Chapter 976: :problem found!

Bile-enteric anastomosis is an important part of the reconstruction of digestive tract function. Although it can not be said that it is very difficult, it is definitely very important.
In the reconstruction of the digestive tract, the most difficult operation is pancreaticogastric anastomosis, and pancreaticoduodenectomy is one of the most difficult operations.
The difficulty of reconstruction of the digestive tract is actually around the small intestine!
The difficulty is naturally in the management of the small intestine.
The small bowel anastomosis seems to be the simplest, but as the central link, it is the hardest.
Because he connects the stomach, biliary tract, pancreas,
These three important digestive organs, combined with the small intestine, make up 90% of the digestive tract.
For colorectal anastomosis, it seems that everyone has not paid much attention to it.
At first Chen Cang originally thought that the reconstruction of the digestive tract was not difficult, but with deeper understanding, he also realized that this difficulty seemed to be much higher than he thought!
Otherwise, it won't bother digestive surgery for hundreds of years, so far there is no better solution.
At this time, when Chen Cang looked back, he suddenly found that the pancreatic surgery skill expansion package that he obtained at the beginning was really a big deal.
The rarest problem seemed to have him solved first.
After the operation, Chen Cang was meticulous in holding the mirror.
The gallbladder operation under laparoscopy is actually very challenging.
For example, in this patient at this time, the reason for the occurrence of biliary stricture was that the bile duct was accidentally damaged during the original cholecystectomy, so that the bile duct was narrowed, leading to cholestasis and jaundice.
Under laparoscopic surgery, injury to the bile ducts seems to have become a very serious problem.
This is no longer a matter for one person, it has even become an industry issue.
Thinking of this, Chen Cang is no longer anxious to think about stealing a teacher or doing anything. He hopes to use his own skills to observe the gallbladder to see if it can reduce the chance of biliary tract injury!
Chen Cang simply settled down and began to watch Oster's surgery.
After laparoscopic exposure of the bile duct, careful separation is required.
Because the blood vessels around the bile duct are dense, caution is required during the passage of multiple vessels.
When Oster was undergoing surgery, he did not relax his vigilance because it was an operation he was good at, but took it seriously.
At this time, Chen Cang suddenly said: "Professor Oster, what do you think is the most important reason for bile duct injury during bile duct surgery and gallbladder surgery?"
This question made Oster suddenly silent!
Extrahepatic bile duct stenosis accounts for about 80% to 90% of the injury to the extrahepatic bile duct during surgery.
Inflammation, infection, and ischemia secondary to the bile duct after surgery account for only 10% to 20%.
So why is it damaged?
This is a very important question!
With such a high injury rate, why not tackle it?
As Oster thought of it, he couldn't help but say, "This is a problem!"
In a word, Ma Yuehui couldn't help rolling his eyes!
What thoughtful words can you say?
At this time, He Zhiqian, who was an assistant, also thought about it.
The operations to deal with traumatic bile duct stenosis are all re-biliary tract surgery, some even more than 10 times, it is a very difficult operation.
It is definitely not a successful operation, including the patients at this time, it was done once three years ago!
Four people think at the same time.
After a while, Oster said, "Maybe it's because of the problem of Shu Ye?"
He Zhiqian also nodded: "Well, even in open surgery, when the gallbladder is being processed, due to the liver and blood vessels, etc., it is easy to damage the bile ducts when processing the triangle of the gallbladder."
When Oster was dealing with the common bile duct, Chen Cang suddenly said, "Wait a minute, I will change the angle for you, and you will deal with it again!"
At the time of separation and entering the small omental hole, Chen Cang took the lead in following this time. At this time, Chen Cang turned the optical fiber. Soon, the knots and scar nodules in the bile duct strictures left by previous surgery appeared on the TV. Screen.
After seeing this original narrowness, Chen Cang fell into meditation.
Why is it hurt here?
Thinking of this, he quickly said, "I'll see where the last punch operation was."
Suddenly, Oster blinked.
Imprints left between several operations on the abdomen.
Chen Cang looked at several marks, and Oster quickly distinguished which one was the operation hole and which one was the auxiliary.
And Chen Cang stared, stared at the four-dimensional map, and kept thinking ...
At this time, he discovered the power of his four-dimensional map!
This is clearly a simulated structure diagram.
Through the three holes, they even started to simulate the operation at the time.
After a few minutes, Chen Cang had thought about the possibility of dozens of injuries.
This ... is no different from not thinking.
Dozens of operations are obviously not representative, and he needs to find a commonality of injury!
Thinking of this, Chen Cang understands that this is no longer a problem that can be solved by one operation, and more surgery may be needed to verify it.
Chen Cang simply said: "Professor Oster, you handle it, I will give you vision!"
Aus's character, Chen Cang's question, also made him ponder.
Minutes and seconds passed.
Chen Cang constantly puts out the skills of endoscope, taking into account all structures and organizations as much as possible.
Oster's bile duct jejunal anastomosis is done smoothly!
This is the first time that Oster was supported by Chen Cang himself, and it really felt how powerful Chen Cang's mirror-holding technology is!
At each step, Chen Cang could even think of it in advance.
Blood vessels, ligaments, liver, bile ducts ... Any tissue that may be damaged, Chen Cang will use the endoscopic technique to illuminate the field of vision in advance, and then do a good job of warning!
The endoscope is like the doctor's eyes, and as a mirror holder, Chen Cang has turned the doctor's eyes into a 360-degree camera without dead ends!
So much so that Oster's next operation went smoothly!
Oster also feels that this surgery today is unprecedentedly smooth ~ EbookFREE.me ~ Every detail can be grasped in place.
All this is naturally due to Dr. Chen.
For a time, Oster had a hunch. Is it possible that Chen Cang could perform this operation better than himself?
Thinking of this, Oster looked up at Chen Cang, only to see that he was frowning, not knowing what he was thinking!
Suddenly, Oster was a little stunned in his heart, a little worried in his eyes.
Isn't that ... dissatisfied with the performance of this surgery?
Thinking of this, Oster suddenly felt uneasy, and the operation became more rigorous and serious!
The operation is over soon!
However, Chen Cang still said nothing, which made Oster even more disturbed!