Auto chess in the operating room

Chapter 149 Tang Lou's Suggestion: ERCP+EST+LC Combined Operation
"However, the patient's condition is relatively critical now. He has just been rescued. If the time is delayed due to transfer, it may cause irreparable consequences."

From a rational point of view, Qingping naturally agrees with Yan Ruoyun's point of view, but from a doctor's point of view, the patient's life is always the first, so he still insists on the operation. Be aware of the risks of this surgery.

"We naturally understand Dr. Qing's concerns, but the risks of the current surgery are indeed too high, and the attitude of the patients and their families may cause potential medical disputes in the future. After all, this surgery is to be performed by Dr. will prevail.”

At this time, Yan Ruoyun, of course, has to express her opinion. After all, something really happened later, and it was Lin Dong who was responsible.

Lin Dong felt warm when he heard Yan Ruoyun defending himself like this. He was just about to organize his words, how to politely refuse the operation.

I only heard a voice in the corner next to him say faintly: "Actually, Dr. Lin and Dr. Yan mainly think that the risk of surgery is too high. There are indeed some limitations in laparoscopic cholecystectomy alone. However, we can improve it through improved surgery." method to improve the success rate of the operation. It is not impossible to try this operation.”

Everyone turned their eyes to the place where the voice came from, which was naturally Tang Lou.

Lin Dong was a little surprised. Since he had never participated in a consultation with Tang Lou before, in his concept, the moment of being an intern was just to attend the meeting, listen to suggestions, and gain insights.

How could he put forward his own opinions so boldly like him, and what's more, it was an improved technique from the very beginning?

On the contrary, Qing Ping and Yan Ruoyun were not too surprised, and neither stopped nor questioned Tang Lou's words.

Just quietly listen to his explanation.

Lin Dong, seeing the rhythm of the two big men listening attentively, of course closed his mouth, and looked at Tang Lou, feeling very puzzled in his heart.

However, he was also curious about what Tang Lou could say?

"In this patient, I would recommend endoscopic retrograde cholangiopancreatography (ERCP), endoscopic RT sphincterotomy (EST), and laparoscopic cholecystectomy (LC)."

Tang Lou straight to the point put forward his own plan.

Yan Ruoyun and Qingping, after hearing Tang Lou's plan, fell into deep thought, and quickly figured out the reason behind it. These three techniques are very commonly used in the liver and gallbladder field alone, but combined, they can be used There are indeed not many, but it is not without precedent.

Seeing the expressions of Qingping and Yan Ruoyun, Lin Dong naturally understood that Tang Lou's plan was very feasible.

Taken apart, Lin Dong has done all three techniques with his qualifications, especially ERCP and LC, which can be said to be very proficient.

But the combination of the three techniques made him really a little apprehensive.

Ignoring everyone's expressions, Tang Lou continued to explain why he suggested using this comprehensive technique:
"The reason why we think that Hu Jie's laparoscopic cholecystectomy is risky. The biggest hidden danger is that we can't clearly understand the distribution of stones and the stenosis of the patient before operation. At the same time, the conventional cholecystectomy has a lot of blood loss during the operation. The recovery time will also be longer, and Hu Jie has just been rescued, so there are too many uncertainties."

"However, if ERCP+EST+LC is used, the incision is smaller, there is no need to destroy the sphincter of Oddi, and stones can be removed under direct vision of the choledochoscope."

"On the other hand, ERCP can clearly understand the distribution of stones and the narrow position of the patient before operation. The operation is convenient during the operation, and the occurrence and infection of residual abdominal stones can be avoided. During the operation, ERCP water injection can be used to observe whether there is bile leakage, etc., so as to prevent Complications occur."

"In addition, postoperative patients do not need to use T-tubes, which is conducive to the recovery of the patient's digestive function. It is very suitable for patients like Hu Jie."

"To sum up, I think that ERCP+EST+LC for Hu Jie in the treatment of gallbladder stones combined with extrahepatic bile duct stones has a very high success rate, and can significantly reduce intraoperative blood loss, shorten postoperative recovery time, and have high safety. Can try."

After Tang Lou finished expressing his opinions, he closed his little notebook and waited for the responses of the two attending physicians.

Yan Ruoyun was present, the one who had the most research on cholecystectomy and also had the most practical experience. After listening to Tang Lou's analysis, he had already come up with the answer.

Yan Ruoyun didn't express his opinion directly, but wanted to see Doctor Qing's attitude: "Doctor Qing, what do you think?"

Although he mainly specializes in the field of appendicitis, Qingping certainly has a lot of experience in cholecystectomy as a primary and secondary operation, and has experienced many cases under his staff.

After thinking about it, Qingping said decisively: "I support Tang Lou's opinion. If endoscopic retrograde cholangiopancreatography (ERCP), endoscopic RT sphincterotomy (EST) combined with laparoscopic cholecystectomy Surgery (LC), the success rate of this operation is already within the controllable range, and this risk is still acceptable. Of course, before the operation, it is still necessary to communicate with the patient carefully."

After listening to Qingping's opinion, Yan Ruoyun nodded.

In front of the conference table, only Lin Dong was left, staring at Yan Ruoyun's mouth with anxiety.

"The operation can be carried out, and I also agree to operate on the patient. Since the success rate can be controlled, as long as the operation is successful, the so-called entanglement between the patient and his family will no longer exist."

Yan Ruoyun made the final decision.

Lin Dong thumped in his heart, and said with some embarrassment: "Dr. Yan, I also agree with Tang Lou's point of view. The combined ERCP+EST+LC operation is theoretically very suitable for the treatment of this patient. But I don't I have no previous surgery experience, so due to my own uncertainty, this surgery, I think, can still be discussed.”

Lin Dong himself was a little embarrassed, but it was better to admit that he was not good enough before the operation than to stop on the operating table afterwards.

[Ding, new mission: Specializes in treating dissatisfied patients, with superb medical skills, successfully operated on Hu Jie, convincing the patients and their families.Task reward: 2 gold coins, the card library is refreshed once. 】

"If everyone agrees, I am willing to try it, and I will be the chief surgeon."

Tang Lou expressed his willingness to be the chief surgeon in a full-fledged way.

Lin Dong couldn't believe his ears. He said that he was afraid that he might not do well. Tang Lou is so rigid?

Ye Kai and Hong Guan, who had their ears pricked up in the distance, were a little unbelievable. Is Tang Lou crazy?
Such a difficult operation, even Dr. Lin Dong tried his best to refuse, and he even jumped into the fire pit.

"Tanglou, this is no joke. Even I dare not say that I can perform it satisfactorily. After all, this operation is very complicated and requires very high standards from the surgeon. Can you do it? If not, don't force it."

Lin Dong didn't feel that Tang Lou had robbed him of the limelight, but he sincerely persuaded him. If he couldn't do it, he would try to be brave, and then he would have a medical accident, and his family members and patients were obviously not saving money, and he wasn't trying to make himself unhappy.

"I can."

Tang Lou looked at Lin Dong seriously, then at Qingping and Yan Ruoyun.

Under the two-star cholecystectomy, his level is already at the level of a chief physician, and he still has various talents and diagnostic skills.

"I agree."

"I agree."

Qingping and Yan Ruoyun finally came to a conclusion, and the small consultation ended.

(End of this chapter)