Exploratory laparotomy, also known as exploratory laparotomy, is an examination and/or treatment method used by general surgeons to find the cause or determine the extent of the lesion and then proceed with the corresponding surgery. Indications include abdominal injury, acute upper gastrointestinal bleeding, abdominal mass, and acute intestinal obstruction. Its risk and technical difficulty coefficient are relatively low, not to mention a tertiary hospital such as Tianyang Maternal and Child Health Hospital, even in a grassroots hospital such as a township health center, which is a common type of surgery in primary hospitals.

For extensive necrosis of the small intestine caused by acute intestinal obstruction, such as Fan Leilei, if you can't determine the extent of necrosis, then you can draw the most accurate conclusion by doing a laparotomy and opening the stomach to actually examine it.

Huang Guohui smiled bitterly, he was afraid that Zhang Xiangyang would make such a suggestion. As a pediatric surgeon who has been practicing medicine for many years and has such a senior title as deputy chief physician, Huang Guohui would never have thought that he could perform a laparotomy on Lei Lei first to open his abdomen?

But the problem is that for Huang Guohui, the stomach is easy to open, and it is difficult to sew it again. This is the biggest difference between pediatric surgery and general surgery.

If it is for adult patients, if the imaging examination results show that there is extensive necrosis of the small intestine, but the degree and extent of necrosis can not be determined, you can first do an open examination, if it is found that the degree of necrosis of the small intestine is so serious that there is no rescue value, then the wound is sutured, sent back to the ICU ward, and the family is prepared for the future.

But for infant patients like Lei Lei, if the doctor opens the abdomen and finds that most of the necrosis of the small intestine has no rescue value, and then prepares to suture the wound as it is and send it back to the ICU ward, it may be better to meet reasonable family members, and those irrational family members may be smashed on the spot.

It is precisely because of this that Huang Guohui did not tell Tian Guifen about laparotomy, but directly said that he would undergo small bowel resection, and told her the serious consequences after the total removal of the small intestine, just to deter her in this way, so as to avoid getting into trouble.

Now that Zhang Xiangyang has raised this issue, Huang Guohui is no longer easy to avoid.

"Director Zhang, laparotomy is just the most common examination method for your general family, but for our children, it is much more complicated!" Huang Guohui decided to put his concerns on the table to talk, "Take Fan Leilei as an example, if you decide to carry out laparotomy, then once it is confirmed that it is indeed extensive necrosis of the small intestine, what should you do? When the time comes, do you choose to continue with the next step of total small bowel resection, or give up the operation, suture the abdomen as it is and send it back to the ward, and let the child fend for himself?" Director Zhang, tell me, which choice do we make, and are you sure that Fan Leilei's family will not make trouble?"

"Well...... Zhang Xiangyang hesitated, not knowing how to answer Huang Guohui's question.

Although he knew that the implementation of laparotomy was the safest plan at present, in order to fight for that last opportunity, he hoped that if Ren Jiangchi's pulse diagnosis could be correct, then the child's life could be saved. But will Tian Guifen understand it in this way? Can she understand that the purpose of performing the exploratory laparotomy is to give her grandson a chance to survive at the last time? Once the opposite result is reached, how can he dare to package a ticket to Huang Guohui and guarantee that Tian Guifen and her other family members will not make trouble?

"Director Huang, I'm in charge of doing Aunt Tian's work, you just need to clearly list the relevant terms on the informed consent form for the operation, and I'll ask Aunt Tian to sign a guarantee that you won't be held responsible, isn't it?" Ren Jiangchi interjected.

"This is a solution!" Zhang Xiangyang nodded and asked Ren Jiangchi, "Are you sure to persuade Tian Guifen to sign?"

"There should be this certainty!" Ren Jiangchi said, "I think Aunt Tian will definitely agree to give it a try, you can't just watch Lei Lei wait to die without taking any measures, right?"

"Director Huang, what do you think? I think you can let him give it a try, as long as Tian Guifen is willing to sign this, won't your responsibility be cleared?" Zhang Xiangyang said.

"That's right, Director Huang, just raise your noble hand and help out!" Liu Nana also looked at Huang Guohui pitifully.

"Okay! Since Director Zhang is here, I have to give this face no matter what!" Huang Guohui shook his head and smiled bitterly, and said to Ren Jiangchi: "Then you go to do Tian Guifen's work." At that time, I will include the terms I just talked about in the informed consent form for surgery, and as long as I am willing to sign, I will arrange for exploratory laparotomy immediately!"

"Okay, you guys wait for my news!" Ren Jiangchi stood up and walked out.

Fang Shengxue hurriedly followed.

"Jiang Chi, are you really sure to convince Aunt Tian?"

"Give it a try, if she really wants to save Lei Lei's life, there is only one way left!"

In the clinic, Huang Guohui looked at Zhang Xiangyang and shook his head again and again, and said, "Old director, I was put on the fire by you today!"

"Don't be so pessimistic, I think Tian Guifen is also a reasonable person!" Zhang Xiangyang touched a cigarette and threw it to Huang Guohui, "The heart of the doctor's parents, although there is a certain occupational risk, but we can't just watch the patient not be saved, right? As long as we do our best, whether it is the patient or the family, they should be able to understand." ”

"The lesson of the old director is that I have also been frightened by all these years of medical trouble!" Huang Guohui took two puffs of cigarette, and then spewed it out again, hiding his face in the smoke.

Soon, Ren Jiangchi and Fang Shengxue took Tian Guifen to the consultation room.

Huang Guohui sighed softly, obviously he didn't expect Ren Jiangchi to do Tian Guifen's work so quickly.

"Director Huang," Tian Guifen looked at Huang Guohui with red eyes, "I can promise you that you will never make trouble, but before that, I still have some questions for you." Tian Guifen said.

"What's the problem?" said Wong.

"I just wanted to ask you, if my family Lei Lei is just an ordinary intestinal obstruction, and the necrosis of the small intestine is no more than ......," Tian Guifen said as she looked at Ren Jiangchi.

"No more than two centimeters!" Ren Jiangchi said with a nod at her.

"Yes, the necrosis of the small intestine is no more than two centimeters," Tian Guifen turned her head again and looked at Huang Guohui, "Then you have surgery to remove the obstruction, will Lei Lei's life be in danger?"

"As far as Lei Lei's situation is concerned, the necrosis of the small intestine is not more than two centimeters, as long as it is no more than fifty centimeters, his life will not be in danger!" Huang Guohui replied while looking at Zhang Xiangyang, "Old director, am I right?"