty liver will appear first. In other words, obese people and people who love drinking are prone to fatty liver disease.
If you are a fat person and also like to drink, then your fatty liver will be even more difficult to escape. Not to mention alcoholic fat and non-alcoholic fatty liver disease.
Let’s talk about what fatty liver is in general. It’s actually very simple. In the large office building called Liver, many fat employees have been crammed in. These fat people are just fat particles.
These guys don't do any work. They don't do any decomposition or combination. They are all uncles. Not only does he work, he also squeezes the living space of thin liver cells.
More and more fat people are crammed into office buildings. The liver, a large office building, becomes a piece of fat. This is fatty liver. At this time, the liver cells can still work, so there are no obvious symptoms.
If the liver has only reached this stage, there is still hope. Stop drinking and lose weight, and your fatty liver will gradually recover. It doesn’t take long, as long as you stop drinking and eating, and lose weight scientifically, you will be back to your original state in six weeks.
As long as six weeks, not 998, nor 666, as long as six weeks, these fat people will be slowly catabolized and metabolized by the liver cells in the liver. The liver can still return to its original state and continue to be his little piece of meat.
If you continue to eat, continue to drink. Well, more and more fat people will enter these writing rooms and use their fat bodies to tire out the weak liver cells.
Can liver cells be willing to be fattened to death for no reason? No, so this guy will become fibrotic. That is to say, it turns out to be a little fresh meat.
Because of his unwillingness, Xiao Xianrou changed into a corpse after his death. It turns into dehydrated beef jerky, exactly the same.
Then the liver, which had become a fat office building, turned into a hard piece of meat with no channels and functions, greasy on the outside and fibrotic on the inside.
When it has developed to this stage, fatty liver has changed its name, and in a very advanced form, it becomes cirrhosis.
At this time, the disease comes, and at this stage, it is impossible to restore the liver to its original state, which means it can only be delayed but not cured!
Diseases follow. The first is ascites. The veins in the lower abdomen cannot pass through the liver and cannot return to the heart. Blood containing a large amount of protein leaks out of the blood vessels, and the human belly begins to enlarge.
Because the liver is on strike, various hormones and toxins in the body cannot be inactivated, and the skin turns yellow directly. The skin is like turmeric in the early years, sallow and sallow, like an unbleached wax statue.
Men can also experience breast development, while women simply suffer from irregular menstruation and are unable to get pregnant. Bleeding tendencies and hypoalbuminemia immediately follow.
Because the liver stops working and becomes blocked, the related blood vessel pressure begins to increase, just like a rubber hose holding the water outlet.
The most common one is esophageal varicose veins. Eating Oreos, usually crispy Oreos, is like a sharp blade for esophageal varicose veins.
With a slight stroke, blood can spurt out from the person's mouth, just like a fountain, either vomiting or spurting out. This is also a common cause of death in patients with liver cirrhosis.
If these diseases have not killed this person, after all kinds of advanced surgeries and various advanced drugs, money will be spent like water.
This man survived for seven years. At this time, the liver, which had become dehydrated beef jerky, was enlarged. The boss of the disease, cancer, liver cancer, came.
Therefore, in modern society, with such a high-energy diet, if you eat less meat and drink less alcohol, you will not be starved to death. Run a few more steps, take a walk if you have nothing to do, you won’t die from exhaustion.
There are many cancers in the liver, which are unexplained and cannot be prevented. We will not talk about them. It is unreasonable to not prevent such preventable cancers.
The surgical incision for liver cancer is very large. The incision for appendix surgery and the incision for gallbladder surgery are all little things in front of it.
"Transfuse plasma directly." Zhang Fan said to the circulating nurse when he was about to open his abdomen.
The circulating nurse hesitated for a moment and looked at Professor Zhao Jingjin. Old Zhao nodded quickly. After all, it was a provincial tertiary hospital, and the nurses in the operating room were somewhat arrogant.
Zhang Fan didn't care and started taking action directly!
Instead of beating people, start making surgical incisions. The old man's skin has turned yellow to the point of dazzling the eyes, and the color of iodine can no longer be seen anywhere on the skin after wiping it with iodine.
Because the patient had a huge tumor in the center of the liver, Zhang Fan directly made a large incision. Start under the xiphoid process and make an incision along the costal arch. How big should it be?
Pulling up the camera and looking through the shadowless light, Zhang Fan completely uncovered the right side of the patient's abdomen. To use a crude metaphor, it is like a disemboweled pig on a meat case, its belly has been completely opened.
While cutting, he stopped bleeding and ligated at the same time. Zhang Fan's technique could not be more skillful. He was able to ligate large and small bleeding points and electrocoagulate them. No obvious bleeding could be seen in the surgical field.
In the Department of Science and Education, the director who called Lao Chang regained his composure. Looking at Zhang Fan's technique, he said to the other director next to him: "It's interesting. He has skills. He can do this at this age. It’s very rare. Where did this guy come from, and the person named Zhao didn’t let out a single word?”
"Old Zhao Shen was afraid that others would take away his credit, so he didn't say anything at all. He just waited for others to be helpless before jumping out. Didn't you see the look on the dean's face at that time!" At this time, these directors believed that Zhang Fan could do it. This surgery was done.
Everyone is engaged in this industry. Whether they have the skills and whether they are experts or not, everyone knows it well as soon as they make a move.
Open the abdominal cavity and start exploring. Tumors are so abominable. There are too many ways for this thing to transfer. From the blood, it can go to other places to develop.
From the lymph, it can travel to other places and develop, and it can also be transmitted directly through nearby tissues. And it can also escape through ascites. Like fruit trees, mature cancer cells can take root wherever they fall.
For other surgeries, the surgical plan is usually formulated before the operation and can be carried out directly. However, this is not possible for cancer surgery. Although modern inspection equipment is very advanced, it is still not practical to conduct on-site inspections.
"There is no ascites, and there is no metastasis in the omentum, mesentery, or peritoneum!" Zhang Fan felt a little relieved after checking it again. Once transferred, the surgery must be changed accordingly.
"It's saved, otherwise it would be difficult for someone at such an age to expand the scope of cleaning." Zhao Jingjin also breathed a sigh of relief.
He knew that today's operation was successful, and the internal affairs of the hospital about his experiment would disappear. When his experiment was successful, he would start charging towards the top of the hospital.
Therefore, the operation cannot fail, nor is it allowed to fail. When Zhang Fan said that there was no ascites, he felt as comfortable as if he had been in a heated room for three days.
God help me!
Liver cancer surgery is difficult to perform. Among other things, the liver has a blood storage function, just like beef filled with water or a sponge soaked in water. If you break it even a little bit, it will bleed profusely, not to mention if you have to cut off a large part of it.
So it is important to stop bleeding. "Although the tumor is not very big, it is located too close to the center. Let's ligate it." After the examination, Zhang Fan looked at the tumor protruding from the liver and said softly to Zhao Jingjin.
"Okay, do you want to start timing now?" Professor Zhao Jingjin asked Zhang Fan. Although he was an expert, Zhang Fan was the chief surgeon, and Zhang Fan was better at this kind of surgery than him.
"Gloves." Zhang Fan took a pair of unused gloves from the equipment nurse. He cut the gloves open and took out the rubber bands from the mouth of the gloves.
"I will perform the ligation." Professor Zhao Jingjin reached out and originally wanted to take the rubber band for ligation, but Zhang Fan directly refused. Once he undergoes the operation, Zhang Fan will never leave it to others to do what he can do.
Liver ligation is simple. It's really simple to say. It's just ligating the ascending and descending blood vessels with rubber bands. How does it work? In fact, it is like an apple on a branch. The apples are connected to the small branches of the big tree with ropes and tied up with ropes.
That's what it means. However, blood vessels are not branches. If the ligation is loose, the bleeding will not be stopped. If the ligation is tight, the blood vessels may be strangled. The blood vessels here are not small blood vessels, but the very large inferior vena cava. Once it is broken, it will kill people. of.
"Tsk, tsk! Look, this guy doesn't even believe Lao Zhao, and he won't even let Lao Zhao do blood vessel ligation." The directors of the Department of Science and Education gloated and began to laugh at Lao Zhao.
"Yeah, let's see what he is capable of, so that the arrogant old Zhao can obey him."
"Time!" Zhang Fan ligated the upper and lower blood vessels gently but forcefully. It sounds contradictory, but this is the right degree and the right force.
Without five years of practice, senior doctors in the Department of Hepatobiliary Surgery would never allow junior doctors to master the power of ligating blood vessels.
Blood vessels cannot be ligated for too long, otherwise the liver will become necrotic. Therefore, the ligation time should not exceed 20 minutes, and patients with obvious liver cirrhosis should not exceed 15 minutes.
In other words, for every 15 minutes of surgery, the blood vessels must be loosened and ligated to allow blood to enter the liver for three to five minutes.
Circulating nurse, turn on the timer. He said to Zhang Fan and Zhao Jingjin: "Start the timer."
When performing resection surgery, the difficulty is actually not the removal, but the dissociation. First, blood vessels, various nerves, ligaments, and various pipes on the liver must be freed.
The purpose of surgery is to save people, not to cut for the sake of cutting, so there should be as little damage as possible. This is a reflection of the level of a doctor.
If the damage is not taken into consideration, it is estimated that any person with a little training can cut out the tumor, but once damage is involved, it will be very troublesome.
The liver is suspended in the abdominal cavity. It is pulled up by many ligaments. Then blood vessels and hepatobiliary channels pass along these ligaments. If you want to remove the tumor, you must first remove these ligaments, blood vessels and various hepatobiliary channels. separate.
Because it was a central tumor, Zhang Fan immediately started removing the gallbladder after ligating the blood vessels. Because after the tumor was removed, the bile ducts were damaged and the gallbladder was no longer useful. Leaving it in would only do bad things.
Therefore, if you want to remove a tumor, you must first clean up the surrounding areas. Just like in a war of annihilation, you must first clear out the surrounding areas before launching a general attack.
