Chapter 315
Words:1975Update:22/06/27 09:05:53
The doctor in charge of the ultrasound knew Zheng Ren. After all, the emergency department was the one that needed the most ultrasounds.
He smiled and said, "Chief Zheng, you can even do your own ultrasound?"
"A little." Zheng Ren took the probe and moved it twice on the patient's stomach. He found the position he needed to look at and carefully looked at the image on the screen.
There was indeed a blockage at the distal end of the bile duct. Under the ultrasound, Zheng Ren changed two hand positions, lateral and anteroposterior. He confirmed that the blockage was not a denser stone but rotten and fermented food residue.
The blockage was consistent with the characteristics of complications after choledochoduodenostomy. The differential diagnosis excluded the distal side of the bile duct.
Anastomosis and the possibility of choledochoduodenal fistula.
The dilation of the bile duct was obvious, which was also the reason for the patient's obstructive jaundice.
There was gas accumulation in the bile duct and cystic mass in the liver. It was highly suspected to be a liver abscess.
It should be pool syndrome. Based on the patient's condition, emergency surgery was needed.
Zheng Ren placed the probe on the rack of the ultrasound car, picked up a square piece of toilet paper, and threw it on the patient. As he pondered the method of surgery, he said casually, "Wipe it."
"Chief Zheng, are you sure?" The doctor in the ultrasound room was very impressed by Zheng Ren's skillful technique. At least, he would never be at Zheng Ren's level.
He could not do it, but he could still understand the image. It saved him the trouble of doing it himself.
He asked as he wiped the coupling agent on the patient's body.
"I should be sure," Zheng Ren said. "Chief Xia, if the patient's family agrees, let's do the surgery. Before the surgery, let the patient's family find me in the emergency ward. "
"Okay." Chief Xia nodded with a heavy and serious expression.
This patient was completely different from the patient who had undergone the TIPS surgery last night.
Chief Xia did not know him and was not familiar with him. She could not confidently say that she would sign for the emergency surgery like last night.
She also had to communicate with the patient's family and explain the patient's condition. However, these things could also be left to Zheng Ren.
Zheng Ren walked out of the gastroenterology department, still struggling between laparoscopic surgery and open surgery.
If it was laparoscopic surgery, the patient's trauma was small. All the patients in the emergency ward who underwent laparoscopic cholecystectomy ran home on the first night after the surgery.
However, the patient had various complications. If they wanted to solve all of them in one surgery, open surgery was the best choice.
But …
"Boss, you just threw the toilet paper on your body and said to wipe it. That feeling really makes you look like a scumbag," Su Yun said with a smile.
At this time, only someone like Su Yun could laugh.
Zheng Ren was stunned for a moment before realizing what Su Yun meant. Just now, he was lost in thought, but he didn't expect Su Yun to catch him.
Scumbag … tsk tsk.
Zheng Ren was also amused by the image.
"What are you thinking about?" Su Yun asked seriously.
"Laparotomy or laparoscopy?"
"We have to open the abdomen. It's very difficult to remove food residue with a laparoscope. It was too troublesome to use antibiotics after the surgery. Also, it's mainly because I don't want to hold a mirror, "Su Yun said confidently.
Su Yun, who looked as delicate as a young girl, pursued a wide and grand surgical field. Therefore, when he was a postgraduate student, he chose the thoracic surgery department.
With the evolution of minimally invasive surgeries, the number of thoracic surgeries that were open for thoracic surgeries also decreased rapidly. Large incisions of 40 cm were rarely seen.
Zheng Ren suspected that this was Su Yun's initial motive for learning heart transplantation.
"Then open the abdomen." Zheng Ren made up his mind. It was not because Su Yun did not want to hold a mirror, but because the patient's condition was complicated. A B-scan ultrasound probe would be needed to locate the liver abscess and extract the pus. There was also a series of procedures to deal with the yellow stem.
They returned to the emergency ward. Old Chief Physician Pan had arranged for Yang Lei to be on the first shift today.
Chang Yue brought the professor around to chat with the patient's family members and explain why they had gone home last night against the rules.
After going around the wards, Chang Yue realized that the patients' medical compliance rate had at least doubled when she brought Professor Rudolf Wagner to the wards.
It was common to see interns doing ward rounds in Sea City. However, no one had ever seen a foreign "intern" doing ward rounds before.
The ward was orderly. Zheng Ren informed Yang Lei to prepare for surgery.
Due to Yang Lei's request that day, Zheng Ren wanted to let him perform some surgeries to improve his skills as soon as possible.
Just a few months ago, Zheng Ren had been troubled by Cen Meng and Chief Surgeon Liu's refusal to let him perform surgery.
He had not expected to let someone else perform surgery now.
When he thought about it, it all seemed so unreal.
Soon, Zheng Ren received a call from Chief Xia, informing him that the patient's family had agreed to the surgery and was on their way to the emergency ward. She was also preparing for the surgery and wheeling the patient to the operating theater once it was done.
Chief Xia's actions were swift and decisive. Zheng Ren admired her character.
Zheng Ren did not let Yang Lei or Chang Yue handle the preoperative tasks.
That was because the patient's family was vague when they talked about the patient's past. Zheng Ren wanted to know if the patient's family lacked professional knowledge or had done it on purpose.
There was a huge difference between the two.
The patient's family arrived at the emergency ward quickly. They were two middle-aged men, probably the patient's sons.
Zheng Ren had seen both of them in the ward before.
He looked quite friendly and was quite proactive.
Zheng Ren asked about the patient's past. From the family's body language, it seemed like they lacked professional knowledge. Moreover, it had been a long time since the patient's surgery. They were probably underage when the patient had undergone surgery.
After confirming this, everything was on the right track.
Zheng Ren explained the possible complications during the surgery and explained the patient's current condition to the family. There was a 30% chance that the patient would not be able to leave the operating theater without surgery.
When Zheng Ren finished, the patient's family's face turned pale and they broke out in a cold sweat.
Su Yun saw that there was no problem and went to the operating theater with Yang Lei to prepare for the surgery.
The family still signed the consent form. Zheng Ren handed the form to Chang Yue and went to the operating theater.
Professor Rudolf Wagner went with Zheng Ren to change clothes and enter the operating theater. He did not nag and try to persuade Zheng Ren to go to Heidelberg with him to establish a research group.
Zheng Ren was too lazy to think about the professor's true thoughts. All his attention was on the surgery that was about to begin.
Sink syndrome. Hopefully, it would not be too severe.
Zheng Ren went to the System's operating theater to practice ten surgeries on sink syndrome while changing clothes.
The surgery went smoothly. Zheng Ren was a Master in general surgery after all. Coupled with his experience in hepatobiliary anatomy, he was very good at regional anatomy.
His basic skills were solid and he could handle any surgery quickly.
He was very careful to practice ten surgeries.
Zheng Ren heard the sound of the stretcher trolley and changed into the operating theater.
"Chief Zheng, I'm going to start anesthesia. Do you need anything?" Chu Yanzhi asked.
"General anesthesia. I don't need anything else," Zheng Ren replied.
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