He took out 45 adult worms from the lower digestive tract. After he was done, Zheng Ren said, "Chief Luo, Su Yun and I will do the ERCP. Can you guide us from the side?"
"Boss Zheng is too polite," Chief Luo said honestly. "I can't take out such a deep worm."
After that, he paused for a moment and said with a smile, "In the past, insects in this position could only be treated with insect repellent. After they die, they would be discharged bit by bit. Many of them can't be discharged and directly become stones. "
"If the bile duct is blocked, then we'll see."
"I'll give it a try. I might not be able to take it out." Zheng Ren said as he prepared the ERCP. "I can't do it alone, so I have to pull Su Yun along."
The patient was lying on the left side. The nurse and anesthesiologist, who were wearing lead aprons, remained in the operating theater while the others retreated to the operating console room.
"Chief Luo, aren't you going to help?" Professor Yang asked in a low voice.
"Boss Zheng is being polite to me." Chief Luo said, "If we're talking about ERCP, I can't even compare to the people under me."
"Look at what you said."
"To be honest, I'm getting old, and I can't do some micro-operations properly. Boss Zheng's age is really good. He can work for at least 20 more years! "Chief Luo said enviously.
Professor Yang sighed in his heart.
Generally, people at Boss Zheng's age were graduate students or doctoral students. It would not be an exaggeration to say anything, but they were definitely still in the process of learning surgery. There was no way for them to go on stage to solve difficult and complicated diseases.
It would be good if he could successfully complete a normal surgery without any mistakes.
However, looking at Boss Zheng through the lead-lined glass, Professor Yang sighed again. Regardless of whether it was interventional surgery or general surgery, he was equally skilled. How about hepatectomy? Interventional radiology was performed first, followed by resection. Gradually, the people in the Department of Hepatobiliary and Pancreatic Surgery got used to this kind of operation.
In the past few days, the chief had been preparing to arrange for someone to learn interventional surgery from Boss Zheng.
There was no need to be too meticulous. All he had to do was administer medicine and embolization. After all, he still had to perform surgery, so there was no need to be too delicate.
Unknowingly, he had changed a lot. He didn't even have a clear feeling when he was in the midst of it. Professor Yang recalled the scenes of his contact with Boss Zheng. When he looked back, he was a little confused.
On the screen, the ERCP surgery had begun. The duodenoscope passed through the esophagus, stomach, and into the descending duodenum to find the duodenal RT.
Professor Yang had seen many ERCP surgeries. The subsequent selective intubation was a rather difficult step. However, when he looked at Boss Zheng's operation, he did not feel anything in his heart.
It was normal for Boss Zheng to succeed. It would be strange if he failed. It was worth the entire hospital discussing why.
Sure enough, after inserting the catheter through the biopsy hole, Boss Zheng adjusted the angle button and lifting forceps so that the catheter was perpendicular to the RT opening. Then, the catheter was inserted into the duodenal RT.
Then, Zheng Ren began the angiogram.
Retrograde cholangiography revealed an abnormal image of about 15 cm near the right hepatic segment of the intrahepatic bile duct. Comparing it with the CT film, it was confirmed that this was the source of the severe pain.
The roundworm was stimulated and crawled all the way from the duodenum to the bile duct in the liver. Every time the roundworm moved, the patient would feel a heart-wrenching pain.
Why bother? If he had the willpower, he might as well eat less and move more.
Professor Yang looked at the image silently and evaluated the patient's condition in his heart. This kind of ERCP surgery was quite difficult. Chief Luo could not do it anyway.
Was there any precedent of using ERCP to remove worms in the country? He had some recollection of it. However, he had never done it before. The difficulty was quite high.
"Little Yang, if it were you, what would you do if it were you?" Chief Luo asked.
Although Professor Yang had never done ERCP before, he still understood the basic theory and operation. This was equivalent to sitting down and discussing the Dao, providing a certain idea.
"Uh …" Professor Yang pondered carefully, but then he smiled bitterly and said, "Chief Luo, you're making things difficult for me."
"I'm just saying," Chief Luo said casually as he stared at Boss Zheng's operation.
"It's not difficult to catch the roundworm with forceps. At least for Boss Zheng, it's not a difficult thing, "Professor Yang said.
It was not difficult, and it did indeed depend on the person.
The intrahepatic bile duct was quite thin. It was very difficult to use ERCP to remove stones from the intrahepatic bile duct, let alone to remove living things.
"The difficulty is that although the roundworm does not have an obvious mouthpart and clings tightly to the bile duct, its outer layer … seems to have a protective layer, right?"
When it came to the details, Professor Yang hesitated.
He could not explain the details clearly, so he just relied on his memory to chat with Chief Luo.
"Yes, the roundworm has a cuticle on the outer layer. Its physical strength and corrosion resistance are comparable to antelope horns and rhinoceros horns. It has a very strong resistance to mechanical damage, chemical damage, and biological damage. Therefore, although the roundworm does not live in the stomach, it will not be digested by the gastric juice, "Chief Luo said.
"It's very elastic. If we grab the end of the roundworm and pull it out, I'm afraid the roundworm will break in the middle."
"It's fine when the space is large. Although the roundworm doesn't have a sucker, its outer wall has the ability to adsorb," Chief Luo said. "The roundworm in the gastrointestinal tract is easy to remove, but the intrahepatic bile duct is too difficult."
"I don't understand."
"I don't understand either," Chief Luo said. "In the beginning, I just wanted to ask Boss Zheng if he had a good idea, but since he's here, it means that he already has an idea. I'm really curious. How is Boss Zheng going to take the worm out? "
"Surgery? If Boss Zheng wants to open the abdomen and cut the liver to remove the worm, it's possible with his level. "
"No, if it's a surgery of this level, Boss Zheng's girlfriend will follow him on stage," Chief Luo said with certainty.
That was true. Professor Yang nodded.
The angiogram had already ended, but in the ERCP room, Boss Zheng and Su Yun only did a simple operation before stopping.
Chief Luo was a little strange and pressed the intercom.
Immediately, Su Yun's voice came from the intercom.
"… Metformin, this is something that dares to eat. This thing can also be used to lose weight. I'm really impressed by the human imagination.
"Metformin improves insulin resistance and lowers insulin levels, which reduces fat synthesis and reduces weight. But won't ordinary people have any problems taking metformin? "
"Of course. Two days ago, a classmate who went abroad to study said that there was an old man who had taken metformin to lose weight and fainted. There was no one at home. When he found out, he was almost in a vegetative state. "
What kind of mess was this? In the middle of the night, there were a bunch of people from two departments watching outside. Why didn't they perform the surgery and talk about metformin here? Professor Yang and Chief Luo looked at each other and saw deep confusion in each other's eyes.
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