Auto chess in the operating room

Chapter 163 New Mission: PTGD
As Fang Qing walked, he greeted Qing Ping and Yan Ruoyun and walked towards the conference table in the middle.

When passing the seat of Tang Lou, Dr. Fang greeted Tang Lou with a smile on his face: "What are you doing in a daze, let's go, come together."

In his tone, he looked like a different person compared to before. After all, the stone that had been pressing on his heart for several days finally fell to the ground, and seeing Tang Lou was also very kind.

Soon, Qingping, Yan Ruoyun, and Tang Lou all came to the conference table together, and sat around the conference table together.

Fang Qing directly spread the ultrasound image on the table, stood with one hand on his hips, and pointed a stubby index finger on it: "Did you see it! Did you see it!"

"Patient's acute cholecystitis changes, the gallbladder enlarges after eating, 10X4cm, gallbladder wall thickness 0.8cm, and fluid around the gallbladder."

"It's really acute cholecystitis."

Yan Ruoyun was also amazed, and looked at Tang Lou, the great hero of the consultation: "Xiao Tang, it's ok. It's really amazing!"

Tanglou smiled modestly: "After all, I only know some symptoms of acute abdomen, it's just a coincidence, it's just a coincidence."

Fang Qing also looked at Tang Lou very curiously. This young man is humble, but it happened to be blindfolded because of his vision?
Fang Qing was a little unsure, but no matter what, as long as he could be diagnosed.

Moreover, now that it is confirmed that it is acute cholecystitis, their internal medicine can be regarded as nothing to do.

Fang Qing licked his lips in embarrassment: "Doctor Qing, Doctor Yan, then the patient will be transferred to your general surgery department. The next step is to deal with the acute cholecystitis first, and then treat the rest. chronic disease."

Hearing that Fang Qing was going to refer the patient to the general surgery department, Qing Ping had no objection, but looked at the patient's symptoms and vital signs, and was a little confused: "Treatment of acute cholecystitis is of course a top priority, but the patient's heart function is extremely poor now. , and the ejection fraction is extremely low, if a cholecystectomy is performed, even a laparoscopic cholecystectomy, it is still difficult to bear."

"Yes, because the patient is too old and has heart problems, open cholecystectomy is risky, traumatic, takes a long time to operate, and causes a lot of blood loss during the operation, which will cause serious complications. stress response."

"At the same time, laparotomy cholecystectomy can also lead to a variety of complications in patients, such as bleeding from the gallbladder bed, cholangitis, bile leakage, and peribiliary effusion, which are not conducive to the prognosis."

Yan Ruoyun also flipped through the patient's case information and sighed: "Doctor Qing is right. Conventional cholecystectomy is definitely unaffordable and our hospital does not have the conditions. There are only two possibilities now. One is , is to choose a less invasive method, and the second is to simply transfer to a higher-level hospital for further treatment."

Fang Qing was not good at surgical options, so he chose to keep silent.

[Ding, new task: Perform percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of acute cholecystitis in elderly patients.Task reward: 5 gold coins, the card library is refreshed once. 】

Tang Lou directly refreshed the card library:
【PTGD (one star, 2), indirect inguinal hernia repair (one star, 2), PTGD (one star, 2), PTGD (one star, 2), indirect inguinal hernia repair (one star, 2)】

Tang Lou directly selected three PTGDs (one star, 2):
【PTGD (one star, 2), PTGD (one star, 2), PTGD (one star, 2) automatically synthesize PTGD (two stars, 6)】

Tang Lou's latest panels:

Level 6: Upgrade 32
Operation column (6/6): suture (three-star, 9), diagnosis (one-star, 3), indirect inguinal hernia repair (two-star, 6), cholecystectomy (two-star, 6), PTGD (two-star, 6), 9), incision (three stars, [-])

Gold: 17
Qingping pondered for a while, then said: "With the patient's condition at present, there is a way to try, but the resident doctors under me are not very familiar with that kind of surgery. It seems that I can only be the chief surgeon."

"Doctor Qing, do you mean percutaneous transhepatic gallbladder puncture and catheter drainage?"

The master of the system has already given the task, so of course Tang Lou can't just give up the chance of surgery and speak out directly.

"Oh, you know?"

Qingping looked at Tang Lou in surprise, he really couldn't understand this young man.

Percutaneous transhepatic gallbladder puncture and drainage is often used in the clinical treatment of acute cholecystitis, especially for elderly patients, because of its small surgical trauma, short operation time, and fewer complications.

Percutaneous hepatic gallbladder puncture and drainage of the gallbladder can completely remove the infected bile in the body, effectively control the toxins absorbed by the gallbladder cavity, and avoid complications.

It belongs to a minimally invasive surgical treatment method, which is safe and reliable, but this kind of surgery has relatively high requirements for the surgeon.

Yan Ruoyun also looked at Tang Lou, very pleasantly surprised: "Tang Lou, what do you mean?"

Tang Lou nodded, and said calmly and calmly: "Doctor Qing, Doctor Yan, I know PTGD very well, and I have studied it deeply. I hope to be the chief surgeon for this operation. With you guiding me, I can do it." Competent."

As he continued to prove himself through surgeries and diagnoses, Tang Lou was now quite confident, and his opinions had to be seriously considered by the attending doctors.

Qingping thought for a while, PTGD is indeed a bit complicated, but it is only for ordinary residents. Compared with Tang Lou's previous ERAT and X-CONE single-channel laparoscopic cholecystectomy, it will only be simpler .

Moreover, Tang Lou has a deep understanding of the anatomical structure of the gallbladder. After a brief evaluation, Qingping was shocked to find that Tang Lou had grown to this point without knowing it.

A PTGD that ordinary residents can't handle, but it becomes no difficulty in Tanglou.

Qingping didn't know whether he should be happy or sad. At this stage of Tanglou, he was thankful to be able to cut his abdomen. If he could cut a simple appendix, he would be happy for a week.

"Then it's settled. Tang Lou, please refine the operation plan and report to me later. If there is no problem, we will arrange the operation in the afternoon."

Qing Ping finally came to a conclusion, Yan Ruoyun also nodded, looking at Tang Lou with a fearful look.

Looking at Tanglou, Qingping remembered a person, once the best young man under Deputy Director Shen Bingbing, Dr. Wang Chuan, who was equally radiant.

Speaking of it, Wang Chuan was more energetic than Tang Lou at that time, and he had no rivals in surgery at his age. He was favored by the professor of the Imperial Capital Union Hospital and invited to study for one and a half years, specializing in the field of acute abdomen.

Speaking of which, my training career is about to end.

Wang Chuan is not only proficient in basic operations such as appendicitis and cholecystitis, but also has a lot of knowledge in abdominal external hernia. When he was still in the city's first hospital, he performed the classic Bassini operation. The postoperative pain and discomfort and recurrence rate are comparable to those performed by ordinary surgeons. Tension-free hernia repair.

Not surprisingly, after Dr. Wang Chuan came back, there would be a second deputy chief physician in the Department of General Surgery of the First City Hospital, and he would be a powerful star doctor with a halo on his head.

It's just that Wang Chuan is too good, and Cheng Jian can't hold him down. To be honest, he doesn't pay attention to the entire surgery department of the city's first hospital.

For Wang Chuan, Shen Bingbing is an unspeakable affection, like a sister but better than a sister, the taste in it is beyond words...

Thinking of Director Cheng, Deputy Director Shen Bingbing, and Deputy Director Wang Chuan, the general surgery situation will also undergo earth-shaking changes.

Qing Ping was a little belated. Could it be that Tang Lou was selected? In addition to the establishment of a provincial acute abdomen subject point, Director Cheng also had this deep meaning.

Thinking of this, Qingping looked at Tang Lou again, his attitude changed again, he supported Tang Lou's surgery more and more, he needed to grow faster.

Of course, Tang Lou knew nothing about this. Half an hour later, he reconfirmed the operation plan and signed the consent of the patient's family.

In another 10 minutes, Tang Lou's first PTGD officially started.

(End of this chapter)