For bile duct cancer, surgery is very difficult.

Cholangiocarcinoma is located in the hilar area of the liver, and the tumor will grow along the common bile duct, hepatic duct, and pancreatic duct, and easily invade the 12 denums of the pancreas. Therefore, it is necessary to remove the gallbladder, part of the bile duct, pancreatic head, duodenum and other organs.

Some cancer cells may invade the transverse colon, and an additional section of the bowel may be removed. In addition, as a radical surgical resection of cholangiocarcinoma, dissection and removal of regional lymph nodes are definitely performed.

Therefore, Dean Guo's surgical incision is quite large, reaching tens of centimeters.

This brings difficulty to the operation, and also increases the chance of postoperative infection and complications, and in the words of ordinary people, it is difficult for the body to recover.

Zhang Jun didn't hear the meaning of Dean Guo's words at all.

If it's just inflammation of the bile ducts, surgery is not needed at all, and the surgical incision is just a few centimeters.

However, radical resection of cholangiocarcinoma not only has a large surgical incision and improves the surgical grade, but also has a negative impact on the patient's prognosis.

Who is responsible?

Zhang Jun thought that Dean Guo was encouraging him, so he was full of confidence, and felt that he had received the attention of the big boss and had a bright future.

Dean Guo also sighed in his heart,

Even as the "Mr. One Knife" of the Viet Chung People's Hospital, he was not sure whether the soft tissue shadow was a tumor or inflammation, so even if he was inclined to inflammation in his heart, he finally operated on bile duct cancer according to the results of the department's discussion.

You can't gamble on your reputation, right?

He is not an intern like Zhang Jun and Chen Qi, as a dean, he has more pressure, needs to think more, and cherishes his feathers more.

Speaking of which, in 1982, there were too few advanced examination instruments in hospitals, especially in Huaguo, where there were even fewer instruments and equipment for clinical diagnosis.

Large laparotomy, the procedure was slow and everyone held their breath.

When Dean Guo drove all the way to the common bile duct, he suddenly involuntarily let out a sound from his mouth:

"Huh?"

The people in the operating room are all professionals, and they immediately knew that the answer had been revealed, Jin Peilin and Shen Zhemin, as surgical assistants, were close to the water and the building was the first to take a look.

The two glanced at each other and stepped aside, which made Li Jun, the third assistant, anxious, but the dean and director were there, which round got him as a little doctor presumptuous?

So while he was obediently preparing for the surgical machine, he was so anxious that his butt was oily.

Dean Guo didn't raise his head, and said to the side: "Lao Zhu, Lao Qi, come, you all come to see this surgical vision." ”

Zhu Huoyan and Qi Damin couldn't help it for a long time, the nurse brought two benches, and they stood on them and looked at them, and they also made a sound:

"Huh?"

Zhang Jun stood on the outermost side full of question marks, and at the same time was anxious, wanting to see but not daring to move the position, relatively speaking, Chen Qi was much calmer, he had a hunch, these few "hey", indicating that there was an accident in the operation.

What accident?

The biggest surgical accident is that this is not cholangiocarcinoma at all, and the surgical copy formulated according to the radical resection of cholangiocarcinoma is completely wrong!

Dean Guo spoke again at this time:

"Come, Director Jin and Director Shen, you two get out of the way for the time being, Xiao Zhang and Xiao Chen, you two come over and take a look by yourself, maybe I'm dizzy and can't find the tumor."

Zhang Jun was the fastest, and he was the first to come to the operating table, his eyes widening.

At the confluence of the left and right hepatic ducts, the bile duct does have obvious stenosis, but there is no tumor around it, nothing is seen.

Zhang Jun was so shocked that the decibel of his voice increased:

"Where did the soft tissue shadow shown in the ultrasound go? Where are the medical records? Where is the checklist? It shouldn't be. ”

Dean Guo looked at Chen Qi with an indifferent face: "Xiao Chen, tell me where the tumor is?" ”

Chen Qi wanted to laugh but didn't dare to laugh, and pretended to be serious and said:

"I judged that it was not a tumor before, so there was no tumor, and the soft tissue shadow that Zhang Jun was misled about was simply this, look, here, this is because of the fibrous hyperplasia formed by the scar contracture of the bile duct for some reason, and the B ultrasound looks like a malignant tumor."

The onlookers in the office let out a gasp of cold air.

Qi Damin couldn't help but snort lightly: "It's troublesome, it's a misdiagnosis." ”

Zhu Huoyan looked at Chen Qi at this time, and he couldn't contain his appreciation, this kid was too godly, too powerful.

Zhang Jun almost went crazy when he heard it, "Impossible, how can it be." ”

Dean Guo didn't say anything, but just asked Zhang Jun to be his assistant and conduct a comprehensive investigation of the bile path, but the result was still nothing.

Now, it has come to light that Zhang Jun's diagnosis was wrong, and the doctors who supported his diagnosis collectively misdiagnosed, and the result of this misdiagnosis was that Zhu Changbai was hit by such a big knife.

The doctors in the operating room all have a little scalp numbness, if Director Zhu knows the truth, it will definitely make trouble, and the supply of ingredients in the canteen of the People's Hospital will become a problem in the future.

At the critical moment, Jiang was still old and spicy, and Dean Guo did not criticize anyone, but just silently continued to do the operation.

"Zhang Jun and Chen Qi, the two of you will retreat first, Director Jin and Director Shen will continue to take over, we will first remove all the bile duct tissue in the stricture, and immediately send it to freezing, so that the pathology department can issue a report as soon as possible.

In addition, biliary stenosis is objective, and sooner or later it will affect the patient's future health, so we will do gallbladder removal, and by the way, the hepatic hilar bile duct stenosis will be removed together, and finally a biliary-intestinal anastomosis. ”

As an internist, Qi Damin didn't understand the meaning of this for the time being, and was about to ask a question, when Director Zhu next to him explained:

"What the dean meant, we helped him remove the biliary stenosis, and there will be no systemic infection caused by cholestatic obstruction in the future, and the hidden danger will be completely solved. As for whether it is cancer or not, this needs to be said in the pathology examination report, anyway, our operation was successful. ”

Qi Damin reacted immediately:

"Oh, yes, yes, the operation was successful, the bile duct stenosis problem was solved, the lesion was removed, it was not the best cancer, but the cancer was eradicated."

The tense atmosphere in the office was suddenly relieved, and everyone began to laugh and talk softly.

Chen Qi glanced at Dean Guo and thought that it was really an old fox, so he avoided the important and trivialized, and passed away the previous mistake of misdiagnosing cholangiocarcinoma and expanding the scope of incision and surgery.

Anyway, the patient and the family couldn't figure it out, thinking that the operation should be done like this, and the incision should be so big.

Maybe they were already frightened when they saw such a big incision, and they had to thank Dean Guo for his clever operation and help them completely cure the hidden danger.