As soon as Yao Yusen saw Zhang Gu's reaction, he knew that Zhang Gu had a solution.

This kind of hepatic common duct misjudgment is most needed for nothing else, but precisely an expert in anastomosis sutures.

Just like Zhang Gu.

Zhang Gu's sudden appearance made Yao Yusen's heart feel much more steady! He even felt more down-to-earth than Director Xiang and Director Ning.

Chang Zhang Gu stood on the operating table.

Yao Yusen served as a deputy next to him, and at the same time explained to Zhang Gu the details of the patients and the reasons why they couldn't make up for the difficulties.

The deputy chief physician, whose hands trembled, stepped back from the operating table a little lost, his eyes glancing over the wounds of the patients on the table from time to time, expecting a miracle to happen there.

"Doctor Zhang Gu, what should I do?" Yao Yusen was also completely clueless.

Zhang Gu's gloved hands were already in depth and looking at the patient's wounds.

"Don't worry, find the patient's hepatic duct first. ”

Yao Yusen nodded, the top priority now is to stop the bile leakage first.

Zhang Gu examined the hepatoduodenal ligament stump, and soon, he found a protruding white round hole, which was constantly leaking bile.

Zhang Gu was convinced: "This is the common hepatic tube that was mistakenly judged. ”

"This is the head of the liver, isn't it?" Yao Yusen paused, and the surgical team next to him was also a little confused.

Everyone has a sentence in their hearts, are you really right?

There is a probability of error in intraoperative identification, and the wrong cutting just now, on the one hand, is of course an operation error, and on the other hand, it is an error in identification.

Everyone wondered if Zhang Gu had also misdistinguished.

Zhang Gu said firmly: "This is the common hepatic duct, but the stump of the common hepatic duct in this case is relatively thin, so it doesn't look very similar." ”

Yao Yusen was shocked in his heart, the general liver tube was so thin, he had seen a case before.

Why did you forget about it this time!

Yao Yusen sweated on his back. Empiricism really kills!

He carefully distinguished, a layer of fine beads of sweat appeared on his forehead, and he also affirmed: "That's right! This is the common liver duct, this patient is special, the common liver duct is too thin. ”

He was scared for a while, but fortunately Zhang Gu recognized it, otherwise, I am afraid that there would really be a medical accident this time.

Once this step is complete, it means that a new, more difficult problem has emerged.

The common hepatic duct is too thin, how to anastomosis?

Yao Yusen looked worried: "Doctor Zhang Gu, is this anastomosis more difficult?"

Even if Yao Yusen is not specialized in anastomosis, he also knows that the two parts of the broken end anastomosis are best if the opening is the same and the diameter is similar, and the anastomosis effect is the best.

In this case, the gap between the two sides is too large, and anastomotic leakage is easy to occur.

Zhang Gu's tone was unhurried, and he said: "Just don't do cross-sectional end anastomosis." ”

Everyone looked puzzled, so what should I do?

In Zhang Gu's mind, he consumed a skill blank card "Jejuno-hepatic portal anastomosis." ”

Consumed 3 more beginner cards and 4 intermediate cards to advance to the advanced level.

Zhang Gu: "The excessively thin hepatic duct cannot be forcibly end-to-end anastomosis, which will cause tissue damage and edema, which will bring great disadvantages to wound healing. ”

"The way to deal with this kind of thinning of the common hepatic duct is to directly perform jejuno-common hepatic anastomosis. ”

The reactions of the crowd were mixed, some thoughtful, some had a flash of inspiration, and some were confused.

Yao Yusen remembered that when he went to the provincial hospital for further study, the teacher once gave an example of such a marginal discipline with jejunohepatic anastomosis in the classroom.

This is a cross-disciplinary marginal discipline involving both hepatobiliary surgery and gastrointestinal surgery, which is an emerging discipline, and the teacher has also highlighted it in class.

It's a pity that at that time, Yao Yusen's mind was not in the field of coincidence, so he didn't listen carefully.

Looking back now, he really regretted it. If you could have learned one more skill at that time, you might have been able to save one more patient.

But now a new learning opportunity has emerged.

Since Dr. Zhang Gu said so, it must be that he will also have this kind of jejuno-liver anastomosis!

Yao Yusen cheered up his spirit, and his eyes showed a look of expectation and eagerness to learn.

While Zhang Gu was speaking, he had already begun to suture and seal the stump of the common hepatic duct.

"Bougie 4. Director Yao, help me expand the liver tube. ”

As soon as Zhang Gu spoke, Yao Yusen immediately prepared his deputy.

As soon as the instrument nurse handed over the bougie, Yao Yusen began to fully expose the liver tube.

After the closure and embedding are completed.

Zhang Gu began to do jejuno-hepatic door anastomosis.

Yao Yusen and the others were all staring carefully, for fear that they would miss the key operation in the blink of an eye.

Zhang Gu cut off the jejunum, free the mesangium, and preserved the blood supply at the severed end. At the same time, a long silicone tube is built into the common hepatic hilum tube, which is led out of the body from the jejunal wall, and the distal end of the jejunum is connected to the hepatic hilum.

While Zhang Gu was doing it, he also saw Yao Yusen's eyes eager to learn.

He deliberately mentioned Yao Yusen: "Director Yao, there are a few key points to do this match. First, the external opening of the hepatic surface of the common hepatic duct needs to be dilated and flared suture. ”

"The second is that the difficulty of intraoperative needle insertion is the key, and it is not too deep or too shallow. ”

Yao Yusen nodded repeatedly.

He subconsciously asked, "Doctor Zhang Gu, what happens if it's too deep or too shallow?"

As soon as he asked this, he regretted it!

At such a critical moment of surgery, who can take care of answering his questions?

Dr. Zhang Gu was not his tutor and had no obligation to answer his questions.

What's more, once Zhang Gu answers his question, it will inevitably affect the actual operation of surgery, which is definitely taboo in surgery!

Besides, this operation almost caused a medical accident, and at this moment, there must be no more mistakes.

Zhang Gu calmly explained while operating.

I didn't slow down my movements in my hands because I wanted to explain, and the movements in my hands were still fine, and there was no mistake.

"If the needle is too deep, it is easy to ligate the intrahepatic bile duct together, and if it is too shallow, it will crack due to the fragility of the liver tissue, resulting in the failure of suturing. This strength also requires you to exercise more and figure it out carefully. ”

When Zhang Gu answered, Yao Yusen stared at Zhang Gu's hands in horror.

I was afraid that Zhang Gu would make a mistake because of distraction, and it would be his sin.

As a result, it turned out that he was obviously overthinking, and Zhang Gu's hands were like iron pliers, not moving at all.

After listening to Zhang Gu's explanation, Yao Yusen and several senior doctors all nodded deeply.

The biggest difference between the liver and other organs is that the bile ducts are present in the liver, which needs to be handled with great care.

Under the operating table, a ridiculous thought suddenly flashed in a doctor's heart.

Even Yao Yusen, the director of their hepatobiliary surgery department, needs to think carefully and exercise more intrahepatic stitch techniques, why is this Dr. Zhang Gu, who does gastrointestinal surgery in the general surgery department, so skilled?

Who is the director of hepatobiliary surgery?