I Am Diagnosed as a Medical Titan

Chapter 76: Chapter 76: Teacher, Do You Remember the Bottom-Up Approach?

On the balcony, Jiang He called Yang Xu.

Yang Xu sounded surprised. ”Jiang He? Calling so late?”

”Professor, are you out of Yangcheng right now?” Jiang He got straight to the point.

”I’m in Peng City for a hepatobiliary surgery conference. I won’t be back until tomorrow afternoon. What’s wrong?”

Jiang He said, ”There’s a patient at Affiliated Hospital No. 1 with severe pancreatitis complicated by infected necrosis. His condition deteriorated sharply this afternoon. A splenic artery pseudoaneurysm ruptured, causing massive hemorrhage. They performed an emergency interventional embolization, but now the infection is uncontrollable. He’s on the verge of multiple organ failure. The patient’s family is a senior student from our university...”

After Jiang He finished explaining the situation, the other end of the line was silent for two seconds.

Yang Xu’s voice grew grave. ”What’s the proposed treatment plan?”

”Immediate open laparotomy for retroperitoneal debridement of necrotic tissue.”

”Did anyone take the case?”

”No.”

Yang Xu fell silent again.

A surgery like this was extremely difficult. It was normal that no one at the hospital dared to take it.

In truth, even he himself wasn’t very confident he could pull it off.

Jiang He knew what Yang Xu was worried about and said, ”Professor, do you remember the surgical plan for hilar cholangiocarcinoma we discussed in the research office more than half a month ago?”

Of course Yang Xu remembered. ”The bottom-up retrograde resection?”

Jiang He said, ”Yes. You’ve been working on the related anatomical simulations during this time, haven’t you?”

”I have been, but what does that have to do with severe pancreatitis?”

”It’s related. The spatial logic is similar. The deep vessels of the pancreas are difficult to handle because the conventional open laparotomy approach is completely obstructed by the gastrocolic ligament in front. But what if we change the approach? Instead of going from the front, we borrow the anatomical logic from the bottom-up method. We incise the lateral peritoneum along the paracolic sulcus and medially rotate the spleen and the tail of the pancreas as a single unit...”

”...This way, we can ligate the main splenic artery beforehand, cutting off the blood supply at the source. With the risk of massive hemorrhage gone, we can then debride the infected necrotic tissue in front, breaking the stalemate of deep, blind suturing.”

After Jiang He finished speaking, the other end of the line was silent for a full ten seconds.

Yang Xu mentally simulated every step Jiang He had described.

Posterolateral approach... en bloc rotation... avascular fusion fascia plane... early ligation...

It worked. The theory was completely viable from an anatomical standpoint.

Moreover, this reverse-thinking approach perfectly aligned with the bottom-up resection method they had discussed before. The two shared a striking similarity in their use of spatial anatomy.

This time, Yang Xu was genuinely astonished. ”You kid... How did you even come up with this approach?”

Jiang He answered quickly, ”It was an extension of the thought process while simulating the bottom-up plan. Professor, the theory is sound. All we’re missing now is someone who dares to wield the scalpel.”

Yang Xu was silent. After a moment of deliberation, he said, ”Alright. I’m coming back right now. If there’s no traffic, I can be there in two hours. You go to Affiliated Hospital No. 1 immediately. Tell Director Liu Jianbang in the ICU to prepare blood, arrange for an emergency operating room, and save a table for me.”

”Understood,” Jiang He replied.

”One more thing,” Yang Xu suddenly added.

”Yes, Professor?”

Yang Xu was walking on his end, his voice accompanied by the sound of footsteps. ”I promised you before that if your paper produced results, I’d let you into the operating room early.”

Jiang He was momentarily stunned.

”The LNR paper is definitely getting published this month, so you’ve met the condition. Besides, you’re the one who proposed today’s bottom-up plan to bypass the dead ends. For a surgery of this caliber, just simulating it in your head isn’t enough. You need to see it with your own eyes.”

”When you get to the hospital, go change directly into scrubs. For tonight’s surgery, you’re scrubbing in as my third assistant.”

The moment Yang Xu finished speaking, Jiang He’s heart gave a sudden, powerful thump.

His original plan had been to tell Yang Xu the surgical plan and then let him handle it.

He never expected his professor would actually want to bring him along...

Third assistant. This meant he could stand right beside the operating table and watch the procedure up close.

If Yang Xu encountered a limited field of view or had difficulty suturing, he might even have a chance to step in and help.

This was, of course, the outcome he most desired.

”Yes, Professor,” Jiang He replied before hanging up and coming back in from the balcony.

On his computer screen, the private message window on Dingxiang Garden was still blinking.

Jiang He typed out a line of text:

[I’ve contacted Director Yang Xu of the Hepatobiliary Surgery Department at Southern Medical University First Affiliated Hospital. He’s already driving back from Peng City and is expected to arrive in two hours. Go find your Director Liu immediately. Tell him to prepare blood, use the emergency green channel, and get an operating room ready.]

He clicked send.

Jiang He didn’t wait for a reply. He closed his laptop and prepared to leave.

It was October in Yangcheng, and there was a slight chill in the air.

Before heading out, he opened his closet, found a jacket, and put it on.

The dorm room had been quiet, with everyone busy with their own things.

Li Zijian, Wang Bo, and Chen Hao were all studying.

Hearing the sound of Jiang He zipping up his jacket, Chen Hao looked up from a pile of notes, glanced at the wall clock in surprise, and asked:

”Old Jiang, where are you going this late?”

Jiang He walked to the door, grabbed a key, and replied, ”To Affiliated Hospital No. 1.”

Chen Hao was taken aback. ”What are you going to the hospital for?”

Jiang He was already out the door. His calm voice drifted back from the hallway, ”To assist in a surgery.”

CLICK.

The dorm room door closed softly.

Chen Hao: ”???”

He was completely baffled.

Beside him, Li Zijian also froze, looking up at Chen Hao in a daze.

”What did he just say he was... going to do?” Chen Hao suspected he was hearing things.

”I think he said... to assist in a surgery,” Li Zijian repeated numbly.

Chen Hao: ”???”

Outside, the night wind rustled a few camphor leaves.

Jiang He walked alone down the road, his pace fast and incredibly determined.

This was the perfect opportunity for him to truly stand at a core operating table in Affiliated Hospital No. 1.

If this surgery, which incorporated his reverse-anatomical approach, was successful, his standing in Yang Xu’s eyes would undergo a fundamental change.

It would be an immeasurable boost to his future plans of establishing his own lab and acquiring more clinical resources to conquer pancreatic cancer.

Moreover, when he saw the message from Gu Yizhou—”I can’t save her”—

Jiang He felt as if he had come face-to-face with his 2014 self—the man who had knelt despairingly before a hospital bed, forcing himself to lie to his wife that a new drug was almost ready.

The most soul-crushing torture in this world was never the insurmountable walls of medicine, but feeling a loved one grow cold in your arms, bit by bit.

To possess all the skill to gamble with Death, yet not even have the right to feel her pain for her.

In his past life, he had failed to save Shen Yu.

He only needed to taste the feeling of his entire world collapsing once.

Tonight, while he was going to save this girl he had never met partly for his own benefit, it was more about redeeming the helpless man he once was.

Where the gods would not ferry a soul across the threshold of life and death, his scalpel would.

Within the scope of his abilities, he would rewrite every last one of those endings filled with lifelong regret, one by one.