Chapter 173 Lan Yan’s Confidant
Peng Xia’s progress is still very fast. He and Wu Xiaofu have had surgeries not once or twice. Not only his own level is pretty good, but he also knows Wu Xiaofu’s habits. If Wu Xiaofu gives a hint, he will understand what to do, and the cooperation will be relatively smooth.
The cancer focus of this patient is a little lower than that of the previous patient.
Wu Xiaofu summarizes, this surgery actually pays attention to four points, which is almost the same.
Pay attention to the body position with the head down and the feet up, which is very meaningful for exposing the visual field during the operation;
2. Pay attention to the pressure of pneumoperitoneum, keep it at 13 to 15mmHg. The pressure of pneumoperitoneum is also very particular. If it is too high, it will not be safe for the patient. It does not necessarily mean that the belly is too bulging. The clearer you can see. I have seen it twice. Now that he has built one himself, Wu Xiaofu can vaguely grasp the degree of pneumoperitoneum in various patients.
Well, this is the charm of experience.
Third, pay attention to the position of the poke card. If it is a low rectum, the poke card should be moved downward appropriately, just like this one. Although the surgery is similar, there are still differences in the subtleties. If this The position of the surgical stamp card is still the same as before, but it will be uncomfortable when doing it. You have to learn to adapt to the same set of formulas, and rigid application will not work.
Be careful to separate the layers carefully in the four techniques. This is a matter of serious attitude.
Squeak!
The door of the operating room opened, and the nurse on duty took a quick look at it, feeling a little dissatisfied. Who was here to borrow something again? In fact, during the operation, it is very annoying for people to open and close the door frequently. Not only will it increase pollution, but it will also affect the surgeon. Surgery, but after one glance, there is nothing dissatisfying about it.
Handsome guys are always exempt.
"Doctor Chu."
Wu Xiaofu was still immersed in the operation at this time and did not raise his head to see. After the operation started, Wu Xiaofu quickly entered the state. In this state, his field of vision Only on the stage, except for Peng Xia and the patient, pay attention to what the anesthesia teacher said. After all, this person controls the patient's life status.
Chu Jingming came to the operating table, looked at Wu Xiaofu, and saw that he was doing surgery seriously, and then fixed his eyes on the surgical field of view.
He had just gotten out of the operation and was originally going to leave directly, but when he heard that Wu Xiaofu was performing the operation, he couldn't sit still. He quickly asked where the operating room was and came over.
Yesterday Wu Xiaofu said he was giving it a try, but Chu Jingming didn’t take it seriously. Yu Shifu would not take it seriously. He really should find a case for him so quickly.
Who thought it would be so fast.
It was arranged the next day. After entering the operating room, Chu Jingming was really surprised. Just give him a chance. Why is there no one here? Don't you need to watch? Are you so relieved?
They are all experts. Seeing Wu Xiaofu's skillful movements, Chu Jingming knew that he might really be worrying too much.
This may really be a genius who is more talented than himself.
He arrived late. Wu Xiaofu had almost separated the layers and was about to start cutting the lesions.
Look at the patrol nurse next to you.
“Which channel is this?”
The nurse who patrols the station is also an old man. One look at Chu Jingming’s appearance, and he can guess what this person is thinking, and he smiled. He said, "This is the third surgery. Director Tian's surgery was done in the morning, and it was done by Dean Yu. The next two surgeries were performed by Dr. Wu. The second surgery was done by Dr. Yu, who left in the second half of the operation." Very smooth.”
After following him for more than half a year, I already have so much trust in Wu Xiaofu!
Chu Jingming felt a little inexplicable. At the beginning, his teacher was not so relieved to let him go.
“Let’s start cutting.”
Wu Xiaofu’s voice came, and everyone was refreshed.
Chu Jingming looked at his watch, one and a half hours.
It only took an hour and a half, how could it be so fast? Of course, if he had performed this operation, it might have been faster, but who was he? Who was Wu Xiaofu? How many rectal cancer resections had he performed? Which one is Wu Xiaofu? Compared with Wu Xiaofu, he is only the second surgeon in charge, and his assistant is still a novice, and his proficiency is worrying.
The stage of removing the lesion was reached within an hour and a half?
Especially when he saw Wu Xiaofu’s separation of levels, it was really good and very detailed. At least Chu Jingming didn’t think there would be any hidden dangers if he handled it this way. This showed that Wu Xiaofu was not in a hurry for quick success. The fact that it can be done so quickly shows that Wu Xiaofu's understanding of this surgery is no less than his level.
That’s outrageous!
Chu Jingming looked at Wu Xiaofu with a strange look. At this time, he was already saying sorry to Wu Xiaofu in his heart. He really underestimated the little brother in front of him.
There is no rush to leave. Removing the lesion is the most critical part. If it is not done well, the rest will be in vain.
“Resection of rectal cancer is relatively simple among digestive system cancer resection surgeries. Unlike resection of liver cancer, the resection of rectal cancer is very clear-cut and the scope of resection is also large. As long as you are not It’s almost impossible to go wrong if you get on stage drunk.”
Wu Xiaofu said to Peng Xia while cutting off his rectum.
Chu Jingming couldn't help but look a little weird when he heard this. Could it be that this guy could eavesdrop on his thoughts? He thought that this was the key to the operation, but the guy said that this step was very simple. Well, it was indeed very simple. Wu Xiaofu was as decisive as cutting out a necrotic intestine, so decisive and frightening.
Expand the incision and take the specimen.
The operation went directly to the later stage. The anesthesia teacher saw the progress of the operation and began to calculate the dosage and recovery time.
Yeah, reliable.
Watching Wu Xiaofu's treatment of the rectal wound, Chu Jingming couldn't help but nodded. This technique was very experienced, not like a novice at all. He also wondered whether Wu Xiaofu might have become angry at this step and had made any omissions. Well, I ended up thinking too much.
“The wound treatment of rectal cancer is actually similar to that of the gallbladder and appendix. When anastomosis is done, remember to be more careful.”
Okay!
The major surgery of their department, rectal cancer resection, is directly listed with the appendix and gallbladder!
Chu Jingming couldn't help but roll his eyes, and could this guy really listen to his heart?
Wu Xiaofu didn’t know what Chu Jingming was thinking. The operation was just at this point. It was just a real feeling. Peng Xia said that following Wu Xiaofu’s operation was just the same feeling. It was simple. The gallbladder and appendix were drinking water and eating. The liver cancer lesions were acne. Rectal cancer resection is similar to gallbladder and appendix surgery. Well, if it weren't for the fact that it was not the same level of surgery, Peng Xia would really believe it.
But in Wu Xiaofu’s hands, these surgeries were solved with such ease.
This is what Peng Xia admires about Wu Xiaofu. After having an operation with Wu Xiaofu, he was extremely confident when he performed the operation again. Moreover, after Wu Xiaofu gave the surgeon a chance last time, he felt that he was familiar with the operation. His understanding has been directly improved by several levels. This is why Peng Xia wants to perform surgery with Wu Xiaofu so much.
Wu Xiaofu's ideas can always give him a lot of inspiration.
Studying with Wu Xiaofu is really easy and efficient. Before, he was obsessed with choosing a superior doctor, which became Peng Xia's top regret.
Rinse the abdominal cavity and start suturing the small holes.
This is when Wu Xiaofu noticed Chu Jingming, "Hey, Brother Chu, you have an operation behind you. I'll finish it here soon."
Chu Jingming couldn't help but smile bitterly when he heard this, this guy , just noticed him. Looking at Wu Xiaofu's serious expression, although he had only seen him a few times, in his opinion, Wu Xiaofu was not the kind of scheming person who put on pretense. He probably was too invested in the operation and didn't pay attention. To him, too, if the surgery had not been done so seriously, how could it have been so effective.
Now he actually feels sympathy for Wu Xiaofu. He is the kind of person who stands in the position of the chief surgeon and doesn't care about anything else. Wu Xiaofu is really similar to him.
"No, I just had the surgery. I heard that you were doing the surgery here, so I came over to have a look. Well, you did a good job."
Wu Xiaofu was stunned when he heard this. Chu Jingming actually He was praising him, let alone hearing such praise, Wu Xiaofu was in a really good mood. I don’t know if it was an illusion. Wu Xiaofu felt that Chu Jingming’s attitude towards him had changed a lot, and he felt much more comfortable. However, this is a good thing. Wu Xiaofu also laughed.
"I still need to learn from Brother Chu. By the way, I was about to ask Brother Chu for advice. This..."
Wu Xiaofu handed the rest to Peng Xia and got off the operating table. , pulled Chu Jingming and asked. I have seen a lot of gastrointestinal related surgeries in the past two days, and I have only a limited understanding of many of them. I asked Yu Shifu about those surgeries that were not suitable. Now it is just right, Chu Jingming is a genius in this area, look at Chu Jingming I seem to be in a good mood today, and I just want to ask for advice.
Chu Jingming looked at Wu Xiaofu who felt no burden to ask for advice, and he looked at Wu Xiaofu with a certain disdain.
Geniuses are very burdened and will rarely take the initiative to ask questions to their peers. Wu Xiaofu is really an exception. He is not a stingy person in academics. Wu Xiaofu sincerely asks for advice, so naturally he will not hide his secrets. , the two of them really became more and more congenial as they talked. After leaving the hospital, both of them were fine. They went directly for a massage and dinner. They kept talking until about eight o'clock in the evening before going back to their respective homes.
Looking at the newly added contact information, Chu Jingming was in an inexplicably good mood. Although they had only known each other for a few days, after today, he had already regarded Wu Xiaofu as a confidant. He talked to many people. It’s not too much to speculate, but it’s really relaxing and fun to communicate with Wu Xiaofu.
From the process of communication, Chu Jingming knew why Wu Xiaofu was able to achieve such achievements. This knowledge reserve is really profound.
He graduated with a Ph.D. and studied abroad. He has been working for two years. But as for Wu Xiaofu, he found out that he had just graduated with a master's degree two months ago. With such a foundation, he was actually in the exchange process. , it was incredible how much he was inspired by. From today on, Wu Xiaofu must be added to the list of people he admires.
Wu Xiaofu didn't know this. He really gained a lot today.
In the past two days, he has read a lot of gastrointestinal surgeries and books. After today's surgery, he has learned a lot. However, in the gastrointestinal field, after all, he can only be regarded as a newcomer and needs to learn. There are a lot of things, but after talking with Chu Jingming, Wu Xiaofu felt like he had achieved some success in gastrointestinal matters.
Wu Xiaofu also recognized this friend. He was really easy to get along with and didn’t hide anything.
Home.
Opening the door, the scent immediately hit your nostrils.
"Hey, you're back?"
It's Wu Bin and Sarilang who are back. Wow, it's already eight o'clock, and they have just eaten. The smell makes him feel a little bit after eating. Couldn't help it anymore.
“Come, talk to your sister.”
Sarilang was still busy in the kitchen, Wu Bin said, and gave the phone to Wu Xiaofu. Although Wu Bin favored Daughter, but her daughter's nagging also made Wu Bin a little bit unbearable. You must know that Wu Bin was also very aggressive in smoking and drinking before, but under Wu Man's control, he drank less and smoked less.
Nowadays, I basically smoke a pack of cigarettes every few days. I rarely drink except for guests. Those who don’t know think it’s to keep in good health.
I guess he was nagged again. When he saw Wu Xiaofu, he immediately regarded Wu Xiaofu as his savior. Since Wuman became pregnant, his nagging has increased even more. When he was a child, Wu Xiaofu couldn't stand Wuman's nagging, but it doesn't work, you If you don't listen to the nagging, Wu Man can also give you a fist to eat, a real female devil.
"Sister, your due date is soon, isn't it?"
"It's almost the end of September. I'll try my best to see if I can give birth on October 1st. From now on, I'll call her Liu Guoqing. ”
“Sister, how about You are the best. This thing can make you work hard to make a living. Does your brother-in-law know that you are so good?”
“Is your skin itchy again? Do you want me to go over and fix it for you?” Repair? ”
"Hmph, are you flying to the sky or hiding on the earth? You still want to fly over, but you can't even get on the plane."
Airports are not recommended for flying in the first and third trimesters of pregnancy. Wu Xiaofu is not happy at this time. Happy mouth.
“Okay, you can do it, you wait.”
“Okay, you are a mother of a child, and you are still so violent. Where is my brother-in-law, he is not crazy because of your nagging, is he?”< br>
……
The siblings were like this every day, and Wu Bin laughed heartily when he heard this. As long as he was not around Wu Man, Wu Xiaofu's talkative skills were still as good as Wu Man's.
In fact, he also wanted to feel like his daughter and son were at home. After all, when Wu Man was with Wu Xiaofu, most of his energy would be spent on beating Wu Xiaofu, and he would spend less time talking about him.
Hang up the phone and the food is served.
"Mom, why are you eating so late? It's already past eight o'clock. You'll finish eating later and I'll go down with you for a walk."
Sarilang hasn't spoken yet. Well, Wu Bin spoke first.
"When we came back in the morning, your mother started cleaning it for you. Didn't you see that your house has changed a lot?"
Yeah!
Wu Xiaofu looked around. Not to mention, it was much brighter, cleaner, and had a lot more things.
It seems that we have been busy all day, no wonder we eat so late.
“Hey, when my sister gives birth to the baby, you can stay here with me. Without you, I don’t even know how shabby I will look like in this house.”
"You think so. I have such a big industry. I'm used to living on the grassland. I don't like the East China Sea anywhere."
Wu Xiaofuton felt helpless, the East China Sea, the Pearl of the Orient.
But seeing Sarilang looking like the grassland was better, Wu Xiaofu also knew that it was impossible to keep them. They were all used to living on the grassland, and that was their paradise, the East China Sea. No matter how good it is, it can't be better.
Dingle bell, ding bell.
While eating, Wu Xiaofu made a video call to Qu Ying, but it took a long time for the other person to answer the phone.
"Xiaoying, what are you busy with over there?"
"Forget it, I told my parents that I have found a boyfriend. My mother is okay, but my father is not willing yet, so it's okay to wait. In a few days, I will go abroad, otherwise, I will have to quarrel with him again." Wu Xiaofu also smiled when he heard this. It seems that if he wants to marry Qu Ying in the future, he will have to go through the hurdle of his father-in-law and mother-in-law.
He also heard Qu Ying say that Qu Ying’s father was quite stubborn and wanted to arrange everything for his daughter, not to mention this major life event. Now Qu Ying is quietly looking for It’s strange that Wu Xiaofu would be willing. What’s more, after his father-in-law knew about him, he probably wanted to kill him. Xiao Baicai, who had been raised for so many years, was taken away just for a trip to the East China Sea. No It's weird to be irritable.
Wu Xiaofu decided to stay out of the way for a while and then go to please his future father-in-law. Well, it was easy for him. He found a girlfriend and used all his military skills.
In the community, Wu Xiaofu and Wu Bin Sarilang were walking around after dinner.
“Hey, Xiaofu!”
Walking in front, Wu Xiaofu heard the sound and turned around quickly. It turned out that a couple was also walking.
"Director Zheng, do you also live in this community?"
It turned out to be Director Zheng, the director of the gastroenterology department. It seems that he also lives in this community. This community is very close to the hospital. , I am afraid there will be many people buying houses here in the first attached courtyard.
"Yeah, I didn't expect you to live here too. By the way, this is my wife. She came back late and just had dinner. She didn't want to go out for a walk. What a coincidence. These are your parents? ”
Wu Xiaofu hurriedly greeted Director Zheng’s wife and introduced Wu Bin and Sarilang to them.
"Director Zheng, aunt, these are my parents, parents, this is Director Zheng from the Gastroenterology Department of our hospital."
The two sides exchanged pleasantries again.
“Let’s go for a walk together?”
"Okay."
Director Zheng and Wu Xiaofu soon stayed behind. Director Zheng obviously wanted to say something to Wu Xiaofu.
“I had two rectal cancer surgeries today. How do you feel?”
“Director, I was planning to go to the department another day to thank you, but this time I want to thank you for the opportunity. Well, after completing these two surgeries, I discovered that the surgeries on our digestive system are actually pretty much the same, as long as they involve anatomy If you are solid and careful, you will get started quickly.”
Although Yu Shifu chose Wu Xiaofu’s two surgeries this time, they were both gastrointestinal surgery patients, and Wu Xiaofu is also now the same. He is not a gastrointestinal surgeon, but Director Zheng is willing to treat patients in the department for him. Wu Xiaofu cannot pretend to be ignorant.
"Thank you no matter what. It's all about treating diseases and saving lives. It doesn't matter who does it. What's important is whether it can relieve the patient's pain. You did a good job in these two surgeries. I watched them in the observation room for a while. Dean Yu said you are a genius. I I was dubious at first, but after seeing it this time, I had to admit it. How about it, have you ever thought about which department you want to work in in the future? "
Wu Xiaofu immediately understood that Director Zheng was here to recruit him? Ah, Wu Xiaofu is in the emergency department now, but both Yu Shifu and Director Zheng know that Wu Xiaofu cannot stay in the emergency department all the time. At this stage, the emergency department can also play a big role in training Wu Xiaofu. But as Wu Xiaofu improves later, the emergency department will become very limited.
It is only a matter of time before you leave the emergency department and go to other departments.
Given Wu Xiaofu’s major, he is most likely to be in general surgery. Director Zheng had never thought about this before. After all, Wu Xiaofu specializes in liver, gallbladder, pancreas and spleen. But this time when I saw Wu Xiaofu perform surgery, the pattern I immediately understood why it must be the Department of Hepatobiliary Surgery. Their gastrointestinal surgery department is also good.
Although there is no shortage of doctors in gastrointestinal surgery, there is a shortage of talented doctors.
Having been on stage twice, he was able to perform rectal cancer resections. Director Zheng had never seen anyone with such talent, so he naturally wanted to take down Wu Xiaofu.
"Director Zheng, to be honest, I haven't thought about this matter. Right now, I'm afraid the focus is still on the emergency department, and then I successfully graduate with a doctorate. I'm afraid I can't answer this question until I graduate with a doctorate." "Director Zheng, I'm sorry, Director Zheng."
Director Zheng also smiled and said, "We are just chatting normally. The emergency department is still suitable for you. When you want to transfer, you can talk to me." I said, gastrointestinal surgery will not bury talents. As long as you are good enough, you will be able to perform any surgery you want. Well, they have all gone away, let’s take a few steps quickly.”
Thursday.
After the morning meeting, Duan Hao handed the information about the two surgeries to Wu Xiaofu. During this period, Duan Hao saw that he was getting busier and busier, and he was no longer so crazy about undergoing surgeries, just like Today, there are only two.
"You will come to the operation with me later. After the operation, I have an out-of-hospital consultation. I am so busy that I am fuming."
Wu Xiaofu took a look and saw a case of chronic cholecystitis, gallbladder stones and bile duct stones. The operation is still difficult.
The other patient is a patient with pyloric obstruction?
Wu Xiaofu has seen a lot of gastrointestinal surgeries in the past two days, and pyloric obstruction is one of them.
It is very important that the digestive tract has two doors, one is the cardia and the other is the pylorus. The cardia is the junction between the esophagus and the stomach, and the pylorus is the junction between the gastroduodenum.
This is the most famous stenosis of the digestive tract, but it is also an indispensable part of the digestive tract. Because of the stenosis, the risk of blockage is very high, especially the pylorus, which is narrower than the cardia. The normal diameter is 1.5cm. Then However, no matter how narrow the digestive tract is, the blockage will naturally be greater. There are many patients with pyloric obstruction in the gastroenterology department. Generally, those who are admitted need to undergo surgery.
The surgical procedure is generally distal subtotal gastrectomy.
Pyloric obstruction means that due to the obstruction of the passage of the pylorus, the gastric contents cannot enter the intestine smoothly, and a large amount of them are retained in the stomach. Well, just think about the situation when the toilet is suddenly blocked. The toilet is blocked and the size is still large. We have been working on it inside, what the bathroom will look like, what the home will look like, well, the body will be similar.
After pyloric obstruction, the retention of gastric contents will lead to hypertrophy of the gastric wall muscle, expansion of the gastric cavity, and inflammation, edema, and erosion of the gastric mucosa. It is like this. If it goes on for a long time, the stomach will probably also Damn it, the toilet was so clogged that I just threw it away without even wanting to wash it, let alone my stomach.
And after the blockage, you will lose your appetite. You will not be able to eat normally for a long time and will vomit a lot. A series of complications will follow, such as malnutrition, hypoalbuminemia, anemia, Severe dehydration, hypokalemia, alkalosis and other water and electrolyte imbalances are all possible, and anything serious can be fatal.
The solution to pyloric obstruction is also very simple, that is, to relieve the obstruction. Functional pyloric obstruction can generally be solved with internal medicine.
However, there are also many organic pyloric obstructions that can only be solved by surgery. For example, in this case, it is caused by submucosal fibrosis caused by chronic ulcers, resulting in scar stenosis and scar contracture. It cannot be solved with medical means. If it is not treated as soon as possible, it will continue to worsen. Therefore, once it is found that pyloric obstruction is caused by scar contracture, surgery should be performed as soon as possible.
"Then which one should we do first?"
"It's pyloric obstruction. After the pyloric obstruction is done, I will withdraw first and leave the next one to you."
Surgery indoor.
At this time, the patient's abdomen has been opened. The surgical procedure for this case of pyloric obstruction is distal subtotal gastrectomy plus gastrojejunostomy. The operation involves resection of the lower half of the stomach and then anastomosis with the jejunum.
After the stomach is opened, the taste is really needless to say.
These things in the patient's stomach have been there for more than a week at the shortest, and needless to say, the ones that have been there for a long time cannot go down. If they ferment in the stomach for a long time, the smell may be the worst. What a nice smell.
Duan Hao couldn't help but frown, and Zheng Hua and You Ruiming turned green.
Wu Xiaofu had already expected to wear an extra mask. Even this was very strong. This is why relatively few people choose gastrointestinal surgery in general surgery. The smell is really too strong. Whether it is the stomach or intestines, it is inevitable to encounter this situation. Well, in hospital surgery, it may be second only to the anorectal department.
Emergency departments rarely accept this kind of surgery, and few can perform it. Now, the only ones who can perform subtotal gastrectomy in the entire emergency surgery department are probably Duan Hao and Director Zhang.
Speaking of Director Zhang, Wu Xiaofu couldn't help but shake his head.
During this period, Director Zhang also wanted to be the executive deputy of the emergency department, but in the end his dream was shattered. Duan Hao had already told him that the hospital had recruited a new chief physician who would do emergency surgery. However, Duan Hao still helped Director Zhang to tell Yu Shifu that if the deputy director was not good enough, the director would have to be hired.
Two goals, finally one was solved.
Duan Hao had already started to free the greater and lesser curvature of the stomach, then cut off the duodenum, and finally cut off the stomach.
Peptic ulcer is actually a very troublesome disease. The cause of pyloric obstruction is gastroduodenal ulcer. The reason for performing subtotal gastrectomy is to reduce the occurrence of ulcer. Well, if everything is removed, how can ulcers and obstruction still occur? The incidence rate is naturally low, and gastrojejunostomy is chosen in order to be able to cut more of the stomach.
If a gastroduodenal anastomosis is performed, the stomach will be left less, but it will not be easy to anastomose. If the anastomosis breaks, it will cause a fistula, which will be more troublesome.
What we do more now is gastrojejunostomy, which has been improved again and again, and the effect is very good.
Wu Xiaofu cooperated with Duan Hao in the operation while using the formula.
Yeah, it works too.
The abdominal cavity is opened in the same way, the gastric vascular ligaments are freed in the same way, the stomach is incised in the same way, and the anastomosis is the same.
Compared with the rectal cancer resection performed yesterday, there is one less step of lymph node dissection. Speaking of which, this operation is actually simpler than the rectal cancer resection.
"How is it? Do you think this is more difficult than the rectal cancer resection done yesterday?"
"Well, this feels easier."
"I just I like your confidence. I will leave it to you when there are cases like this later.”
Wu Xiaofu naturally agreed directly. Although this kind of surgery was very unpleasant, it was about practicing skills, treating diseases and saving lives, so why did he care about these things.
"Okay, I'll leave the rest to you,"
After the anastomosis was over, Duan Hao took off his clothes and left. Wu Xiaofu took over the position of the surgeon, and the rest was just a side dish. Duan Hao was naturally relieved when the CD was released.
“Boss, I can do any kind of surgery with you.”
Zheng Hua couldn’t help but sigh. Yesterday, when Wu Xiaofu took Peng Xia to perform rectal cancer resection, Corey also Everyone knows that Zheng Hua has never done much surgery for pyloric obstruction except in the emergency department, that is, he followed Wu Xiaofu. Otherwise, Zheng Hua probably wouldn’t have had the opportunity to do it in the past few years.
"Why, you like this kind of surgery? If I have one later, I will take you with me."
"Okay, thank you, boss."
Zheng Hua almost jumped up when he heard this. I'm afraid that Wu Xiaofu will take care of Peng Xia instead of him in the future. Not to mention, Peng Xia's literary work is really beautiful. Zheng Hua really can't compete with Peng Xia for favor in this aspect, but who let him I was the first one to visit the pier, but the boss is still nostalgic.
Wu Xiaofu didn’t know what Zheng Hua was thinking. After flushing the abdominal cavity, he started to close it.
The case of bile duct stones at the back was also done laparoscopically.
In fact, Wu Xiaofu had a lot of gallbladder operations, and there were very few cases of common bile duct stone removal. Most of these cases went to the general surgery department, and it was not easy to save a few in the emergency department.
This opportunity is also good.
Although it is one patient, this operation is actually three operations, laparoscopic bile duct stone removal + laparoscopic cholecystectomy + T-tube drainage.
The first thing to do is laparoscopic bile duct incision and stone removal.
This patient's bile duct stones, in Wu Xiaofu's opinion, should have been caused by gallbladder stones.
After incising the peritoneum in front of the hepatoduodenal ligament and peeling it off layer by layer, the common bile duct can be seen. Wu Xiaofu carefully performed a routine puncture 1cm away from the upper edge of the duodenum, fearing that he would make the wrong cut. , many people who perform common bile duct incision and stone removal cut the common bile duct incorrectly. If a knife is applied to the pancreas, the problem will be huge.
Therefore, some steps really cannot be omitted, and exploration before common bile duct incision and stone removal is even more necessary.
After the routine puncture, what he saw was bile, Wu Xiaofu was relieved, and then he cut it directly, and used a spoon to take out the stones in the common bile duct under the microscope. Wu Xiaofu would like to call this move "Strong man touching", because the force is too strong, it is easy to damage the inner wall, or even burst it.
Be careful when digging out. If one or two are left, the meaning of the operation will not be complete, and there will still be various symptoms after the operation.
It’s not easy to dig out, but it can be flushed with pressure. However, it can’t be rushed and the common bile duct will be ruptured, which will cause serious problems.
After doing this several times, I saw that the inside of the common bile duct was clean, so I just placed the T-tube.
The T-tube is placed to help drain bile, prevent cholestasis and infection after surgery, reduce bile duct pressure, maintain the tension of the bile duct, and prevent contracture. Well, it’s just such a small tube. , the use is so great.
The T-tube must be placed. Normally during cholecystectomy, the bile duct is not moved. But now it is different. The bile duct has been cut. If the bile duct is not placed, the chances of the above complications occurring are high. It’s not a question of whether it’s high or not, but it will definitely happen.
After the T-tube is placed, the next step is to take out the gallbladder and it’s over.
“How was it?”
Um!
When Zheng Hua heard this, he always felt that the words were a bit familiar. Did Duan Hao also ask Wu Xiaofu this sentence just now?
However, Zheng Hua is not as confident as Wu Xiaofu.
“Boss, I think my goal should be to focus on minor surgeries like gallbladder and appendix first. For things like bile duct stone removal, I have to continue to upgrade.”
In the ward.
Wu Xiaofu told the patient what to pay attention to, but everything else was fine, including a light diet, mainly the T-tube.
The T-tube needs to be retained for about two weeks, and the amount and nature of the drainage must be paid attention to every day. The sutures are basically removed when the tube is extubated.
Wow wow wow wow.
"Come on, make way, hurry up, make way."
Coming out of the ward, Wu Xiaofu was about to change clothes, and there was chaos in the hall.
(End of this chapter)