The doctor in charge of emergency B-ultrasound in the B-ultrasound room knew Zheng Ren. After all, the emergency department needed the most emergency B-ultrasound.
He smiled and said, "Mr. Zheng can even do B-ultrasound by himself?"
"Understand a little bit." Zheng Ren took the probe, rubbed the patient's belly twice, found the position he needed to look at, and carefully looked at the image on the screen.
There was indeed a blockage at the distal end of the bile duct. Under the B-ultrasound, Zheng Ren changed his hands, lateral and frontal, to confirm that the blockage was not a denser stone, but rotten and fermented food residue.
The obstruction point was consistent with the characteristics of postoperative complications of side-to-side choledochoduodenal anastomosis, and the differential diagnosis excluded the possibility of end-to-side roux-en-y choledochoduodenal anastomosis and choledochoduodenal fistula.
The bile ducts were significantly dilated, which was why the patient developed obstructive jaundice.
Pneumatosis was seen in the bile duct and cystic parcels were seen in the liver, which was highly suspicious of liver abscess.
It should be cesspool syndrome. Depending on the patient's condition, emergency surgery is needed.
Zheng Ren put the probe on the shelf of the B supercar, picked up the square toilet paper, and threw it on the patient. While thinking about the operation method, he said casually: "Wipe it."
"Mr. Zheng, are you sure?" The doctor in the B-ultrasound room was very impressed by Zheng Ren's skillful technique. At least he could never reach Zheng Ren's level.
I can’t make it, but the image can still be understood, and I don’t have to do it myself.
He asked while wiping the coupling agent on the patient's body.
"It should be confirmed." Zheng Ren said: "Director Xia, if the patient's family agrees, let's do surgery. Before the operation, tell the patient's family to go to the emergency ward to find me."
"Yes." Director Xia nodded, his expression heavy and serious.
This patient is completely different from the patient who had tips surgery last night.
Director Xia didn't know or be familiar with him, so he couldn't say as confidently as he did last night, "I will sign for emergency surgery."
You also need to communicate with the patient’s family and explain the condition. But these things can also be left to Zheng Ren.
Zheng Ren left the Department of Gastroenterology and was still torn between laparoscopic surgery and laparotomy.
If laparoscopic surgery is performed, the trauma to the patient is minimal, as evidenced by the fact that all patients undergoing laparoscopic cholecystectomy in the emergency ward ran home on the first night after surgery.
However, patients have various complications, and if they want to resolve them all in one operation, laparotomy is the best choice.
but…
"Boss, you just threw the toilet paper on your body and said wipe it. You really felt like a scumbag." Su Yun said with a smile.
At this time, only people like Su Yun could laugh.
Zheng Ren was stunned for a moment, and then realized what Su Yun meant. I was distracted by my thoughts just now, but unexpectedly, Su Yun grabbed the pigtail.
Scumbag... tsk tsk.
It was so impressive that Zheng Ren was also happy.
"What are you thinking about?" Su Yun immediately asked seriously.
"Should it be laparotomy or laparoscopically?"
"We have to open the abdomen. It's difficult to remove food residues with a laparoscope. It's too troublesome to use antibiotics after surgery. Besides, the main reason is that I don't want to hold the mirror." Su Yun said confidently.
Su Yun, who looked as delicate as a little girl, wanted to have a wide and spacious surgical field, so when he was a graduate student, he chose thoracic surgery.
With the evolution of minimally invasive surgery, thoracotomy surgeries in thoracic surgery have also decreased rapidly, and large incisions of 40cm are rare.
Zheng Ren suspected that this was Su Yun's initial motivation to learn heart transplantation.
"Then let's open the abdomen." Zheng Ren also made a decision, not because Su Yun didn't want to hold the mirror, but because the patient's condition was complicated. It might be necessary to use a B-ultrasound probe to find the point of liver abscess during the operation, and puncture to extract the pus. In addition, a series of operations such as stem yellowing must be processed.
The two returned to the emergency ward. Director Pan arranged for Yang Lei to be on the first shift today.
Chang Yue took the professor around the wards, chatting with the patients' families and explaining why they went home in violation of the rules last night.
After going around the wards, Chang Yue found that he had taken Professor Rudolf Wagner to the wards, and the patient's medical compliance had at least doubled.
In Haicheng, it is common to lead interns on ward rounds. But when I brought a foreign "intern" to check the ward, no one saw it.
The ward was in order, and Zheng Ren informed Yang Lei to prepare for surgery.
Because of Yang Lei's request that day, Zheng Ren also thought of letting him have some surgeries to improve his level as soon as possible.
Just a few months ago, Zheng Ren was struggling with Cen Meng and Director Liu's refusal to let him undergo surgery.
He didn't expect that he would be able to let others perform surgery now.
Thinking about it all, it seems so fantasy.
Soon, Zheng Ren received a call from Director Xia, saying that the patient's family had agreed to the surgery and was on their way to the emergency ward. She also made preoperative preparations and pushed the patient to the operating room after preparation.
Director Xia was quite vigorous and resolute in his behavior, and Zheng Ren admired this personality.
Zheng Ren did not leave the tasks explained before the operation to Yang Lei or Chang Yue.
This is because there is ambiguity when the patient's family members talk about the patient's past history. Zheng Ren wanted to determine whether the patient's family members lacked professional knowledge or did it deliberately.
The difference between the two is huge.
The patient's family members soon came to the emergency ward. They were two middle-aged men, who should be the patient's sons.
Zheng Ren had seen the two of them in the ward before.
He seems kind-hearted and positive.
Zheng Ren asked about the patient's past situation. Judging from the body language of the patient's family, it should be due to a lack of professional knowledge. In addition, it was so long ago that the two of them were not yet adults when the patient had the surgery.
Having determined this, everything is on track.
He explained the possible situations that may occur during the operation one by one, and explained the patient's current condition to the patient's family. It would not be possible without surgery, and there is a 30% chance that he would not be able to make it to Taiwan even with surgery.
After Zheng Ren finished speaking, the patient's family members turned pale and sweated profusely.
Seeing that there was no problem, Su Yun and Yang Lei went directly to the operating room to make various preparations before the operation.
The family members still signed their consent for the operation. Zheng Ren handed the signature form to Chang Yue and went to the operating room.
Professor Rudolf Wagner went with Zheng Ren to change clothes and enter the operating room. He did not hesitate to persuade Zheng Ren to follow him to Heidelberg, Germany, to establish a research group.
Zheng Ren was too lazy to think about the professor's true thoughts. All his attention was focused on the surgery that was about to begin.
Sewage pool syndrome, I hope it’s not too severe.
While Zheng Ren was changing clothes, he went to the system operating room again and practiced ten surgeries on cesspool syndrome.
The operation process went smoothly. After all, Zheng Ren is a master of general surgery. Coupled with his experience in liver and gallbladder anatomy, he is very strong in local anatomy.
With solid basic skills, he can quickly master any surgery.
Practicing ten sets is already very cautious.
Hearing the sound of the flat car, Zheng Ren changed his clothes and walked into the operating room.
"Mr. Zheng, I'm starting anesthesia. Is there anything you need?" Chu Yanzhi asked.
"General anesthesia, nothing else is needed for the time being." Zheng Ren said.
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