Vol 3 Chapter 2396: Intraoperative chat

45 adult worms were taken out from the lower digestive tract, and Zheng Ren said, "Director Luo, Su Yun and I are doing ERCP. Can you guide me?"
"Boss Zheng is very polite." Director Luo said really: "I can't take out such a deep worm."
After speaking, he paused and laughed: "If before, insects in this position could only use insect repellents, and after they died, they would be discharged a little bit. Many of them could not be discharged, and they became stones directly. Now. "
"If the biliary tract is blocked, it depends on the situation."
"Try it, I may not be able to take it out." Zheng Ren said while preparing the ERCP stuff, "This is not, I can't do it alone, I have to pull Su Yun together."
The patient is lying on the left side. The nurse and anesthesiologist are wearing lead clothes and stay in the operating room. Others retreat from the operation room.
"Director Luo, don't you help?" Professor Yang whispered.
"People Boss Zheng is polite to me." Director Luo said, "To be honest with ERCP, I am so close to the people under my hand."
"You see what you say."
"To be honest, the age is over 喽, some micromanipulations are not in place. Boss Zheng is really good at this age, at least 20 years!" Director Luo said enviously.
Professor Yang Yang sighed slightly.
Generally, Boss Zheng is a graduate or doctoral student. It is not an exaggeration to say anything, but it is definitely still in the process of studying surgery, there is no way to come to the stage to solve incurable diseases.
The normal operation can be taken smoothly without error.
You can see boss Zheng through leaded glass, and Professor Yang sighed again. Regardless of intervention or surgery, the same thing is done. How about liver cancer resection? People first get involved in surgery and then do resection. Gradually, people with liver and gallbladder are used to this operation.
主任 The director is planning to arrange a person to learn interventional procedures with Boss Zheng these days.
It doesn't need to be very meticulous, as long as the medicine and embolization can be used. After all, there is still surgery to be performed, and there is no need to do it too delicately.
He has changed a lot unconsciously, and he doesn't feel too clear about being in it. Professor Yang recalled the scenes of contact with Boss Zheng, and looked back in shock.
On the screen, ERCP surgery has begun. The duodenum was passed through the esophagus, stomach, and descending duodenum in order to find the duodenal RT.
Professor Yang Yang has seen many ERCP procedures, and subsequent selective intubation is a very difficult step. But he looked at Boss Zheng's operation, but felt nothing in his heart.
Boss Zheng made it as it should be. It's weird if it can't be done. It's worth discussing together in the hospital.
Sure enough, the catheter was inserted through the biopsy hole, and Boss Zheng adjusted the angle and the forceps lifter so that the catheter was perpendicular to the RT opening, and then inserted the catheter into the duodenal RT logically.
Then Zheng Ren started the angiography.
Retrograde biliary angiography shows an abnormal image of about 15 cm near the right hepatic segment of the intrahepatic bile duct. Compared with CT films, it can be determined that this is the source of severe pain in patients.
The maggots were stimulated and crawled in from the duodenum RT all the way to the bile duct of the liver. Every time the tapeworm moves, the patient feels the pain of heartbreaking lungs.
苦 Why did this come, and with this perseverance, I really believe it is better to eat less and move more.
Professor Yang Yang looked at the image silently and assessed the patient's condition. This ERCP operation is quite difficult, anyway, Director Luo cannot do it.
Is there a precedent for ERCP in China? Proximity, I have an impression. But I have never been so deep, it is quite difficult.
"Xiao Yang, complete fetching, what would you do if it were you?" Director Luo asked.
Although Professor Yang has never done ERCP, he still understands the basic theory and operation. This is equivalent to sitting down and providing a certain idea.
"Uh ..." Professor Yang pondered carefully, but then smiled bitterly: "Director Luo, this is hard for me."
"Whatever you want to say." Director Luo stared at Boss Zheng's operation tightly and said casually in his mouth.
"It is not difficult to grasp the tapeworm with pliers. At least for Boss Zheng, it is not difficult." Professor Yang said.
It is not difficult to divide people.
内 The intrahepatic biliary tract, which is quite thin, can be operated by ERCP. It is very difficult to take stones in the intrahepatic biliary tract, let alone take a living thing.
难 "The difficulty is that although the tapeworm has no obvious mouthparts and climbs up the biliary tract, but it has an outer layer ... it seems to have a protective layer, right?"
When talking about the details, Professor Yang was hesitant.
He was too detailed, and he could not say clearly, but just chatting with Director Luo with his memory.
"Well, the tapeworm has cuticles on the outer layer, but its physical strength and corrosion resistance are comparable to antelope horns and rhino horns. It has very strong resistance to mechanical damage, chemical damage and biological damage. So although the tapeworm does not survive in the stomach, Nor is it digested by gastric juices. "Director Luo said.
"It's very flexible. If I grab the end of the tapeworm and pull it out, I'm afraid the bug will break from the middle."
"It's okay when the space is large. Although the tapeworm has no suction cup, the outer wall has the ability to adsorb." Director Luo said, "The tapeworm in the stomach and intestines is easy to take, but the intrahepatic bile ducts are too difficult."
"I don't understand."
"I don't understand ~ EbookFREE.me ~" Director Luo said: "At first I just wanted to ask if there is a good way for Zheng, but since he is here, it proves that he has an idea. I'm really curious, how is Boss Zheng going to get the bug out. "
"Surgery? If Boss Zheng had an open abdomen and cut the liver for worms, it would be possible at his level."
"No, if it is surgery or this level of surgery, Boss Zheng's girlfriend will follow suit." Director Luo said with certainty.
Alas, Professor Yang nodded.
The radiography is over, but in the ERCP room, boss Zheng and Su Yun stopped after a simple operation.
Director Luo Luo was a little strange and pressed the intercom.
Immediately Su Yun's voice came from the intercom.
"... metformin, this is what you dare to eat. This stuff can also be used to lose weight, don't really admire the human imagination too much."
"Metformin works by improving insulin resistance, lowering insulin levels, thereby reducing fat synthesis, and reducing body weight. But will ordinary people eat metformin without any problems?"
肯定 "Absolutely. A classmate who went abroad for study two days ago also said that there was an old man on his side who ate metformin to lose weight. He was almost vegetative when he found it."
What a mess this is, most of the two departments outside the middle of the night watching a bunch of people, why not do surgery, here to say metformin? Professor Yang and Director Luo looked at each other and saw deep confusion in each other's eyes.