I really don't want to be a doctor

Chapter 127 Mirizzi Syndrome

Yu Wenxing didn't know what to do next.

The obviously dilated cystic duct can even vaguely see the common hepatic duct oppressed by it, which has been pasted together.
In this situation,
There is almost no room left for Yu Wenxing to operate,
If normal,

The cystic duct is separated until it becomes skeletalized, and then clamped, and the treatment is complete.

But if it is still the case in this patient, it is impossible to separate the cystic duct. If the cystic duct is forcibly separated, the common hepatic duct will be damaged.

Once the common hepatic duct is damaged,

you have to open your stomach,
A T-tube was placed for drainage.

Yu Wenxing must consider the consequences of the common bile duct injury.

Yu Wenxing's hand was too hard, and the hand holding the joystick trembled slightly.

"Doctor Yu, what, what's going on?"

Wu Liang's heart almost burst into laughter.

He knew it was the case,

Next,
It's just an open stomach.

Even if the common hepatic duct was damaged during the laparotomy, a T-tube was installed at worst. The patient is only 46 years old and has no underlying diseases. The recovery after the placement of the T-tube is good.

In fact, at Xihua Hospital,
The same is true for the surgical method given.

Go in with a laparoscope first. If it can be handled, it will be treated. If it can't be handled, it will be opened.

Wu Liang admitted that he did not let the patient suffer.

It's just that the surgeon was replaced by Yu Wenxing from Xihua Hospital's doctor.

Seeing Yu Wenxing being so devastated, Wu Liang's heart instantly felt happy.

"call!!"

Heaving a sigh of relief, Yu Wenxing put down the joystick, "Doctor Wu, show me the medical record card."

Yu Wenxing didn't feel that Wu Liang was deliberately making things difficult for him.

After all, for general surgery,
All auxiliary examinations can only be regarded as auxiliary examinations. You have to open the stomach and go in to find out what is going on in the stomach.

Like the dilated cystic duct in this patient,
Before the stomach is opened, B-ultrasound and CT should not be able to see it.

If you really want to see,

Then you have to do ERCP or MRCP,
Can.
Few people will do these two checks before surgery,
Unless a problem with the bile duct has been considered.

Wu Liang's face was heavy, and he brought the medical record card in front of Yu Wenxing, flipping through the pages.

Yu Wenxing watched carefully,

When he saw the color Doppler ultrasound at Xihua Hospital, his eyes suddenly shrank a little.

"Upper common bile duct dilation"

There are many causes of dilation of the upper common bile duct, but in this patient,
Yu Wenxing thought of a disease.

Mirizzi syndrome.

Mirizzi syndrome is an extremely rare complication of gallstones, because stones embedded in the neck of the gallbladder or in the cystic duct compress the common hepatic duct, which can cause jaundice.

But before surgery,

It is extremely difficult to diagnose this disease,

Because it's so rare.

And until now,

Yu Wenxing also reacted,

I have encountered a rare disease.

"It seems that I didn't prepare enough before the operation, and I still took it too lightly."

Yu Wenxing looked back and saw that he had recurrent cholecystitis and jaundice, and his liver was fine. The color Doppler ultrasound showed gallstones and dilation of the upper part of the common bile duct, so he should have thought of this disease.

But unfortunately,
Yu Wenxing didn't read the medical records too carefully.

One is to believe in Wu Liang, after all, the other party is also a graduate student,
Second, the arrival of Gu Jianjun made his mentality a little turbulent.

"Let's turn this patient into an open laparotomy. According to the intraoperative findings, the patient's diagnosis should be Mirizzi syndrome type I. This disease cannot be done laparoscopically."

After Yu Wenxing finished speaking, he remembered that the name Mirizzi syndrome was from the previous earth. He wondered if Wu Liang could understand it.

"Mirizzi syndrome??"

Wu Liang pretended to be surprised, pretended to be thinking hard, and said after thinking for two seconds: "Doctor Yu, are you talking about the rare complication of gallbladder stones?"

Seeing that Wu Liang had heard about it, Yu Wenxing breathed a sigh of relief, "Yes, blindly doing laparoscopy in this case will damage the bile duct, and the gain outweighs the gain. Have you communicated with the patient about converting to laparotomy?"

Wu Liang straightened his face, "I have said it, and said it more than once. But the patient's family members mean that they can do laparoscopy as much as possible, after all, the laparotomy is big."

"Now it's not a question of whether to do as much as possible or not. This patient must undergo laparotomy! Otherwise, the laparotomy will be performed after the biliary tract is damaged. The bile will flow into the abdominal cavity and cause abdominal infection, and the recovery will be very poor."

Wu Liang smiled heartily,
Of course he knew that he had to turn his abdomen around now,

But Wu Liang still felt very comfortable seeing Yu Wenxing personally admit that he couldn't do the surgery.

look,

There are times when you can't do it,
There is not much difference between me and you.

With a serious expression, Wu Liang nodded, "Okay, Doctor Yu, I'll go talk to the patient's family right now, and sign the consent for the laparotomy."

Wu Liang left with heavy but brisk steps, and the atmosphere in the operating room became a little heavy.

"Yu Wenxing, this seems to be the first time you have encountered an operation that you can't do?"

Seeing Yu Wenxing deflated, Tang Ling was also heartbroken.

"Ah."

Yu Wenxing shook his head indifferently, "I'm not a god, so of course there are operations I can't do. But I can do it if the patient has an open abdomen."

The difficulty of opening the abdomen is not small.

But Yu Wenxing is confident.

"Hmph, open your stomach."

Tang Ling pursed her lips in disdain, "It's such a big wound in the abdomen, it's leaking just looking at it."

I don't know what Tang Ling was thinking, but suddenly said again:
Yu Wenxing, tell me, when you operated on Li Weiwei, you worked so hard to make the two-hole method into one-hole method, in order to save Li Weiwei a 0.5cm incision; hehe, you are strange, why? Can't you work hard to reduce this patient's scar by more than 10 centimeters?

Do you think Li Weiwei is beautiful?
Could not bear?
And this patient is a middle-aged woman,
Lost interest all of a sudden?
Tang Ling still felt that Yu Wenxing must have something to do with Li Weiwei,
And what can a man do with a woman?

Nothing more than
Mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm that kind!

Tang Ling became angry at the thought, and couldn't help ridiculing.

"I"

Yu Wenxing originally wanted to angrily reprimand himself for working so hard because he asked Li Weiwei,
But when I think about it, I can't say it.

Is it
If it wasn't for asking Li Weiwei,

Then can you not work hard?

Looking at the patient lying on the operating table, Yu Wenxing suddenly had mixed feelings in his heart.

Everyone has a time when they are sick,
Yu Wenxing is confident that he is no exception.

If he was lying on the operating table by himself, the doctor might have given up the opportunity to work hard but gave up.

What would you think then?
The patient is lying on the operating table, either actively or passively becoming his own patient,

Don't try hard yourself,
Does it make sense?
Yu Wenxing asked himself in his heart.

(End of this chapter)