Chapter 356: Good luck

"Then ethanol, hey! This operation is tangled." Old Zhao said helplessly. No way, this operation is too nonsense, the worm sac ruptures, and wants to kill it completely. It is estimated that the worm was not killed, and the person was killed first. Don't kill it completely, maybe it will recur after a while.
"Um." Zhang Fan answered gently. Hemostasis and ligation, Zhang Fan and Zhao Jingjin quickly prepared before entering the abdomen.
"Punching hands," Zhang Fan said to the visiting nurse.
The itinerant nurse lifted the salt water prepared earlier and began to rinse Zhang Fan's gloves and Zhao Jingjin's gloves in order.
This is a general rule, because this kind of surgical gloves is easy to be worn by doctors and has talcum powder on it. If this stuff is not put into the stomach, the patient's intestines will stick together, so it must be washed before entering the abdomen.
When you enter the abdomen, you ca n’t rush to the surgery first, you need to investigate first. In short, it means that you have to look at each organ regularly and successively. Open the liver to see if there are worm sacs under the liver gallbladder, and open the intestines to see if there is any behind the peritoneum.
Zhao Jingjin cooperated with Zhang Fan to flip the patient's organs. "Do the free ligaments first." Zhang Fan said after turning for a while, but no obvious cysts were found. What kind of thing is this really? I turned the intestine to find the worm sac, which sounded awkward, but this is the method of this operation, there is no good way.
If it is multilocular hydatid disease, surgery is the only treatment, and the highest resection rate is 58%. In other words, there is one that almost always recurs. Once the recurrence occurs, the most thorough treatment is to directly cut the liver completely and then change the liver. So eating raw meat comes at a price.
And this thing has a varying number of testicles (a) pills, sub (a) uterus, and reproductive foramen. In other words, it is estimated that this thing can be one-to-many, or many-to-one, and the bloodlines will not be disordered. Super terrible stuff.
After the investigation, Zhang Fan said, "Change the gauze, and remove all the white gauze. Don't go to the stage again."
"Okay!" Bao Yin nodded, and counted the gauze with the roving nurse. There are ten before the stage, and there must be ten after the stage. This is the regulations.
The cysts of the skull are superficial and smaller. The liver is usually deep and large. The worm sac is the largest in the skull and looks like a small egg. And in the liver less than 4cm can be treated conservatively, that is to say it is not strange that this stuff grows into a small ball in the liver.
If the ascus is a pearl jelly in the skull, it will be about the same size as a small dumpling in the liver. The small dumplings will be mixed with water.
Separated point by point, if any tissue was found to be sticking, Zhang Fan would surely open it to see if there was a hidden sac. After Baoyin took the blue dressing on the table. Zhang Fan began to enter, and the liver periphery was clearly separated.
The liver is too complicated. It is not only a synthetic secretory organ, but also a detoxifying and decomposing organ, so this is a super chemical factory. There are various pipes in it, and the worm sac grows here. Then the secreted fluid sticks to the liver and sticks. On various pipes.
Small pipes don't matter. If they stick to the inferior vena cava or hepatic vein, it will be very troublesome.
"Probe." After the separation was clear, Zhang Fan said to the traveling nurse. In this operation, the relationship between the internal structure of the liver and the worm sac must be clearly understood. There is still an error in performing color Doppler ultrasound through the belly. Therefore, after freeing the ligaments and blood vessels surrounding the liver, Zhang Fan began to use color Doppler ultrasound to investigate the intrahepatic condition.
Zhang Fan and Zhao Jingjin carefully looked at the color ultrasound screen at the same time. Zhang Fan slowly moved the color ultrasound probe under his hands, and the probe was wrapped in sterile gloves.
"It's okay, you haven't touched the big blood vessels. Director Zhao, can you look at it again?"
"Okay, I'll see it again." Be careful before the operation, and rest assured when the operation is performed. Cross-checking between the two is more secure.
"I did not touch the large blood vessels." Zhao Jingjin said once after confirming it.
"Okay, let's get started, sharp knife." Zhang Fan said.
Holding a sharp knife, Zhang Fan slowly separated along the cyst of the liver from the parenchymal boundary of the liver. The liver has many pipes, and the operation is very slow. Almost one knife is several pipes.
Constantly ligating and cutting off is considered to be the worst of luck. If you lean on the hepatic vein, you can only pray to God or change your liver.
After cutting off all the blood vessels and biliary tracts that entered the cyst, Zhang Fan gently took the cyst with liver tissue out of the liver gently with a blue dressing.
Looking down from the shadowless lamp, the patient's liver was directly a pit, which was stabbed down into a small bowl-sized pit. Taking down the worm sac, Zhang Fan looked at the situation around one side very carefully, for fear it had another worm sac on the side.
"No!" Zhang Fan looked at it once, and Lao Zhao looked at it again.
"When you come to Dr. Lu, you can also see. Is there a white worm sac?" Zhang Fan said to Lu Shuyan.
"No!" Lu Shuyan said after taking a look.
"Okay, let's open the worm sac." The contents of this worm sac are very important for treatment. If the cyst fluid is clear and contains small fragments, it means that the worm sac is active, and the tissues surrounding the worm sac must be killed with drugs.
If the cyst fluid is milky, it means that the worm sac has weakened but is still infectious. If the capsule is toothpaste-like, it means that the echinococcus has died, so you don't need to kill the surroundings. This is the same as human amniotic fluid.
After Zhang Fan brought the worm sac away from the operating table, he cut the worm sac with a scalpel. A milk-like liquid flowed out, and he was carrying a gurgling water. The pressure inside was not small, indicating that there were a lot of worms in reproduction.
The scoop cut with a knife really looked like a sesame dumpling with white sesame filling that had not been ground and finely bitten a bite and flowed directly into a curved plate.
"Bag." Zhang Fan directly put the entire plate into the tissue bag. Then he said to the tour: "This must be sterilized strictly."
"Ok."
Then, Zhang Fan continued to change gloves. The cyst has been removed, and no other cysts have been found in combination with the color Doppler ultrasound. Zhang Fan said to the old Zhao, "Director Zhao, do you use ethanol?" In this regard, his experience is still not as old as Zhao.
"Forget it, the surgery was very clean, and no other cysts were found. This patient, you see his liver, it was tested by alcohol, it is too fragile, use formalin."
"Okay!" Zhang Fan was better when he was advised to eat enough food.
Gently wipe the gauze with formalin and gently wipe the inner wall gently. As I rubbed it, I watched if any formalin remained. If this thing stays, it will be a big trouble.
"Flush!" A lot of saline, a dozen bottles of physiological saline, was rinsed directly for several minutes, the scarlet liver was almost washed white.
After more than five hours, the operation was finally over.
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(End of this chapter)