Chapter 274 - 181: Put On My BGM

Chapter 274: Chapter 181: Put On My BGM

"Zhao Yumin, focus." Jiang He didn’t look up, his hands never ceasing their work.

"Right." Zhao Yumin gritted his teeth, gripping the aspirator with both hands.

Just then, Jiang He’s fingers dissected behind the head of the pancreas, to the medial side of the descending duodenum.

This was where the inflammatory adhesions were most severe.

The moment a piece of black, necrotic tissue was dissected away...

"SPURT—!"

Dark red blood shot out from the bottom of the deep surgical cavity, instantly submerging Jiang He’s fingers.

"Bleeder!" Zhao Yumin immediately plunged the aspirator in and began suctioning aggressively.

But the bleeding was too heavy; the suction couldn’t keep up.

"Rupture of an anterior superior pancreaticoduodenal artery branch. The inflammation eroded the vessel wall." Liu Jianbang’s expression changed drastically. "Gauze! Pressure!"

This kind of bleeding in a deep, blind spot, surrounded by tissue that had the consistency of mud, was a surgeon’s nightmare.

It was impossible to even find the severed end of the vessel, and blindly applying a clamp would only tear more blood vessels or perforate the duodenum.

"Don’t panic."

Jiang He’s voice was steady.

His left index finger followed the direction of the jet of blood, pressing down with pinpoint accuracy on the bleeding point.

The bleeding stopped instantly.

"Clear the field."

Zhao Yumin immediately suctioned the surgical field dry.

"Dr. Jiang, the location is too deep and surrounded by edema. The electrocautery won’t work; it has to be suture-ligated, but there’s not enough room," Liu Jianbang said, his palms slick with sweat.

"Needle holder, 3-0 Prolene."

Chen Jing immediately slapped the loaded needle holder into his hand.

"Director Liu, press the retractor down another centimeter. Dr. Zhao, aspirator tip against the left side of my finger."

The next second, Jiang He’s right hand descended into the deep cavity.

His left index finger lifted less than a millimeter, and in the split second before the blood could gush out again—

In with the needle, pull it through, and out!

The movements were a single fluid motion, dizzyingly fast.

Within the muck-like tissue, the needle’s tip precisely pierced the vessel wall, corroded by inflammation, and the small, tough bit of fascia that remained just beneath it.

"Tie it."

Jiang He’s hands moved in tandem, tying a slipknot right at the site. A knot pusher then drove the knot deep into the cavity, locking it securely.

"Cut."

SNIP.

The end of the suture was cut.

Jiang He removed his left index finger.

The field was perfectly clean. Not a single drop of blood oozed out.

The entire process, from the start of the bleeding to complete hemostasis, took less than twenty seconds.

Zhao Yumin’s hand, still holding the aspirator, froze in mid-air.

Liu Jianbang’s eyes widened slightly, but he was too stunned to speak.

From that angle, it was impossible to see the end of the ruptured vessel with the naked eye!

’Jiang He had located it purely by the feel of his left finger and performed a blind, one-handed suture with his right!’

’And to do it in tissue that was mushy from inflammation, to place a stitch without tearing anything, perfectly catching the vessel... That kind of tactile skill and that terrifyingly precise understanding of anatomy...’

Liu Jianbang knew that if he had been in that situation, he would have had to incise the lateral duodenal peritoneum and perform a wide dissection just to find the bleeder to ligate it. It would have taken him five minutes, minimum.

’But Jiang He did it in twenty seconds.’

"Continue debridement." Jiang He gave them no time to be amazed.

The surgery continued.

As large amounts of necrotic tissue were cleared and accumulated fluid was drained, toxins were inevitably forced into the bloodstream.

Old Li suddenly shouted, "Her heart rate is dropping! 60... 50! BP is crashing! Systolic is down to 60! Frequent PVCs!"

The waveforms on the monitor began to distort violently as a piercing red alarm blared.

It was a direct hit to the myocardium, a combination of ischemia-reperfusion injury and toxemia.

"Too many toxins have entered the bloodstream; her heart can’t take it." Liu Jianbang snapped his head up. "Old Li, push epinephrine!"

"I did! It’s not working!" Old Li was drenched in sweat. "She could go into V-fib at any moment!"

"Stop the debridement!" Zhao Yumin yelled.

"No."

Jiang He’s hands didn’t slow in the slightest. He scooped out the last free-floating piece of necrotic tissue from the tail of the pancreas. "If we stop now, the necrotic material stays in. She won’t make it off this table."

He turned his head to Chen Jing. "Warm saline, three thousand milliliters. Pour all of it into the abdominal cavity. Now!"

Chen Jing immediately grabbed three large bottles of sterile saline, twisted off the caps, and poured them directly into Zhang Jiaqi’s open abdomen.

The clear saline solution instantly submerged all the abdominal organs, diluting the high local concentration of inflammatory mediators.

"Suction it out. Then another three thousand milliliters."

A washout.

A frantic washout.

He was using the most basic method possible: forcefully diluting the toxins and washing the inflammatory mediators out of the body.

At the same time, Jiang He looked up at Old Li and said, "Push 100mg of lidocaine IV to suppress the PVCs. Crank the norepinephrine pump to maximum. She’s young, her myocardial compensation is strong. She just has to ride out this peak toxin release."

Old Li deftly pushed the drug and adjusted the pump.

Ten seconds.

Twenty seconds.

A long half-minute passed.

The monitor’s piercing alarm suddenly softened.

"Heart rate is recovering... 80... 100! The PVCs are gone!" Old Li let out a long sigh of relief. "BP is stable at 90 over 60. Dr. Jiang, we brought her back."

Liu Jianbang and Zhao Yumin glanced at each other over their surgical masks, both seeing the utter shock reflected in the other’s eyes.

In the face of the extremely dangerous fluctuations in her vital signs, Jiang He, the chief surgeon, hadn’t shown the slightest hint of panic.

’This wasn’t the kind of composure a twenty-one-year-old medical student should possess. This was the kind of goddamn monster forged from a thousand similar surgeries!’

’If they hadn’t seen it with their own eyes, they would never have believed it!’

"The necrotic tissue is almost completely debrided."

Jiang He inspected the surgical field. A relatively clean channel had now been cleared around the pancreas.

"Prepare to place the double-lumen catheters."

This was the core life-saving measure of the entire operation.

Drainage.

The patient would only survive if the inflammatory exudate, which would continue to be produced over the next few days, was constantly washed out.

"Four silicone double-lumen catheters."

The nurse handed him the instruments.

Jiang He took the catheters and deftly began to arrange them.