Chapter 2394 Intraoperative Chat

After taking out 45 adult worms from the lower digestive tract, Zheng Ren said, "Director Luo, Su Yun and I are doing ERCP, can you guide me?"

"Boss Zheng is too polite." Director Luo said very seriously: "I can't get out such deep bugs."

After finishing speaking, he paused for a moment, and said with a smile: "In the past, insects in this position could only be treated with insect repellent, and then discharged little by little after they died. Many of them could not be excreted, and they would directly turn into stones. gone."

"If the biliary tract is blocked, it depends on the situation."

"Try it, I may not be able to take it out." Zheng Ren said while preparing the ERCP, "No, I can't do it alone, so I have to bring Su Yun along."

The patient was lying on the left side, and the nurses and anesthetists stayed in the operating room wearing lead suits, while the others retreated to the operating room.

"Director Luo, don't you want to help?" Professor Yang asked in a low voice.

"Boss Zheng is being polite to me." Director Luo said, "To be honest, my level of ERCP is almost inferior to that of the people under me."

"Look at what you said."

"To be honest, I'm getting old, and I can't do some micromanipulation properly. Boss Zheng is really old, and he can still work for at least 20 years!" Director Luo said enviously.

Professor Yang sighed slightly in his heart.

Generally, people of Boss Zheng's age are graduate students or doctoral students, and it would not be a bit exaggerated to say anything, but they must be still in the process of learning surgery, and there is no way to go on stage to solve difficult and miscellaneous diseases.

It would be good if the general surgery can be successfully taken down without any mistakes.

Looking at Boss Zheng through the leaded glass, Professor Yang sighed again. No matter interventional operation or surgical operation, it is done in the same way. What about liver cancer resection? People do interventional surgery first, and then perform resection surgery. Gradually, people with gallbladder are used to this kind of operation.

In the past few days, the director is preparing to arrange for someone to learn interventional surgery from Boss Zheng.

There is no need to be particularly careful, as long as injection and embolization are enough. After all, surgery still needs to be done, so there is no need to do it too delicately.

He has changed a lot without knowing it, and he doesn't even feel too clear when he is in it. Professor Yang recalled the scenes of contact with Boss Zheng, and when he looked back, he was a little at a loss.

On the screen, the ERCP operation has begun. The duodenoscope passes through the esophagus, the stomach, and enters the descending segment of the duodenum in sequence to find the RT of the duodenum.

Professor Yang has seen many ERCP operations, and the subsequent selective intubation is a very difficult step. But when he watched Boss Zheng's operation, he didn't feel anything in his heart.

Boss Zheng should have done it, and it would be strange if he couldn't. It's worth discussing why the whole house should discuss it together.

Sure enough, the catheter was inserted through the biopsy hole. Boss Zheng adjusted the angle knob and forceps to make the catheter perpendicular to the RT opening, and then inserted the catheter into the duodenal RT logically.

After that, Zheng Ren started imaging.

Retrograde cholangiography showed an abnormal image of about 15 cm near the right hepatic segment of the intrahepatic bile duct. Compared with the CT film, it can be determined that this is the source of the patient's severe pain.

The roundworm was stimulated, and crawled all the way in from the RT of the duodenum, and drilled into the intrahepatic bile duct. Whenever the roundworm moves, the patient will feel heart-piercing pain.

Why bother? With this perseverance, I really believe that it is better to eat less and move more.

Professor Yang watched the video silently, evaluating the patient's condition in his heart. This kind of ERCP operation is quite difficult, and Director Luo couldn't do it anyway.

Is there any precedent for using ERCP to get worms in China? There are near-end ones, and I have an impression. But it has never been this deep, and it is quite difficult.

"Xiao Yang, what would you do if it were you to get the worms completely?" Director Luo asked.

Although Professor Yang has never done ERCP, he still understands the basic theory and operation. This is equivalent to sitting on the road and providing a certain idea.

"Uh..." Professor Yang pondered carefully, but then smiled wryly: "Director Luo, you are making things difficult for me."

"Just talk about it." Director Luo stared at Boss Zheng's operation closely, and said casually.

"It's not difficult to catch roundworms with pliers. At least for Boss Zheng, it's not a difficult task." Professor Yang said.

It's not difficult, and it's true.

The intrahepatic biliary tract is quite thin, and it is very difficult to operate ERCP to remove stones in the intrahepatic biliary tract, let alone remove living things.

"The difficulty lies in that although the roundworm has no obvious mouthparts and clings tightly to the bile duct, its outer layer... seems to have a protective layer, right?"

When it came to details, Professor Yang hesitated.

He couldn't explain it too carefully, he just chatted with Director Luo from memory.

"Well, roundworms have cuticles on the outer layer, but their physical strength and corrosion resistance are comparable to antelope horns and rhino horns, and they are very resistant to mechanical, chemical, and biological damage. So although roundworms don't live in the stomach, they can It is also not digested by gastric juice." Director Luo said.

"It's very elastic. If I grab the end of the roundworm and pull it out, I'm afraid the insect will break from the middle."

"It's okay when the space is large. Although roundworms don't have suckers, the outer wall has adsorption capacity." Director Luo said, "The roundworms in the stomach and intestines are easy to pick up, but the bile ducts in the liver are too difficult."

"I don't understand."

"I can't figure it out either." Director Luo said: "At first I just wanted to ask Boss Zheng if he had a good idea, but since he came, it proves that he has an idea. I'm really curious, how Boss Zheng will get rid of the bugs come out."

"Surgery? If Boss Zheng opened his abdomen, cut the liver and removed the worms, it would be possible with his level."

"No, if it's a surgery of this level, Boss Zheng's girlfriend will follow her on stage." Director Luo said with certainty.

Yes, Professor Yang nodded.

The radiography was already over, but in the ERCP room, Boss Zheng and Su Yun only performed simple operations and then stopped.

Director Luo felt a little strange and pressed the intercom.

Immediately, Su Yun's voice came from the intercom.

"...Metformin, you dare to eat anything. This thing can also be used to lose weight. Don't admire human imagination too much."

"Metformin improves insulin resistance and lowers insulin levels, thereby reducing fat synthesis and weight loss. But is there no problem for ordinary people to eat metformin?"

"There must be. Two days ago, a classmate who went abroad for further study also said that there was an old man over there who took metformin to lose weight and fell into a coma. There was no one in the house. When he found out, he was almost in a vegetable state."

This is all a mess, a bunch of people from the two departments outside in the middle of the night are watching, why not do surgery, and talk about metformin here? Professor Yang and Director Luo looked at each other, and saw deep confusion in each other's eyes.