The Enhanced Doctor-Chapter 574: What is this thing for?

The patient from yesterday suspected of having pancreatic cancer could be considered a "star figure" in the entire emergency center. With her consent, this surgery had become a formal teaching surgery.

"Dr. Liu, we’ve all agreed. Even if it’s pancreatic head cancer, you can proceed with the operation," the patient said as Liu Banxia walked into the operating room.

"I pondered it all night," Liu Banxia said with a smile. "If I was leaning towards pancreatic head cancer yesterday, then today I’m leaning towards it being a very peculiar inflammation."

He continued, "Don’t worry, we’ll soon see its true nature. Currently, apart from jaundice and right upper abdominal pain, you don’t have any other symptoms."

"Thank you, Dr. Liu," the patient said with a smile. "They told me you like chicken drumsticks. If I don’t have pancreatic head cancer, I’ll buy you some."

"That’s a distorted rumor. I’ve graduated to gnawing on pig’s trotters now," Liu Banxia said, perfectly serious.

The patient couldn’t help but laugh.

The outcome was still unknown, but everyone in the operating room hoped for a good result.

"Xu Yino, confirm the patient’s information," Liu Banxia said solemnly, then looked at the patient. "Today, we’ll resolve the issue of your gallstones. Otherwise, living with such a burden is exhausting."

The patient nodded, not saying anything this time, aware that the surgery was about to begin.

Even though Liu Banxia had just been chatting with the patient, he still meticulously confirmed the information. This impressed many observers, as they knew Liu Banxia wasn’t just putting on a show.

Throughout any surgical procedure, Liu Banxia was always like this, never cutting corners.

This was a foundation built from the very beginning, not easily forgotten.

The crucial aspect of this surgery was determining the pathology of the pancreatic head. Whether it was pancreatic head cancer or not, it was undoubtedly a rather unique case.

"Exploration reveals a dilated common bile duct with some adhesions. The pancreatic head is enlarged, compressing the common bile duct and liver. No abnormalities are observed in the peripancreatic lymph nodes. Laparoscopic cholecystectomy and pancreatic biopsy can be performed," Xu Yino reported after the initial examination.

"Wait a moment, let me take another look at this pancreas," Liu Banxia said, frowning.

Because of Wang Mingxing’s case, Liu Banxia had once researched pancreatic head cancer extensively. However, in his view, this patient’s condition didn’t quite seem like pancreatic cancer.

There was clearly a space-occupying lesion causing compression, yet the patient experienced no back pain, only abdominal pain. Moreover, the pancreas hadn’t invaded surrounding blood vessels, nor had it metastasized to nearby lymph nodes; the surrounding area was completely clean.

The slight adhesions were likely due to cholecystitis and weren’t severe.

Logically, if it had progressed this far, it should be at least stage two pancreatic head cancer. Such a clean presentation was more consistent with pancreatitis.

What troubled him now was whether to perform a biopsy on the patient, as pancreatic biopsies carried a high risk of complications.

Both pancreatitis and pancreatic cancer would cause some degree of pancreatic hypertension. A puncture could lead to a pancreatic leak, complicating subsequent treatment.

What if the patient only has pancreatitis? he wondered. This puncture would cause further damage to her pancreas, potentially leading to a worse outcome.

This was his biggest dilemma. After observing the actual conditions, the thought that it was pancreatitis had sprung into his mind. As for why it had swollen to such an extent, he was still uncertain.

Although Xu Yino was the lead surgeon for today’s cholecystectomy, Liu Banxia was in overall command. The final decision on how to proceed rested with him.

To do it or not? Liu Banxia asked himself.

More than a minute passed, and Liu Banxia still hadn’t made a decision. This was quite unlike his usual decisive nature, making those watching the surgery curious.

In front of his computer screen, Zhou Shuwen also furrowed his brows. He had been repeatedly watching the laparoscopic exploration footage. He had performed more pancreatic cancer-related surgeries than Liu Banxia, yet even he was unsure now. He knew what Liu Banxia was grappling with. But how to choose? Either option had its merits.

Medically speaking, performing a puncture biopsy on a patient in her current condition was standard procedure. Even if some complications arose, they would be within acceptable limits.

From a human perspective, however, if complications did occur, it would undoubtedly place immense psychological pressure on the surgeon. If not for this patient’s peculiar condition, a biopsy wouldn’t even be considered at this stage.

This was because some cancers could be stimulated by a biopsy, causing cancer cells to grow more rapidly and spread more widely.

He was also very curious: what kind of decision would Liu Banxia make?

Liu Banxia’s mind was in turmoil. After taking a moment to compose himself, he once again directed the laparoscope towards the gallbladder and common bile duct, then frowned again.

He felt as though he had overlooked something. If the patient’s gallstones and common bile duct stones are truly so numerous as to cause stenosis of the common bile duct, shouldn’t the adhesions be more severe given the current findings?

The accumulation of stones, especially gallstones, is a lengthy process and would surely have caused the patient significant pain in the past.

But when the patient came for consultation, it seems she didn’t mention this, did she?

The patient’s blood tests showed high bilirubin levels, proving there’s definitely a problem with bile flow. This, combined with the current findings and ultrasound results, all seems to fit.

But why did the patient’s gallbladder and common bile duct disease progress so quickly? It can’t simply be a case of good luck that her adhesions aren’t severe, can it?

I’ve performed many cholecystectomies, and this patient’s adhesions are practically nonexistent compared to many others—just a tiny bit, as if they’re only in the initial stages of forming.

Upon closer observation, he furrowed his brow again. Why are there signs of fibrotic scarring on the common bile duct? There aren’t many, just a tiny amount.

This is something that wouldn’t be detected during imaging studies. This piqued Liu Banxia’s intense interest; the patient’s situation was just too peculiar.

"President Liu, what should we do next?"

Others didn’t dare ask what Liu Banxia was up to, but the anesthesiologist, Li Liwei, ventured the question.

An anesthesiologist is a key player in the operating room. While they cooperate with the chief surgeon, this cooperation is conditional. The primary principle is always to prioritize the patient’s well-being.

The exploration had been going on for nearly twenty minutes now; they couldn’t continue like this indefinitely.

"Brother Li, wait a little longer. I have a feeling something’s not quite right with the patient’s condition," Liu Banxia said.

"Let me take a closer look. Whether it’s a cholecystectomy or a pancreatic biopsy, both are quite invasive for the patient. We need to be cautious."

Hearing his words, those in the observation room and watching on their screens were perplexed.

Many had come expecting to see a pancreatoduodenectomy. But what are we watching? Just a laparoscopic exploration?

First the interns look, then Liu Banxia. After the gallbladder and bile duct, he looks at the pancreas. After the pancreas, he goes back to the bile duct. Is this supposed to be interesting?

Just because you’re Zhou Shuwen’s star disciple doesn’t mean you can grandstand like this, does it? Trying to show how different you are?

It’s a straightforward procedure, isn’t it? Cholecystectomy, then an intraoperative biopsy of the pancreatic head. If pathology confirms a tumor, resect it, and it’s done.

What’s he doing now? He’s stopped looking at the bile duct and pancreas and is actually using the scope to examine other organs in the abdominal cavity!

Yes, it’s a teaching surgery, but this isn’t a masterclass on laparoscopic exploration techniques, is it?

The onlookers were growing restless and confused. Liu Banxia’s actions today were too high-profile and unusual, even more bizarre than the patient’s already perplexing condition. What on earth was he doing?

The interns assisting him in the surgery were feeling the pressure even more; none of them dared to glance towards the observation room.

They knew the people outside were definitely murmuring. Liu Banxia had turned a minor exploratory step into a major lecture. There would undoubtedly be a lot of discussion after the surgery.

Even though Demon King Liu can be a bit erratic at times, today it seems particularly severe, they thought.

"Xu Yino, take over the laparoscope. We’ll explore again in a bit," Liu Banxia finally said.

His words didn’t just shock those in the operating room; they stunned the observers outside as well.

Still exploring? Hasn’t he done enough? Is he ever going to stop probing?

Xu Yino didn’t dare object, hastily moving to take over.

And Liu Banxia? He didn’t remain idle. He walked around to the patient’s head, extending his hands to gently palpate her cheeks, mandible, and eyelids repeatedly.

Given Liu Banxia’s current focus in the operating room, no one, whether in the observation gallery or watching on screen, dared to interrupt him. Any voiced criticism would have likely been met with a barrage of disapproval.

This is outrageous! many thought. If the patient’s husband found out, there’d be serious trouble. And what on earth is he examining? The patient has pancreatic cancer, not parotid gland cancer!

Is he giving her a facial massage? And so meticulously, too!

Many were grumbling internally, but those who knew Liu Banxia suddenly became fully alert.

They knew Liu Banxia never wasted effort and would certainly never "mess around" with a patient in the operating room. That was an absolute impossibility.

His unusual actions suggested he might have discovered something. Considering the patient’s already unusual presentation, this discovery could be significant.

After examining the patient’s head, Liu Banxia took back the laparoscope. He then thoroughly inspected the patient’s liver, spleen, bile ducts, and pancreas, not even sparing the intestines.

"We’re not performing the surgery today."

Liu Banxia finally spoke, but his words landed like a bombshell in the operating room.

This time, it wasn’t just the interns and onlookers who were stunned; even Zhou Shuwen, who was taking a sip of water, choked.

What on earth is this guy up to?

Actually, that was what everyone was wondering: what on earth was he up to?