Auto chess in the operating room

Chapter 268 The Power of Two-Star Diagnosis
Tang Lou quickly separated the lower pole from the wall of the inferior vena cava, and then freed the caudate process to the right.

"Amazing." Shen Bingbing was slightly surprised, this kid Tang Lou is really good, no wonder he dared to speak like that.She didn't even guide her in this step, so he did it alone.

Surgery continues.

But when Tanglou started clamping, cutting, and suturing the small blood vessels and bile ducts between the caudate process and the V liver segment, the biggest thrill of the operation occurred.

"Tang Lou, stop your operations and leave the rest to me."

Shen Bingbing was directly prepared to interrupt Tanglou's operation. Since the patient's tumor was close to the first porta hepatis, and the patient had a history of abdominal surgery before, the adhesions were severe, the common bile duct suffered some damage, and the bile duct wall was damaged, requiring liver surgery. Roux-en-Y tubejejunostomy.

Shen Bingbing naturally didn't think that Tang Lou could perform such a complicated and delicate anastomosis.

Tang Lou did not stop, but continued to operate, and said flatly: "If it is the first time for me to try the previous operation, then I have already cooperated with Dr. Qingping for the Roux-en-Y anastomosis of the hepatic duct and jejunum. I’ve done several of them.”

Confident, calm, under the aura of the main knife, Tang Lou raised his head slightly, glanced at Shen Bingbing, directly stated the solution, and immediately lowered his head and continued to operate.

Shen Bingbing was in a daze, and nodded instinctively. I have to say that Tang Lou's self-confidence and professionalism are really convincing.

"Absorbable Sutures. Microscopes"

Tang Lou started to perform the extremely difficult Roux-en-Y anastomosis of hepatic duct and jejunum very skillfully.

"Tang Lou, you boy, you are amazing!"

Shen Bingbing saw Tang Lou's operation and completely believed his words. What she didn't know was that under the three-star anastomosis technique, Tang Lou didn't even use his full strength.

After that, Tang Lou blocked the first hepatic hilum at the textbook level, cut the liver capsule around the tumor with an electric knife, dissociated, ligated, and cut off the portal vein and hepatic artery branches entering the caudate lobe
Two to 10 minutes later, the caudate lobe tumor was resected, the dissection was clear, and the tissue was intact.

"Confirm that the bile duct is unblocked and there is no bile leak."

"Second assistant, you can start closing your abdomen."

[Ding, we will complete the new mission differently.Reward: Diagnosis skill upgraded to two stars. 】

Seeing that his panel was equipped with diagnostic skills (two stars, 9), Tang Lou was naturally very excited, and couldn't wait to see the patient who was bleeding from seven orifices.

Action now!

While Director Shen and Doctor Yang were still finishing the work, Tang Lou walked towards the dressing room very ignorantly. To put it bluntly speaking, this was the prerogative of the superior doctor, the chief surgeon.

Shen Bingbing frowned slightly, although she had to admit that Tang Lou was really a genius.However, it is really too difficult to discipline!
"Tang Lou, are you in a hurry to leave?"

Shen Bingbing didn't call Tang Lou directly, but just clicked Tang Lou in a dissatisfied tone.

You don't know how to respect people!
It's like being with you and me one minute ago, and then pulling up your pants the next minute, and leaving ruthlessly. I don't know how to comfort you, hand me a wet wipe or something
"Oh, I suddenly thought of a possibility of Xiao Yunyun's illness, so I'm going to look into it again."

Tanglou nodded matter-of-factly, unaware of the dissatisfaction in Director Shen's tone, and walked away, even quickening his pace.

Listening to Tang Lou's answer, Shen Bingbing was stunned. She didn't know what to say, as if she knew Tang Lou all over again.

"After completing such a difficult operation, he didn't express his merits and pride at the first time, but thought about the recent condition of another patient who had little to do with him? He didn't realize that it might come from his superiors. Physician dissatisfaction."

"He is really an admirable kid."

Shen Bingbing smiled.

A doctor's character is sometimes more important than technology.

"However, it is futile to spend a lot of time on Xiao Yunyun's condition."

Shen Bingbing wanted to stop Tang Lou. After all, even so many experts couldn't find the reason, but it was not easy to dampen his enthusiasm.

Let him go!

Shen Bingbing began to supervise Dr. Yang.

After Tang Lou changed into clean clothes, he rushed out of the operating room.

"Doctor Tang, why did you come out so quickly?"

Yuan Xun was a little surprised to see Tang Lou come out.

"Oh, mine is already done, the second assistant will clean up the rest for me."

After Tang Lou said something, he couldn't wait to rush to Xiao Yunyun's ward.

When Tang Lou stood in front of the patient's bed, his heart beat a few times, took a deep breath, and began to try the power of the two-star diagnostic technique:
[Patient, Xiao Yunyun, female, 1 year old and [-] months old
Symptoms: persistent fever for 12 days, bilateral bulbar conjunctival hyperemia, bleeding from eyes, mouth, nostrils, navel and other organs, and diffuse hyperemia of oral mucosa.Abdominal pain, facial paralysis and arthritis.coronary artery damage.
Diagnosis: The patient suffered from atypical mucocutaneous lymph node syndrome, which is an acute febrile and eruptive disease. It is also called Kawasaki disease in clinical practice. Children under 5 years old are the main group of this disease.

The main manifestations of mucocutaneous lymph node syndrome are enlarged lymph nodes, mucous membrane damage, fever, systemic vasculitis, etc. Once suffering from this disease, it will not only affect the growth and development of the child, but also affect the health of the child. endanger the life of the child.

Because the patient is not typical, it is easy to misdiagnose.

In addition, current clinical treatment of mucocutaneous lymph node syndrome generally adopts drug treatment. Although there are many treatment options, their efficacy is still controversial.

The conventional treatment plan recommends aspirin drug treatment, and then, according to the temperature change of the child, moderately reduce the drug dose, and on this basis, gamma globulin therapy.

System recommended optimization plan: Note that it has not been clinically verified, and it is only used when the patient is seriously ill: methylprednisolone and gamma globulin therapy, in which the usage of gamma globulin is the same as above; the usage of methylprednisolone is: the dose is 2mg·kg- 1·d-1, after continuous intravenous infusion for 5 days, prednisone was changed to oral administration at 2 mg/kg per day for 14 days. 】

After seeing the diagnosis, Tang Lou was also startled. One is that the cause of the patient is too rare, and it is still atypical symptoms. In order to be diagnosed, it really depends on medical experience and a little bit of luck.

The other thing is the shock of the power of the two-star diagnostic technique, not only can it be completely diagnosed, but it can even come up with a plan that has not been proven clinically.

"Little girl, now you are finally saved."

Looking at the little girl with all kinds of tubes and monitoring instruments on the bed, Tang Lou felt a little distressed, but he was finally saved.

"wait for me!"

The next step is to convince Director Shen.

However, he came in a hurry, so he didn't prepare a notebook. Tang Lou came out and walked down the corridor, just in time to see Tian Linsheng in another ward.

He walked over directly and saw Tang Lou, of course Tian Linsheng came over to say hello in a very sensible and respectful manner.

The two exchanged simple politeness, and Tang Lou confiscated his notebook temporarily. Of course, Tian Linsheng had no complaints about it, and was very honored.

Tang Lou quickly returned to the ward and began to record Xiao Yunyun's various physical examinations and inspection data. In order to be able to convince Director Shen, of course there must be sufficient evidence.

While recording, integrate key data and eliminate all kinds of misdiagnosed information.Soon, Tang Lou organized the materials, and then began to write down his own diagnosis results and suggested conventional treatment plans.

After thinking about it, Tang Lou still didn't come up with a system optimization plan.After all, the patient's condition is still within the controllable range. It is better not to use this kind of plan that has not been clinically proven unless it is a last resort.

After Tang Lou finished writing, he was ready to leave.

It's just that Tian Linsheng's notebook is different from Tang Lou's. It is worn and old, and the paper clips are also loose. Therefore, Tang Lou didn't notice that one of the papers recording key data fell off and landed on the under the patient's bed.

Nobody noticed.

Tang Lou waited for a while at the door of Deputy Director Shen Bingbing's office before Shen Bingbing came back from the operating room.

Seeing Tang Lou, Shen Bingbing was naturally very surprised: "Tang Lou, didn't you go to see Xiao Yunyun, why are you here?"

(End of this chapter)