In fact, in terms of surgical options, endoscopic sphincterotomy + bile duct clearance is the least invasive method for patients.
However, according to literature reports from around the world, although the trauma is small, the possibility of postoperative recurrence is very high, about 30%.
The patient is not young. If the disease relapses after 5-10 years, the patient is around 70 years old, and surgery will take huge risks.
Therefore, Zheng Ren ruled out the possibility of endoscopic sphincterotomy + biliary tract clearance from the beginning.
Not only should we look at the current treatment effect, but also the long-term treatment effect.
When she reached the operating room, Xie Yi had already finished brushing her hands. With the cooperation of the circulating nurse, she opened the sterile surgical bag and began to prepare the instruments.
"Zheng Ren, what technique are you using?" Xie Yiren asked.
In the operating room, including the emergency ward, there were only two people who called Zheng Ren by his first name, Director Pan and Xie Yiren.
"Oddi sphincteroplasty + bile duct clearance + liver abscess drainage." Zheng Rendao.
Xie Yiren nodded, not thinking how difficult it would be if there were too many techniques.
She also asked the circulating nurse to pick up a few instruments that might be used. If there were no ready-made instruments, she directly used a high-pressure steamer to sterilize them immediately.
It really saved a lot of trouble. Zheng Ren felt happy when he saw the little lady busy talking.
Together with Su Yun and Yang Lei, Chu Yanran carried the patient to the operating table, and Chu Yanran started anesthesia. The professor didn't reach out to help. Perhaps in his view, these tasks were not his own, so he stayed away out of habit.
Anesthesia, disinfection, sterile drape is laid, and the operation begins.
Standing in front of the operating table, Zheng Ren heard a "ding dong" sound in his ear, and the system issued a task.
Emergency mission: cesspool handler.
Task content: Complete the surgical treatment of a patient with cesspool syndrome.
Mission reward: 2,000 skill points, 25,000 experience points.
Mission time: 4 hours.
The task was quite satisfactory and not too difficult for Zheng Ren. Having just completed the first phase of the Crown Jewel mission, Zheng Ren belongs to the nouveau riche stage.
After taking a look at the task and the time limit, Zheng Ren stretched out his hand, and the hemostatic forceps holding iodophor gauze fell on his hand.
Xinglinyuan live broadcast room, surgical live broadcast is open as scheduled.
What's the surgery today
I just finished reading it, it’s cesspool syndrome... The surgeon’s operations are getting more and more weird. Although I am not a general surgeon, most of the operations have been mentioned by others. However, this was the first time I heard this name.
Fortunately, this disease is not uncommon in general surgery and gastroenterology departments, and several cases are seen every year. Most of them were postoperative patients who had undergone common bile duct and duodenal lateral incision and anastomosis.
It’s so high-end. I’m also unfamiliar with this surgical technique.
There are so many strange things. The Montreal Medical Center is one of the top five large medical institutions in the world. What rare cases have it not seen
I estimate that more cases will not be broadcast live at all.
It's pity that I, a doctor with an external brain, hold my mobile phone every day to watch the surgeries in the general and interventional departments. I don’t know when it will be rainy and dew-free, and I will also broadcast the brain surgery live.
In the barrage in the live broadcast room, everyone started chatting after learning about the condition. The initial steps were nothing to look at. The surgeon chose a right subcostal oblique incision with a length of about 15cm.
Because the patient has a surgical incision and scar tissue needs to be avoided, the incision looks a bit odd.
The next step is of course blunt dissection and opening of the peritoneum. The surgery after that is worth watching, so everyone seizes the time to use hand speed and send out barrages.
The brain surgeon's words resonated with many people, and everyone complained.
Surgical live streaming allows the doctors to watch the operation from the perspective of the surgeon. The experience value gained by the doctors is far beyond that of the ordinary surgical viewing platform, and is even better than that of a first assistant.
Modern medicine is an empirical science. Mature surgeons demonstrate surgeries and various difficult cases. All the doctors watching the live broadcast in Xinglin Garden know how rare this opportunity is.
But so far, there are only general surgeries and interventional surgeries. They are very sorry, but they also have greater expectations.
The barrage floated for a few minutes. After opening the peritoneum, everyone unanimously reduced the number of barrages and watched the operation carefully.
In the abdominal cavity, due to an operation, the normal physiological structure was changed.
Coupled with the inflammatory stimulation caused by this illness, the eyes were filled with inflammatory edema and adhesions with unclear tissue structure.
If I were to put it into perspective, I think I could give up the surgery at this time. Perform a switch operation to save the patient from being unable to get off the stage.
If the adhesion is so severe, will it damage the proliferating blood vessels
Yes, I can’t see the organizational structure at all. This surgery... I wanted to give up after seeing it.
When Zheng Ren saw the condition inside the patient's abdominal cavity, his mood did not change at all. When he reached out his hand, Xie Yiren slapped the blunt scissors into his palm.
The blunt tip of the blunt scissors separates the proliferated connective tissue, sometimes peeling it off and sometimes cutting it. The action is neither urgent nor slow, and is extremely stable.
Su Yun's eyebrows wrinkled.
The adhesion was so severe, how did Zheng Ren know where the abnormally proliferated blood vessels were
This is definitely not knowledge that can be written in books.
Too strange.
Although Yang Lei approached Zheng Ren and wanted to learn more surgical skills. But when he took him to the stage, he realized that he couldn't understand Zheng Ren's surgical method at all.
When Zheng Ren separated, clamped, and ligated a slightly thick blood vessel with #4 wire, Su Yun asked, "How did you find out that there is a blood vessel here?"
"You can touch it." Zheng Ren replied indifferently.
He focused all his attention on the patient's surgery. How could he have time to explain to Su Yun that even abnormally proliferated blood vessels would pulsate
Zheng Ren also mastered this technique after repeated training in the system operating room.
The most important thing is that Zheng Ren doesn't know how to describe this seemingly small, but actually very important skill.
Suddenly I felt that the surgeon had clairvoyance and could see abnormal blood vessels hidden in the connective tissue.
Yes, I feel this way too, otherwise I cannot explain how the surgeon can quickly and bluntly separate the connective tissue without damaging the blood vessels.
So far, the bleeding from the operation is less than 5ml, which can be said to be a miracle.
The doctors in Xinglin Garden were also surprised by this, but... they couldn't understand how Zheng Ren operated.
Layers of tissue were broken down by Zheng Ren, and the complex and abnormal anatomical structures became clear.
Although Su Yun didn't know how Zheng Ren found the blood vessel, he fully understood the meaning of Zheng Ren's every move.
The appendix retractor and small retractor in his hand always appear where they should be, helping Zheng Ren reveal his vision for the next step.
Finally, 5 minutes later, Zheng Ren peeled off the last layer of connective tissue, and the smell of putrid pus spread.
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