"Enough time to fast for water. Wu Mian asked.

"Enough, I haven't eaten or drunk for nearly 20 hours. Director Liang replied, "The patient is an old patient, and all of them have experience in hospitalization, and they know that when they have a stomachache, whether they eat or drink, they are guilty of themselves." ”

Wu Mian nodded, the preoperative preparation is very cumbersome, but it is a routine process, as long as he knows that Director Liang has no red eyes, he has to catch the ducks on the shelves.

When he came to the ERCP room, Dean Xue did not dodge, but took the initiative to put on a lead coat and stand behind to watch the situation.

"Teacher Wu, what do you think I have to pay attention to?" asked Director Liang.

"Just do it slowly, don't rush. Wu Mian said, "If there is any problem, I will say it in time, and I must slow down." ”

"Good. ”

Director Liang put on a full set of equipment and looked thin, but the thick lead suit was obviously a special one.

Wu Mian saw that Director Liang was dressed like a tin man, and he couldn't cry or laugh.

Generally speaking, when I do interventional surgery, I don't want to be fully armed, after all, the equipment I wear more than 20 kilograms is too heavy, and if the operation takes a long time, even Wu Mian's body can't bear it.

At Director Liang's age, he wears a special lead coat, a lead skirt, a lead hat, lead glasses, and a lead scarf that is thicker than ordinary lead clothes......

"Director Liang, can you bear it?" Wu Mian asked with some curiosity.

"Mr. Wu, I was timid back then, and I was forced to be helpless. I know how to eat noodles, but I always have to learn new techniques. Director Liang smiled and put on a leaded glass mask, "Then more protection, I have a wire detection box inside, and when I wear this set of things, the amount of thread I eat is really not big." ”

"How many pounds does this cost?"

“36.2kg。 Director Liang said, "Mr. Wu, don't laugh at me, I'm just cowardly, and there is nothing else wrong with me." ”

"No jokes, no jokes. Wu Mian said, "How many hours can you resist wearing this?"

"I got used to it, and I didn't feel anything. Director Liang said, "Under normal circumstances, 3 hours can still resist." No matter how much I have, I haven't tried it, after all, I still have a group of professors under me, and I only have one or two surgeries a day. ”

Wu Mian nodded, looking at Director Liang dressed like a lead iron bucket, a little funny.

It's not about sticking around at all, it's about driving a tank and going to surgery.

The patient's right forearm has venous access established as part of the preoperative preparation.

"Intravenous iscolidine 20 mg, diazepam 5 mg, meperidine hydrochloride, 50 mg. "The only thing Director Liang didn't wear was lead gloves, after all, he had to do normal surgery. He straightened out his heavy lead coat and gave medical advice.

A nurse in a lead suit immediately gave the patient a bolus of the drug.

These drugs are designed to effectively control gastrointestinal peristalsis and facilitate operation, so as to avoid agitation and delay the operation time.

The patient is positioned in the left lateral decubitus position, with the left arm behind the back. A professor with a group operated the duodenoscopy and Director Liang personally operated the pancreatoscopy.

Normally, the endoscopy nurse assists in the operation of the endoscopy and gently operates under X-ray fluoroscopy. Wu Mian saw that the operation would start immediately, so he said gently, "Director Liang, shall I take a hand?"

"Huh?" the leader of the group was stunned for a moment, trying to get out of his place.

"No, I'll help deliver the camera. Wu Mian said.

The endoscopy nurse was also stunned for a moment, what she did was the simplest "rough work", but Mr. Wu actually had to do this?

Taking the thread from the nurse's hand, Wu Mian smiled and said, "Thank you." ”

"Emmm, you're welcome. The little nurse's face turned red all at once.

"Let's get started, Director Liang. Wu Mian calmed down and said to the screen.

Director Liang first did ERCP, determined the lesion location and measured the diameter of the pancreatic duct, and then inserted the pancreatic duct microscope. The whole process went smoothly, and you can see that he is skillful, and ERCP is not too difficult for him.

Wu Mian is very pleased that there are many doctors who can achieve this level of ERCP, but it must not be said that there are many.

In particular, Director Liang was still wearing a 37-kilogram lead suit......

The weight of the lead coat really didn't affect his operation, maybe he had been wearing it since the beginning, and he was used to it? Wu Mian was very curious about this, maybe it was like a martial arts master laying the foundation at the beginning.

If Director Liang wore an ordinary lead suit, would he fly directly?

All that needs to be done in the early stage is preparation, and the real focus is on the operation of SpyglassDS.

Picking up the lens of SpyglassDS, Director Liang couldn't help but feel a little apprehensive, after all, he has done less and is not as skilled as ERCP.

"Teacher Wu, look ......"

"Just do it slowly, the Spyglass system overcomes the shortcomings of the previous two physicians who generally need to operate and cooperate at the same time, the narrow field of view of the factor scope, and the continuous adjustment of the direction and angle of the over-dilated bile duct to aim at the target. You're just starting out, and it's robust to operate with two people. ”

Wu Mian said briefly, and then watched Director Liang go down the Spyglass lens into the patient's mouth.

Under X-ray fluoroscopy, Director Liang inserted the cannula into the lesion site, and then inserted the pancreatoscope into the main pancreatic duct along the cannula, and the end of the subscope could be observed by exposing the cannula.

The whole process went smoothly, and Wu Mian had nothing to say.

The catheter is pushed via the four-way controllable Spyglass DS, providing a 360-degree panoramic view of the lumen with the ability to navigate through surrounding tissues except for the RT.

What used to be blind spots is now clearly visible on the screen.

After starting the operation, Director Liang entered the state, and the heavy lead clothes on his body seemed to no longer exist, and even Wu Mian standing beside him no longer existed. His hands are nimble, his operation is delicate and gentle, and he carefully observes the 360-degree panorama of the official cavity while retreating from the mirror.

Through ERCP+SpyGlass examination, it was found that the patient's pancreas really had some problems.

The pancreatic duct is dilated, jelly-like material is faintly visible at the RT site, and the mucosa of the nearby pancreatic duct is congested and slightly uneven.

"The internal scaffold is in place, a large number of flocculent mucus-like structures can be seen in the main pancreatic duct, and part of the pancreatic duct in the body is staggered like canine teeth. ”

"Multiple hypoechoic nodules can be detected on the wall of the tube, and the hypoechoic nodules on the wall of the injection of contrast medium show a strengthening signal on the hypoechoic nodules on the wall of the sac, which is weaker than the pancreatic parenchyma. ”

"Consider pancreatic intraductal tumors. Director Liang said calmly.

His nurses recorded the entire procedure on a note sheet and wrote down the diagnosis. The ERCP room was quiet, and only Director Liang was talking.

Xue Chunhe felt a little unfamiliar with the situation in front of him, usually when Teacher Wu was there, Teacher Wu commanded, but this time he was willing to do what a nurse should do.

The operation of ERCP+SpyGlass unfolded smoothly under Director Liang's hands, and he himself was quite comfortable and immersed in it, so much so that he forgot the existence of Wu Mian.

32 minutes, the end of the examination, quite detailed.

Pulling out the camera, Director Liang let out a sigh of relief.

"Teacher Wu, it's done. Director Liang's old face was faintly red.

"Not bad. Wu Mian smiled and helped the nurse tidy up her belongings and take off her lead clothes.

"Do you see a problem with my diagnosis?" asked Director Liang.

"Nope. Wu Mian nodded, "Director Liang, if you want to go to my side, report to Dean Xue within 1 week." ”