Is this still digging people? Xue Chunhe was quite helpless.

"If it's okay, I'll go first. ”

On this day, as if in a dream, Director Liang watched Mr. Wu leave and was in a trance for a long time.

thought that he didn't have a chance, and kept telling himself that the risk on the side of Bajingzi was too great, but Mr. Wu threw down a sentence lightly and knocked himself unconscious.

It must have been seeing that his level was high, which moved Mr. Wu, Director Liang sent the patient back, sitting in his office and thinking happily.

ERCP+SpyGlass is technology, even in the magic capital, bringing your own teacher to do it is not as smooth as it is today. Could it be that he has accumulated a lot of money and suddenly realized it? Director Liang was stupidly happy.

Every time I make a little bit of progress in technology, I will be very happy, especially Director Liang's own technical level is very strong, and I haven't experienced this pleasant feeling for a long time.

Director Liang recalled the process of making ERCP+SpyGlass, and every step was so smooth and perfect. Looking back now, it's like drinking nectar, and my heart is very happy.

It's no wonder that Mr. Wu didn't hesitate to go over by himself when he saw that he had such an operation, at this level, it was a piece of gold wherever he put it!

The more Director Liang thought about it, the happier he became, and the technological progress made him so excited that he couldn't help himself, like a child who had just gotten a toy, and was anxious to try it again.

Are there any suitable patients in the ward? Director Liang began to ponder this.

There is definitely no such thing as his own group, Director Liang knows it. He thought, picked up his phone, and contacted his subordinate professor to lead the group.

But after thinking about it, Director Liang put down his phone and walked around to the operating room to take a look, ready to familiarize himself with SpyGlass's equipment.

Now he is like a swordsman who has just learned peerless swordsmanship, wiping his sword to the extent that he has reached the level of unity of human and sword, and it is estimated that he will be able to go to the next level in the future.

When he came to the operating room, Director Liang heard the laughter from the nurse's duty room.

"I'll go and hand in the application in the afternoon, and it's useless for you to laugh at me. A voice came out.

"Teacher Wu has a girlfriend, and it's useless for you to go. ”

"What's the matter, it's good to have a look at everything. Buy a ticket for a concert, and you will have to pay more than a thousand in the front row, and you can't see anything yet. Mr. Wu was standing next to me just now, although he was wearing a mask, it was also good-looking, and the masks were much more pleasing to the eye. ”

"Go, go, I'm old, just be a mother and bless me from afar. The head nurse's voice came out.

Director Liang smiled, is the head nurse a fan of his own mother? This is really a world of faces. If you set up a hospital in Bajingzi by yourself, let alone a little nurse, I am afraid that the head nurse who has cooperated for many years will not take you with you.

Look at Mr. Wu, the most lacking nursing power is directly taken away with full blood.

Thinking about things in a mess, Director Liang went straight to the ERCP room.

There are 3 operating rooms in the ERCP room of the Second Hospital of the Medical University, and the innermost is Director Liang's operating room, which is the quietest and has the best equipment. It's the director's prerogative, and no one is going to beep over it.

Director Liang walked briskly, humming a little song in his mouth, ready to inspect the SpyGlass device like a soldier wiping a steel gun.

Suddenly, the door of the second operating room opened, and the operator was Professor Li, who hurried out in a lead suit.

"Director. Professor Li said hello, didn't say anything, and continued to walk out.

"What's the matter, you're in such a hurry. Director Liang asked.

"Director, I did ERCP imaging, and the common bile duct stones looked much larger than the preoperative image, so I couldn't do it, so I was ready for the next plastic stent. "I'll go and talk to the patient's family. ”

Huge stones? Director Liang's mind moved slightly, frowned and said, "What patient?"

"Director. Professor Li stopped and looked at Director Liang and reported, "An 84-year-old male patient complained of epigastric distension and pain for 5 months, which worsened for 4 days. On examination, the skin and sclera are mildly yellowed, the right upper quadrant is mildly tender, and the liver is mildly percussion. ”

"What about lab tests. ”

"TBIL 189.5umol/L, DBIL 113.2umol/L, ALT 226.4U/L, AST 458.2U/L, GGT 1250.8U/L, ALP 1145.3U/L, Alb 24.8g/L, CRP 53mg/L, blood Rt, coagulation normal. CT of the upper abdomen: multiple stones to the common bile duct with dilated bile ducts, multiple stones to the gallbladder, cholecystitis. ”

Professor Li reported, "Director, the CT scan showed that the largest stone in the common bile duct was 3×2cm in size, and it is estimated that it can be removed before surgery. ”

There is an old saying that the heart is separated from the belly, and when put in the medical process, this sentence is quite accurate.

Imaging examinations such as CT and MRI can only provide a reference, and sometimes the results of direct visual inspection are completely different from the imaging results. This has little to do with technology, mainly because imaging is not so accurate.

It is estimated that Professor Li encountered a similar problem.

"The preliminary imaging saw that the stone was very large, but the development was not very good, the guidewire was withdrawn into the knife, I hooked it with a knife, and saw a stone about 2.5cm wide and 4cm long, and there was a small stone below, which seemed to be very different from the preoperative CT. ”

3.5×4cm?What a big stone!

Such a large choledocholithiasis is beyond the therapeutic scope of ERCP stone removal, and if you poke it for a long time, you have to smash the stone, which may lead to damage to the common bile duct.

Professor Li meant that the patient is older, and the next plastic biliary stent will ensure that the bile flows out smoothly. The service life of plastic biliary stents is estimated to be longer than that of patients, and there is no problem of removing them.

In the past, when encountering such a large common bile duct stone, Director Liang would definitely make this choice.

But!

Now he feels like he's leveled up! After a long time in the jungle, he can solve this problem in a new way.

Yes, a new way, an upgraded version of yourself is about to debut!

"Professor Li, I'll talk to the patient's family later. Director Liang said.

"Huh?" Professor Li was stunned.

"You go and push Spyglass's machine over. Director Liang said with a smile.

Professor Li looked at Director Liang and was only slightly stunned, and immediately responded after understanding what he meant, and went to push the Spyglass device.

In the second hand, Director Liang saw the ERCP imaging and mentally assessed the patient's condition. He felt that Professor Li had not done enough, so he went up directly and blocked the RT opening with a stone removal balloon and did another imaging.

Because the RT opening was blocked, the length of the common bile duct stones shown this time was longer than that seen by Professor Li, about 5 cm.

This type of stone is a large stone, and if the patient is a teenager, a laparoscopic cholangiotomy can be used to remove the stone. But after all, the patient is 84 years old, and at such an age, there is nothing wrong with Professor Li's approach.

But now that there is a better choice, Director Liang smiled slightly, and he was in his chest.