I really don't want to be a doctor

Chapter 171 Let me try
bile flowed down,
Gu Jianjun's face paled instantly.

what does that mean,
Everyone is very clear.

Going to bed Mei was also taken aback for a moment, and then a smile appeared on her face,
"Professor Gu, this patient's diagnosis seems to be a bit wrong. You don't mean to mess with this young man on purpose, do you?"

They all see clearly,

Yu Wenxing was very quick when dissecting the gallbladder triangle,
But when touching the cystic duct, be extremely careful.

When pulling the stone,
Also very cautious.

From their professional point of view, this kind of strength would not break the common hepatic duct which is compressed by the cystic duct.

And now,
bile flowed down,

That means,

A gap has long been formed between the cystic duct and the common hepatic duct.

"Open the belly! Turn the belly!"

The thunderstorm is a bit panicky,

When the gallbladder is removed, the most feared thing is the damage of the bile duct.
At this time a gap is formed,
It must be dealt with immediately.

If it is not handled in time,

or not handled well,

The patient's prognosis will be extremely poor.

Thunder Shower shouted while looking at Gu Jianjun.

Gu Jianjun moved his feet and nodded heavily.

Things exceeded his expectations,
This is not a mirizzi type I,
It was a Model II.

In type II mirizzi syndrome, the cystic duct forms a ostium, that is, a channel is formed between the cystic duct and the common hepatic duct.

this channel,

It has to be closed.

Otherwise, bile outflow, which is the easiest.

And if the intra-abdominal infection retrogrades into the bile duct, causing inflammation of the bile duct and even liver function damage, at that time, even liver transplantation will be required to save the patient's life.

This is not an impossible aftereffect.

Although I don’t know why I didn’t see the mouth when I was doing MRCP a few days ago,

but,
Now is not the time to dwell on this issue,

The question now is,

How to open the stomach quickly.

Gu Jianjun was ready to wash his hands.

"need my help?"

Pete asked.

"It's okay, Chairman, I will take care of it."

Gu Jianjun ran out.

Yu Wenxing was also pale.

Feeling guilty,

careless,
Really careless!
I forgot the wise words of general surgery.

All the situations were expected before seeing them. Only when you open them, you will know what is going on!
He looked at the auxiliary inspection,
After watching MRCP,

but,
Those are just secondary checks.

Yu Wenxing shook his head, looked at the basket in the empty hole, and slowly began to think in his mind.

The mouth of the basket is not big.
It can even be said to be small,
Presumably it should be formed after doing MRCP.

but,
Although the mouth of the basket is small,

But don't underestimate it,
This hole must be blocked.

What should I do if I have an open stomach?

Yu Wenxing thought about it.

Although open surgery for Mirizzi syndrome is not small, it is far from the difficulty of laparoscopic surgery.
the reason is simple,
During laparotomy, there are many more things that can be done than just opening two small holes.

The method of laparotomy is: firstly, start from the gallbladder bed. When the gallbladder is separated to a certain extent, cut the cystic duct to remove the stones. After removing the stones, remove the gallbladder fundus and gallbladder body, and then use the remaining gallbladder neck or Part of the gallbladder wall covers the opening of the common hepatic duct and is sutured with small needles and fine threads.

Subsequently, another incision was made on the common bile duct, and an unconventional T-tube was placed for support drainage.

After doing this,

very difficult,

The remaining gallbladder neck or part of the gallbladder wall should be sutured above the mouth of the common hepatic duct.
This step is difficult,

The stitches are too thin, bile will flow out,

The sutures were tight, there were too many threads, the common hepatic duct was blocked, and the bile could not be drained.

This is an absolute meticulous work,
Without more than ten years of suturing experience, few people dare to suture the bile duct.

Therefore,
Even under open laparotomy, surgery for Mirizzi syndrome type II is extremely difficult.

What's more, under laparoscopy,

When Mirizzi syndrome type II was diagnosed during the operation, everyone's first reaction was to open the abdomen.

fastest lapping,
fight for,

Minimize damage.

"Can I sew?"

Yu Wenxing felt a little movement in his heart.

In terms of suturing under laparoscopy,

he did
and very skilled,
And he is confident that he can sew better with the joystick than with his hands.

but,
Now it's not a simple stitching,

Instead, the wall of the gallbladder or the wall of the cystic duct and the wall of the common hepatic duct should be sewn together.
This is equivalent to sewing two layers together,
and,

He is not familiar with the thickness of the wall of the gallbladder or the wall of the cystic duct and the thickness of the common hepatic duct,
How much does the suture needle go in?

He doesn't understand.

Therefore, if it is necessary to sew two layers, for Yu Wenxing, he also finds it very difficult.

but,
Yu Wenxing suddenly had an idea.

Gu Jianjun came back after washing his hands, wearing gloves with a gloomy face.

"Professor Gu, how about I try first?"

Yu Wenxing spoke suddenly.

Gu Jianjun was suffocated, turned his head with difficulty, looked at the serious Yu Wenxing, and opened his mouth after a while, "You dare to try this?"

In fact, Gu Jianjun originally wanted to say that there is no chance to try at this time,

Because the common hepatic duct is very thin,
If the suture attempt fails, a pinhole must be left,

This is undoubtedly worse.

But with so many people present, Gu Jianjun was a little more tactful.

The expressions of the others were different.

Mei also laughed wildly when she went to bed,

have seen the ignorant,
I have never seen such ignorance.

Is it possible to try the suture of the common hepatic duct?
In this situation,
Although it is a bit harsh to say that the requirements for the surgeon,

but,
it must,
A success!
Because the patient does not have the slightest ability to bear failure!

The skin is so dark that the face is terrible,
Combined with Yu Wenxing's drastic dissection of the gallbladder triangle just now,
He had already given Yu Wenxing a reckless definition in his heart.

Just as he was about to reprimand, Yu Wenxing spoke,

"I thought so."

Yu Wenxing brought the camera closer, "Professor Gu, professors, it's like this. If you want to sew another layer on the opening of the common hepatic duct, the requirements for the surgeon are very high. Not only must you have a good understanding of the common hepatic duct Thickness, hardness, and extensibility, but also a strong grip on the joystick."

"I am not talented, but I am confident that my control over the joystick is pretty good."

Yu Wenxing's words were a little arrogant, some people groaned, some nodded, but no one spoke.

"However, I know too little about the common hepatic duct. I also find it difficult to sew a layer of gallbladder wall on the mouth of the common hepatic duct. It can even be said that I dare not sew it."

As soon as this is said,
The crowd nodded.

Pi De's face looked better.

How many times did Gu Jianjun's mouth squirm?

What do you mean?
you find it difficult,

Are you afraid to sew?
so what do you try?
"What I mean is, how about just one stitch to close the mouth of the basket, so that you only need to sew one layer."

Yu Wenxing's words are very light,

fall on the ears of all,

But it was like thunder.

(End of this chapter)