Ten minutes later, Lin Yuming came in and sat on the rostrum with a smile on his face holding an enamel jar.

He looked around the lecture hall, and most of the clinical directors had arrived.

Dozens of directors, deputy directors, and responsible attending doctors represent the backbone of the mine.

When the person arrived, Director Li of the Department of Gastroenterology sat in the front row, trembling.

Lin Yuming picked up the enamel jar, blew the tea foam, and drank saliva.

"It's almost over, and now the whole hospital consultation will begin." Lin Yuming's voice came out through the microphone and buzzed in the lecture hall.

"General surgery reports the medical history first."

There was silence in the lecture hall.

There are a lot of consultations in the whole hospital, and it is said that it is the whole hospital, but in fact, there are too many three or five related departments. With so many people gathered here today, it should be ...... No, there must be cats.

Everyone knows that stretching their necks is ready to watch the excitement.

Chen Yong stood up stubbornly, and he tried to report his medical history on the spot, but Luo Hao stood next to the microphone on the podium and waved at Chen Yong.

There is no way, Chen Yong hates Luo Hao to death at this moment.

When he came to Mike, Chen Yong took the medical records and began to report on the patient's condition.

"The patient suffered from abdominal pain and jaundice all over the body......"

Chen Yong's hand holding the medical record trembled a little, this was because of excitement, excitement, and excessive adrenaline secretion in his body, not because he was afraid.

After making a start, Chen Yong calmed down, his body had adapted to adrenaline, his hands no longer trembled, and the more he spoke, the more fluent he became.

A few minutes of medical history presentation, concise and quite competent.

After he entered the hospital, he was brought up by Jiang Wenming, and his basic skills were solid and reliable.

Lin Yuming was very satisfied with the medical records reported by Chen Yong, which were detailed and appropriate, highlighting the key points. If the young doctors of the mine are like him, it can really be said that the future is promising.

"After the medical history is reported, which director will say his opinion first." Lin Yuming asked.

Director Li of the Department of Gastroenterology hesitated to stand up, but as soon as she moved, she saw Wen Youren beside her striding onto the podium.

"I'll throw bricks and stones, let's talk a few words first."

Wen Youren stared at Director Li viciously, his eyes full of disdain, like looking at a dead man.

"As soon as I reported my medical history, everyone also heard that the patient had a cholecystectomy 20 years ago." Wen Youren said loudly, "20 years, 20 years have passed, I don't know what the Department of Gastroenterology thinks, and I still send patients to our general surgery department." ”

"Could it be that the patient's gallbladder will grow out again within 20 years, and I need to go on stage to cut it again?"

"Director Li! In the hospital, the Municipal Health Commission repeatedly demanded that patients should not be blamed, and the first diagnosis responsibility system should be implemented. How do you do that? If you can't understand the disease, you can push the patient to the brother department?! ”

The smell of gunpowder filled everyone's mouths and noses, and even the doctors who were the most slow to perceive looked at Director Wen in amazement at this moment.

This is a hospital-wide consultation, which is clearly Wen Youren venting his personal anger.

It seems a bit excessive, some directors and responsible attending doctors thought in their hearts.

But when they saw Director Lin Yuming calmly holding the enamel jar and drinking tea, they were helpless.

Wen Youren is looking for an endorsement from the medical department to give a good look to the gastroenterology department.

Alas.

It's all colleagues, so why bother.

"The patient had a liver abscess, and I think that's why the gastroenterology department pushed the patient to me. Director Li, sit down first and listen to my words politely. Wen Youren's words began to go wild.

He also caught a glimpse of Lin Yuming's small movements, thinking that Director Lin was conniving at him, so he became more and more unscrupulous.

"What about liver abscess? Surgery? Not afraid of postoperative sepsis? To treat liver abscesses, it is necessary to puncture! Puncture!! Puncture!!! ”

"In the three-base training, the puncture technique is something that every doctor must master, and it doesn't have to be transferred to our general surgery department to be treated, you Li Shumei don't say no!"

Wen Youren has already begun to name names.

Director Li's face was red and white for a while, and he almost cried without being angry.

"Pushing the patient to me for general surgery is ill-intentioned! If I go on stage for surgery, and the patient has a high fever after surgery and has to be admitted to the ICU, is you Li Shumei in charge, or my Lao Wen is in charge!! ”

"I'm a surgeon here, and the proportion of medicine is low. Patients are likely to have complications such as sepsis that require advanced antibiotics. You're pushing the trouble on someone else and keeping cost-effective patients in your gastroenterology department! ”

"Shameless!!"

Wen Youren's words became more ruthless than one sentence, and he even said things that he usually wouldn't say such as cost performance, and finally scolded him bluntly.

"I ......"

Director Li of the Department of Gastroenterology wanted to refute, but there was no microphone in front of her, and the sound was ignored like the buzzing of mosquitoes in the lecture hall.

"Just kidding!" Wen Youren continued to accuse, "This is a prevarication of the patient, and the spirit of the document of the Municipal Health Commission and the General Medical Office of the Mine has not been accurately implemented." It is not responsible for the general manager of the mine, it is not responsible for the dean, and it is not responsible for the director of Lin!! ”

All the directors present were dumbfounded, Lao Wen's temper was not good, everyone knew it.

But no one thought that Wen Youren would go crazy this time, relying on the support of the medical department, he didn't mention the patient's condition at all, and pointed the finger at the Department of Gastroenterology.

The contradiction between general surgery and gastroenterology has been going on for a long time, and everyone knows this, but they never expected that Wen Youren would attack the gastroenterology department through the consultation of the whole hospital.

"Director Li, tell me about your condition." Lin Yuming interrupted Wen Youren's words.

If you continue to talk about it, you may have to scold your mother, Lin Yuming has been controlling the rhythm.

Wen Youren looked at the short Director Li with disdain.

Director Li's blood pressure rose from anger, walked up to the podium, and calmed down for two minutes.

These two minutes were extremely embarrassing.

The lecture hall was quiet, everyone was staring at each other, and a few doctors who were familiar with the director of the Department of Gastroenterology wanted to stand up and help her say something, but they gave up after thinking about it for a long time.

"The patient's condition was complicated, and ultrasound showed liver abscess complicated by pneumotrium. I think it's probably caused by local inflammation. ”

"What inflammation?" Wen Youren asked loudly, "The gallbladder has been removed, and there is no clear stone in the biliary tract, where do you say the inflammation came from?" It's not a liver abscess yet! ”

"Besides, there is inflammation that can be solved by internal medicine, what does it have to do with surgery?!"

Wen Youren's attitude is aggressive.

Although there was no microphone, his voice was so loud that the head of the gastroenterology department was out of breath.

Luo Hao stood by the curtain and watched all this.

Director Li faced the aggressive Wen Youren and did not give a strong counterattack.

It seems that Director Li does not know about the sewage pool syndrome, but she only judges that the patient may have something to do with the gallbladder removal 20 years ago based on her years of clinical experience.

But if she wants to explain why specifically, Director Li has not been able to catch it.

You still have to do it yourself.

Luo Hao looked at Lin Yuming, and after a while, Lin Yuming saw that Director Li stopped talking, and his face was flushed, and he also looked at Luo Hao.

Looking at each other, Luo Hao nodded.

Lin Yuming's hand was removed from the enamel jar, placed it under the table, and made a knife and two movements.

Luo Hao nodded seriously.

"Director Li, then you take a rest first, they are all colleagues in the hospital, some small conflicts are normal, and Director Wen doesn't need to go online."

Wen Youren looked proud, as if he had won a big battle.

"Which other director to talk about, let's talk about the condition first." Lin Yuming was not in a hurry, and looked around.

No one spoke, no one spoke.

A few seconds later, Lin Yuming nodded, holding the enamel jar in both hands, "Then our medical office will give you your opinion for your reference." ”

Well?

The directors were stunned.

What does the medical office say about its opinion?

The whole hospital consultation, the medical office is only responsible for presiding, so that the relevant departments do not play the ball.

How does the referee get off the field?

Luo Hao stepped onto the podium, and there was an uproar in the audience.

Once upon a time, everyone was full of expectations for this young doctor of Xiehe, but Luo Hao has been in obscurity for nearly two years, so that everyone has forgotten that there is still this person.

Recently, Luo Hao has been a little active, but only obstetrics and gynecology and general surgery are related departments, and others don't know much.

Luo Hao opened the notebook, connected the projector, and opened the ppt.

Yo he!

Specialized!!

The directors and responsible attending doctors in the audience were dazzled.

This is the style of those experts and professors when the annual meeting of the discipline was held, but I didn't expect to see it in the hospital-wide consultation.

The consultation time of the whole hospital is urgent, and I have never seen a PPT before.

This time it was an eye-opener.

"Hello everyone, on behalf of the Medical Department, I would like to talk about this case, and I would like to ask you to point out any shortcomings."

Luo Hao said loudly.

The smile on his face was warm, warm, and generous, like a ray of sunshine shining into everyone's hearts.

The anger that Wen Youren brought to everyone just now was swept away.

"Dr. Chen has just reported his medical history, and we have skipped this paragraph." Luo Hao said, "Here is the magnetic resonance cholangiopancreatography done by the patient 5 hours ago, referred to as MRCP. ”

The image appears on the screen.

"Biliary-intestinal communication between the proximal duodenum and the common bile duct can be seen, and there is a poorly contoured hypointense filling defect in the intrahepatic and external bile ducts......"

Luo Hao began to talk about the film of magnetic resonance cholangiopancreatography.

This paragraph involves the advanced content of the imaging profession, even if all the directors of various departments and responsible attending doctors are here, but those who can understand it can count it on one hand.

Don't say you understand, Luo Hao explained, not many people can understand.

"To sum up, magnetic resonance cholangiopancreatography showed the presence of intestinal contents at the common bile ductoduodenal anastomosis."

Intestinal contents.

Anastomosis......

After a brief pause, the directors present frowned.

"Anastomosis? What anastomosis? The patient himself said that he had a cholecystectomy 20 years ago, and where did the anastomosis come from. Wen Youren asked in surprise.

In an instant, countless memories surfaced in Wen Youren's mind, and he realized that something might be wrong.

"Yes, anastomosis." Luo Hao smiled slightly, "In the past history, Director Wen's description is wrong. ”

Mistake!

Wrong!!

Luo Hao bluntly pointed out that Wen Youren was wrong!!

The smile on Wen Youren's face condensed into ice in an instant, and the iron was terrifying, and Luo Hao's words confirmed some of his guesses.

"Impossible! The patient complained that he had a cholecystectomy in our hospital 20 years ago, which is what the patient said! Wen Youren shouted loudly.

"Director Wen, please be quiet, this is a hospital-wide consultation." Luo Hao looked at Wen Youren indifferently, "Since the operation was done in our mine, the medical records must be in the medical record room." ”

As he spoke, Luo Hao clicked on the computer screen to switch interfaces.

Ancient, yellowed medical record paper appeared in front of everyone.

Even if it's just an image, everyone here can smell the taste of time flies from the handwritten medical records of that year.

Although the medical record room is located there and the past medical records are on the medical record shelf, no one has ever searched the patient's past medical records, let alone the current patient who had an operation 20 years ago.

Both Li Sumei and Wen Youren missed this point.

Many directors and responsible attending doctors have 2MB brains that don't understand the content of 10G at all, and all of them are down.

Luo Hao gently slid his fingers and found the surgical record written by the old director himself.

"Here, the surgical record written by the old director of the General Surgery Department of our mine, Guohua."

"I checked the handwriting, and it was written by Director Guohua himself."

Write it with your own hands!

In those days, when medical records were written by hand, it took 20 minutes to write an operating record, and the old chief surgeon actually wrote it by himself, instead of handing it over to his doctors to do these chores.

Luo Hao's words immediately attracted the attention of the doctors.

No need to knock on the blackboard, everyone knows that's the point.

Especially Director Wen Youren, he looked at the familiar handwriting in a daze.

It is indeed the handwriting of the old director, and it cannot be faked.

And the old director wrote the operation record by hand, and Wen Youren knew that there must be a problem with the operation without looking at the content, or that there might be a problem.

In order to avoid accidents or unclear writing by his doctors, the old director will carefully write the surgical records by himself.

The old director of Guohua looked rough, but in fact, he was as careful as a hair, and he must have done this for a reason.

Wen Youren's heart hung in the air.

He already smelled danger.

Keep your eyes on it.

Wen Youren instantly fell into an ice cave.

The patient did indeed have a cholecystectomy back then, but because the book found a large number of sediment-like stones in the common bile duct, the old director did a lateral duodenal anastomosis of the common bile duct in addition to removing the gallbladder.

If so......

Wen Youren's hair stood on end all of a sudden.

"Common bile duct duodenal lateral anastomosis, this was the procedure of the year. There's no way we can criticize a patient, a person who is not in the medical profession can say this. In general, patients only know that their gallbladder has been cut out. ”

"The medical records are in the medical record room, I think if you have a little bit of professionalism, you should take a look, you say, Director Wen."

Luo Hao smiled, gentle and firm, and looked directly at Wen Youren.

！！！

Wen Youren's blood surged, and he was angry.

This is a slap in the face!

I slapped myself in the face in front of the directors of all departments and the attending doctors in charge!!

Crackling.

And I can't refute it.

"What if you did? The gallbladder has been cut out, what else can surgery do?! Wen Youren began to mess around.

"Director Wen, just because you're loud doesn't mean you're justified." Luo Hao replied indifferently, "Next, let's talk about the postoperative complications of the common bile duct duodenal lateral anastomosis." ”

Luo Hao didn't give Wen Youren a chance to roll around like a shrew, and began to talk about the postoperative complications of the common bile duct duodenal lateral anastomosis.

"The patient's diagnosis should be cesspool syndrome, also known as blind end syndrome, blind bag syndrome, blind fossa syndrome."

"On the magnetic resonance imaging, we can also see the accumulation of food debris, stones, etc. in the blind pocket formed from the biliary anastomosis to the ampulla of Vater, thus causing a series of clinical symptoms."

"The relevant diagnosis is based on ......"

"The relevant differential diagnosis is ......"

Luo Hao talked eloquently on the podium.

Reasonable, well-founded.

It was as if he were writing a medical record, telling everything out of his mind.

Director Wen, who was still in a state of anger and resentment at the beginning, turned pale and his hands trembled.

Doctors, rely on professionalism to speak.

Before becoming an evil dragon, every doctor's dream was very simple - to cure the sick and save people. (Note: This sentence is from this chapter)

Even if he has become an evil dragon, he can only be speechless in the face of iron-like facts that he cannot shake.

Wen Youren thought of Luo Hao's smile and thought of him asking himself for instructions to do magnetic resonance cholangiopancreatography on the patient.

Scene by scene flashed in Wen Youren's mind like a marquee before death.

He realized in a daze that he had fallen into a trap.

Looking at Director Lin, who was holding an enamel jar and drinking tea slowly on the rostrum, and then at Luo Hao, who was high-spirited and attacked him with iron-like facts, Wen Youren's mind went blank.

The only thing these two have in common is that they hide a knife in their laughter and are fooled!

"Cesspool syndrome is a classic surgical case, now talk about treatment. In the past, similar patients required a second incision......"

Luo Hao did not dwell on hitting Wen Youren, but continued to talk about the medical records.

A bloody surgical image appears on the projection screen.

"This is a case from 1995, with only one picture, published in the Chinese Journal of Surgery."

"At that time, the treatment was surgery, but with the development of minimally invasive technology in recent years, ERCP combined with EST stone removal has replaced traditional open surgery in the treatment of stones at the lower end of the common bile duct."

Est？

Ercp？

Two abbreviations appear on the projection screen.

"Doctor Luo, what kind of technique is that?" A doctor sitting in the corner looked at it and asked subconsciously.

Luo Hao seemed to have anticipated that someone would ask a question, and his finger slid on the computer screen to find information about ERCP and ESD and began to explain briefly.

This time, even Lin Yuming listened extremely seriously.

Luo Hao's explanation is concise, easy to understand, and simple to understand.

Five minutes later, Luo Hao smiled, "That's probably it." ”

After finishing speaking, Luo Hao did not continue to speak, but paused for a few seconds.

"Phew~"

I don't know where someone woke up like a dream and let out a long breath.

Some people have heard of ERCP, some people have not, but after Luo Hao's explanation, everyone realized that this type of surgery causes very little trauma to the patient, and the efficacy is far superior to surgery.

Luo Hao opened a door.

The doctor behind the door saw a whole new world.

If surgery is to be performed, not to mention the trauma suffered by the patient, the anatomical changes during a single secondary operation add countless difficulties to the operation.

ERCP+ESD surgery can avoid this, as long as the head mammary muscle is cut and the net is removed.

The thought of how easy it is to make a tricky surgical treatment makes the doctors in the audience excited.

Only Wen Youren is an exception.

His face was pale, and he glared at Luo Hao viciously.

"Director Wen, do you understand? If I don't understand something, I can explain it again. Luo Hao was not afraid in the face of Wen Youren's murderous gaze, and said with a smile.

“！！！”

Provocation, this is pure provocation!!

Wen Youren clenched his hands into fists and creaked.

"Returning to the patient we are going to discuss, I don't think I can do it at the level of Director Wen in terms of surgery, so the medical department recommends that an external expert be invited to perform ERCP+ESD surgery."

Take, no, down, come!

Luo Hao didn't save face for Wen Youren at all, and said his opinion very bluntly.

The key is that Luo Hao carries the medical office with every word, and he represents the general medical office of the mine!

The doctors, who had just been immersed in the new technology, had completely woken up.

For the patients in front of them, it is not only a collision of diagnosis and treatment, but also a collision of old and new concepts.

Although ERCP is no longer a new technology, the mine has not been carried out for a long time, and this technology can be called high-end medical treatment in terms of the mine as a whole.

"Why do you say that?!" Wen Youren squeezed out a sentence from between his teeth.

Every word is rough like a stone, and the eardrum of the grinding person hurts.

Luo Hao looked at Wen Youren thoughtfully.

"What are you looking at!" Wen Youren patted the arm of the chair, and Huo stood up.

He looked at Luo Hao angrily, as if he was about to rush up and punch Luo Hao in the next second.

Everyone became nervous, and someone looked at Lin Yuming.

At this time, Lin Yuming, who is the director of the medical department, should stand up and comfort Director Wen to prevent the situation from worsening.

However.

Lin Yuming was drinking tea with an enamel jar in both hands, ignoring everything in front of him.

Luo Hao didn't smile, and said, "Director Wen, I have already rated you too high just now, are you sure you want to know why I said that?" ”

Oh!

Luo Hao's voice was not loud, but there was a microphone in front of him.

Every word is clear to people's ears.

-for-tat.

A bloodshot shot appeared in Wen Youren's eyes.

"Okay, then I'll tell you why. By the way, Director Wen, you'd better sit down and listen to me, if you rush up and get beaten by me...... Whoever sees you in the courtyard will think about it in the future. ”

Luo Hao paused slightly, and said with a smile, "If that's the case, anyone who wants to make a face won't continue to work in the mine headquarters." ”

"You ......"

Wen Youren knew that Luo Hao was telling the truth, but it was difficult for him to accept the truth.

Luo Hao opened another PPT, "Now let's look at the comparison of the difficulty, completion, and number of patient complaints before and after the general surgery department was your director." ”

"Usually everyone drinks and brags, it doesn't matter how you brag about it. What is going on with the provincial famous doctors assessed, we are all doctors, and we know it in our hearts. It's okay to deceive ordinary people, but don't deceive yourself. ”

Wen Youren narrowed his teeth.

I can't beat it, I can't listen to it, Wen Youren is helpless.

"I have consulted the surgical data of general surgery in the past 25 years in this ppt, and there should be no doubt."

"Before Director Wen became the director of the Department of General Surgery in 2011, the Department of General Surgery completed about 1,800 surgeries a year. Level 4 surgeries accounted for 450%, and the relative number of appendectomy and hernia repair was not large. ”

"Among them, pancreaticoduodenectomy is completed an average of about 30 cases per year."

"Since 2011, pancreaticoduodenectomy has not been done in our hospital, and the difficult level 4 surgery is almost zero."

"Although the decline in the number of surgeries is not obvious, after checking the information, I found that the 'treatment' of paracentesis was turned into surgery by Director Wen and reported to the hospital."

"I really don't know how Director Wen said in front of the leaders of the hospital when he made the annual summary, and under his leadership, the number of surgeries in general surgery reached a new high."

The lecture hall was scary.

Luo Hao was no longer slapping Wen Youren in the face, but pressing Wen Youren to the ground, rubbing his face with his feet.

Lin Yuming was very satisfied, holding the enamel jar in his hand, and took a sip of tea.