The doctor in charge of emergency B ultrasound in the B ultrasound room knows Zheng Ren, after all, the most important thing for emergency B ultrasound is the emergency department.

He smiled and said, "Mr. Zheng can even do B ultrasound by himself?"

"I understand a little. Zheng Ren took the probe, pulled twice on the patient's stomach, found the position he needed to see, and carefully looked at the image on the screen.

There was indeed a blockage at the distal end of the bile duct, and under the B-ultrasound, Zheng Ren changed two hand types, and the lateral and anteroposterior positions determined that the blockage was not a denser stone, but a rotten and fermented food residue.

The point of occlusion is consistent with the postoperative complications of choledochoduodenal anastomosis, and the differential diagnosis excludes the possibility of biliary end-to-side Roux-en-Y anastomosis and choledochoduodenal fistula.

Bile duct dilation is evident, which is the cause of obstructive jaundice.

Pneumata may be seen in the biliary tract and cystic encapsulation may be seen in the liver, and liver abscess is highly suspected.

It should be cesspool syndrome, depending on the patient's condition, emergency surgery is needed.

Zheng Ren put the probe on the rack of the B-ultrasound, picked up the square toilet paper, threw it at the patient, and said casually while pondering the way of the operation: "Wipe it." ”

"Mr. Zheng, are you sure?" Zheng Ren's skillful technique, the doctor in the B-ultrasound room admired it very much, at least he would never be able to reach Zheng Ren's level.

I can't do it, but I can still understand the image, and I don't have to do it myself.

He asked, rubbing the couplant off the patient.

"It should be certain. Zheng Ren said: "Director Xia, if the patient's family agrees, let's do surgery." Before the operation, I asked the patient's family to go to the emergency ward to find me. ”

"Hmm. Director Xia nodded, his expression heavy and serious.

This patient is very different from the patient who had the TIPS surgery last night.

Director Xia doesn't know or familiarize himself, so he can't say as confidently as he did last night, I'll sign for the emergency surgery.

It is also necessary to communicate with the patient's family and explain the condition. However, these things can also be left to Zheng Ren to do.

Zheng Ren walked out of the gastroenterology department, still entangled between laparoscopic surgery and laparotomy.

If the laparoscopic surgery is performed, the patient is less traumatic, and the patients who underwent laparoscopic cholecystectomy in the emergency ward all run home on the first night after surgery.

However, patients have various complications, and if you want to solve them all in one operation, laparotomy is the best option.

But......

"Boss, you just threw the toilet paper on your body and said wipe it, that feeling, you really look like a scumbag. Su Yun said with a smile.

At this time, only people like Su Yun can laugh.

Zheng Renleng paused for a moment, and then realized what Su Yun meant. I was distracted just now, but I didn't expect Su Yun to grab the pigtail.

Scumbag ...... Gee.

It's really imaged, and Zheng Ren is also happy.

"What do you want?" Su Yun immediately asked seriously.

"Is it laparotomy or laparoscopy. ”

"It has to be open, and it is difficult to remove food residues with a laparoscope. Antibiotics are too troublesome to use after surgery. And, the main thing is that I don't want to hold the mirror. Su Yun was right.

Su Yun, who looks delicate like a little girl, pursues surgical fields and wants to be spacious and atmospheric, so when he was a graduate student, he chose thoracic surgery.

With the evolution of minimally invasive surgery, thoracotomy in thoracic surgery has also decreased rapidly, and large incisions of 40 cm are rare.

Zheng Ren suspects that this was Su Yun's initial motivation to study heart transplantation.

"Then it's good to have a stomach. Zheng Ren also made a decision, not because Su Yun didn't want to hold the mirror, but because the patient's condition was complicated, and he might have to use a B-ultrasound probe to find the point of the liver abscess during the operation, and puncture and extract the pus. In addition, it is necessary to deal with a series of operations such as stalk yellow.

The two returned to the emergency ward, and today Director Pan arranged for Yang Lei to be on the first shift.

Chang Yue took the professor to walk around the wards, chatted with the patient's family, and talked about why he violated the rules and went home last night.

After turning around the ward, Chang Yue found that he had taken Professor Rudolf Wagner to the ward, and the patient's medical compliance had at least doubled.

In Haicheng, I often see interns on ward rounds. But with a foreign "intern" to do rounds, no one has seen it.

The ward was in order, and Zheng Ren informed Yang Lei that he was ready to go to surgery.

Because of Yang Lei's request that day, Zheng Ren also wanted to let him have some surgery and improve his level as soon as possible.

Just a few months ago, Zheng Ren was still entangled in Cen Meng and Director Liu's refusal to let go of his own surgery.

I didn't expect that now he could let someone else operate.

When I think about it, it's all so mysterious.

Soon, Zheng Ren received a call from Director Xia, saying that the patient's family had agreed to the operation and was on his way to the emergency ward. She also made preoperative preparations, and pushed the patient to the operating room when she was ready.

Director Xia's behavior is quite resolute, and Zheng Ren appreciates this kind of character.

Zheng Ren didn't throw the things he explained before the operation to Yang Lei or Chang Yue to do.

Because when the patient's family says that the patient's past history, there is ambiguity. Zheng Ren wanted to determine whether it was because of a lack of expertise or because it was intentional.

The difference between the two is gone.

The patient's family soon arrived in the emergency ward, two middle-aged men, who were supposed to be the patient's sons.

In the ward before, Zheng Ren had also seen the two of them.

He looks kind and positive.

Zheng Ren inquired about the patient's previous situation, judging from the body language of the patient's family, it should be due to a lack of professional knowledge, coupled with the long time ago, when the patient underwent surgery, the two of them should not be adults.

With that in mind, everything is on track.

Explain the possible situations during the operation one by one, and explain the patient's current condition to the patient's family, it is not possible to do no surgery, and there is a 30% chance that he will not be able to come to the stage after surgery.

After Zheng Ren finished speaking, the patient's family's face turned pale and cold sweat flowed.

Su Yun saw that there was no problem with this, so he and Yang Lei went directly to the operating room to do all kinds of preoperative preparations.

The family still signed the word agreeing to the operation, Zheng Ren handed the signature form to Chang Yue, and went to the operating room.

Professor Rudolf Wagner went with Zheng Ren to change clothes and enter the operating room. He did not repeat the verbosity, and tried to persuade Zheng Ren to go with him to Heidelberg, Germany to establish a research group.

Jung In didn't bother to think about what was really going on in his mind, and all his attention was on the surgery that was about to begin.

Cesspool syndrome, I hope it's not too heavy.

In the process of changing clothes, Zheng Ren went to the operating room of the system again and practiced ten surgeries on the sewage pool syndrome.

The operation process was very smooth, after all, Zheng Ren is a master of general surgery, and with experience in hepatobiliary anatomy, the local dissection is very powerful.

The basic skills are solid, and any surgery is very fast.

Ten units are already very cautious and cautious.

Hearing the sound of a flat car, Zheng Ren happened to change his clothes and walked into the operating room.

"Mr. Zheng, I'm starting anesthesia, do you need anything?" asked Chu Yanzhi.

"General anesthesia, nothing else is needed for the time being. Zheng Rendao.