I really don't want to be a doctor

Chapter 59 Boy, do you want to stay?
Doctors,

Perhaps it is the profession with the least relationship between superiors and subordinates.

at least,

The relationship between superiors and subordinates is not as harsh as other professions.

Even junior physicians can raise their own doubts to challenge superior physicians.

As long as the subordinate doctor's statement is justified.

And medicine,

Many things are probabilistic. Abdominal CT and color ultrasound done through the abdominal wall can only be used as a reference. Before opening the stomach, no one dares to be [-]% sure.

Unless, the patient's symptoms and signs are particularly typical, as standard as written in textbooks.

But people will suffer from all kinds of diseases if they eat five grains.

How can there be such a typical case.

And this patient is an atypical case.

There was no typical right upper quadrant pain, and Murphy's sign was negative, which did not seem supportive of cholecystitis.

But this patient is not typical right lower quadrant metastatic pain, nor does it look like appendicitis.

Li Xiaojun had a headache.

"But the slightly thickened gallbladder wall of this patient at least gave us some clues; since the auxiliary examination has given us clues, we have to follow these clues to find the cause."

Li Xiaojun tried to persuade Song Rentou.

Song Rentou disagreed, "But the patients were all emergency examinations, and they did not fast. The gallbladder wall thickened after a meal, which is considered a normal phenomenon."

Li Xiaojun was so questioned that he was speechless.

Yu Wenxing nodded secretly,
Song Rentou's theoretical knowledge is indeed very solid.

This is also the reason why fasting is required for abdominal examinations, otherwise the reference significance of the examination results will be much smaller.

"It makes sense for you to say that." Li Xiaojun had no way to refute, "but I still think it is possible to do cholecystectomy or laparotomy directly. If the appendix is ​​found to be no problem after laparoscopic exploration, and the cholecystectomy is performed by laparotomy, the cost to the patient It’s not a small increase.”

"What do you think?"

Li Xiaojun looked at Yu Wenxing.

As the chief person in charge of laparoscopy at the First Hospital of Jiangzhong County, Yu Wenxing is qualified to decide whether a patient is indicated for laparoscopic surgery.

He does not think this patient is an indication for laparoscopic exploration of the whole abdomen.

After all, this person has to consider the acute attack of chronic cholecystitis.

Although laparoscopy was originally invented for inspection, an extra inspection is a financial burden for patients.

Yu Wenxing looked at the medical records at hand and thought about it.

The diagnosis of this patient is indeed in doubt.

It is somewhat difficult to differentiate between acute exacerbations of chronic cholecystitis and acute appendicitis.

He also knew the reason why Li Xiaojun didn't want to do laparoscopic exploration.

After all, now Li Xiaojun is thinking that the diagnosis of this patient is chronic cholecystitis, but in his cognition, the current conditions of the department can only perform laparoscopic appendectomy instead of laparoscopic cholecystectomy. For the problem, the laparotomy has to be performed, which is not of great significance to the patient.

but,
Conversely, if you do laparotomy directly, or you have to do a large incision for exploratory laparotomy, first check the gallbladder and appendix, and then decide which organ or two organs to remove during the operation.

Or just make an incision for open cholecystectomy, go in and cut the gallbladder.

But, in case,

In case the patient’s gallbladder is really just chronic cholecystitis, but the abdominal pain this time has nothing to do with the gallbladder at all, and the gallbladder has been cut by someone else, and the condition has not been relieved, then it will not be a matter of switching to laparotomy.
It was a medical malpractice.

Besides
Even if it is really not the appendix problem but the gallbladder problem,
Can't it just be cut directly?

Thinking of this, Yu Wenxing nodded, "This patient can undergo laparoscopic exploration."

A smile flashed across Song Rentou's face, and he felt a little proud, proud that someone could agree with his decision.

Li Xiaojun couldn't figure out why Yu Wenxing still suggested laparoscopic examination, but after thinking about it, he didn't refute it.

The big deal is to do an extra check on the patient.

The time for the patient to fast was not enough, Li Xiaojun called the operating room and arranged the operation after the elective operation.Only then did he and Yu Wenxing rush back to the operating room.

Song Rentou began to arrange the preoperative preparations, blood drawing, signature, chest X-ray, and electrocardiogram.

The importance of preoperative preparation,
Nothing less than the surgery itself.

At 1 p.m., the patient was sent to the operating room.

After routine anesthesia and washing hands, Yu Wenxing put on the hand washing clothes.

Usually, a pneumoperitoneum hole is opened under the navel, and after looking in the mirror, Yu Wenxing began to think about the location of the second hole.

This patient is indeed undergoing abdominal exploration,

But for now, the scope of exploration is in the right abdomen.

Think about it,
Yu Wenxing first made a hole in the left Maishi point, and then made an incision in the middle next to the rectus abdominis muscle on the right side.

The location of the third hole is obviously different from the usual one.
Li Xiaojun looked puzzled.

Yu Wenxing also saw Li Xiaojun's confusion, and explained softly, "This hole can be used to see the appendix and the gallbladder, and basically the entire right abdomen can be explored."

"Oh." Li Xiaojun nodded.

Yu Wenxing smiled,

He didn't finish his sentence,
This opening is the laparoscopic opening for cholecystectomy.

However, the diagnosis is not yet clear, so it is useless to say more, it is better to talk about it after the investigation is over.

Ever since he found out that Jiangzhong County No. [-] Hospital had created a new laparoscopic appendectomy, Wu Liang's refusal to go to work in Jiangzhong No. [-] Hospital has also quietly disappeared.

Too,

A hospital that can create a new type of surgery,
Thinking about it, it should be about the same place.

At least according to his teacher Shen Changchuan, he knew that this hospital should be a hospital with development potential.

In order not to miss this wave of bonus period, in order to allow myself to gain a foothold in Jiangzhong County No. [-] Hospital as soon as possible.

Wu Liang moved up his graduation time by one and a half months.

8 month 13 day.

Wu Liang carried his suitcase early in the morning and got on the bus to Jiangzhong County.

Said it was a bus,
It's actually not that big.

At best, it is a minibus.

After bumping and bumping for more than three hours, when the bus finally stopped, Wu Liang felt as if he had returned to his childhood, the dizziness after motion sickness made his steps stilted.

Standing at the gate of the station, looking up at the scorching sun, looking around, the scene is completely different from the provincial capital Shudu. There are no high-rise buildings, and there are only dilapidated small buildings.

Thinking that he would have to live in this small county for at least five years, Wu Liang wondered whether his decision to work here was right or wrong.

But then he thought about the situation at home and the 30 settling allowance that he was about to get, Wu Liang sighed.

"Young man, do you want to stay?"

A passionate voice interrupted Wu Liang's thoughts.

(End of this chapter)