Chapter 595 Have You Memorized All the Instructions?

"Director Xia, I'm back." Zheng Ren knocked on the door and came in. Director Xia was studying double gallbladder deformity.

"President Zheng, come and tell me about the deformity of the double gallbladder." Director Xia waved and said calmly without putting on airs.

She wanted to stand up to give way to Zheng Ren, but Zheng Ren pushed her down on the chair with a smile.

"Director Xia, don't dare to do this. You sit, you sit, it's not difficult, I just say a few words." Zheng Ren bent over, held the mouse with his right hand, and began to move the 3D MR reconstruction he had just done.

Both MRI and CT can be used for three-dimensional reconstruction, but clinicians basically only know about CT three-dimensional reconstruction, and few people know that MRI can also perform reconstruction.

The resolution of CT can reach 0.5mm, but although the MRI of Haicheng No. 1 Hospital is 3.0, the resolution is only 6.0mm. The 3D reconstruction made is like a mosaic, which looks very awkward.

Zheng Ren was just trying to save trouble, and also to save some money for the patient.

The gold standard for the diagnosis of double gallbladder malformation is ERCP, but because ERCP is an invasive examination and costs a lot, the current consensus is to use MRCP as an examination for diagnosis.

As for the 3D imaging, Zheng Ren did it conveniently, so as not to bother the patient and avoid any uncertainty, which was difficult for Director Xia.

Although Director Xia didn't intentionally misdiagnose... basically no one would intentionally misdiagnose, and the patient seemed to be more cooperative, but Zheng Ren still subconsciously eliminated all hidden dangers in the bud.

"Director Xia, look here, the patient has cystic ducts in both gallbladders." Zheng Ren used the mouse to outline the area he wanted to talk about, and then explained briefly: "Double gallbladder deformity is divided into type 1 and type 2. Harlaftis type 2 refers to Double gallbladder with 2 or more cystic ducts independently connecting to the common bile duct, type 2 can be further subdivided into H-shaped variant and trabecular variant."

"This patient belongs to the more common Harlaftis type 2, which means that it can be treated surgically."

"The patient has no symptoms of pain now. I think it is unlikely that the patient's family will agree to the operation. But you can tell the patient and the patient's family that I can perform this operation."

Director Xia glanced at Zheng Ren, not surprised, nor said anything.

"In 1997, Gigot reported a case of double gallbladder deformity. At that time, the surgeon only removed one gallbladder, leaving the other one. 27 months after the operation, the patient's other gallbladder was complicated by gallstones and acute cholecystitis. The rest of the gallbladder was removed."

"If it is an operation, I suggest removing both gallbladders."

"Of course, this is just my opinion. I think the patient should go a few more places and consult carefully." Zheng Ren hesitated a little, wanted to say something, but finally held back.

"Mr. Zheng, your back wave really took a picture of me on the beach." Director Xia sighed.

"Look at what you said." Zheng Ren said with a smile, "No way."

Director Xia picked up the Rochefen (Ceftriaxone) instruction manual from the table, waved it, and said, "Boss Zheng, I can memorize the instruction manual. This ability... I can't do it."

Zheng Ren smiled, but said nothing.

"Boss Zheng, how did you know?" In fact, Director Xia didn't believe that Zheng Ren could memorize the drug instructions.

There are at least hundreds of drugs commonly used in clinical practice.

All kinds of medicines, the better the medicine, the more detailed the side effects are written.

If you read the instructions, this medicine can't be used at all.

But the more this medicine, the better the effect. Unlike the shabby medicines produced by the pheasant pharmaceutical factory, the instructions almost cure all diseases.

So Zheng Ren knew about this, in Director Xia's view, it was a very strange thing.

How good is this memory?

"Director Xia, my doctor's certificate is for general surgery." Zheng Ren said, "Have you heard of the medical accident at Liaozhou People's Hospital a few years ago?"

Liaozhou is a county under Haicheng. A few years ago they performed an emergency cholecystectomy on a patient because of cholecystitis and cholelithiasis.

It just so happened that the family members of the patient were serious and insisted on looking at the stone, saying that it was a relic and wanted to keep it as a souvenir.

Red envelopes were also stuffed before the operation, and the chief surgeon confidently said that the stone must be kept for the patient's family members. It's just a gallbladder cut, no one thinks there is any risk.

But after cutting out the gallbladder, the chief surgeon was an idiot.

There are no stones in the gallbladder at all.

This matter ended up making a big fuss. The chief surgeon insisted that there were gallstones in the preoperative B-ultrasound, and there was no problem in the surgery. But the stone was not taken out after the operation, and he refused to let go.

In the end, the family members pulled up banners, and the trouble became bigger and bigger.

Later, the chief surgeon was suspended, and the hospital lost a lot of money.

Zheng Ren's resolute refusal to accept red envelopes is directly related to this matter.

Think about it, feel terrible. The preoperative auxiliary examination is very sure that there are stones, but the stones are not big.

But during the operation, the stone disappeared like a ghost.

How do you explain this to the patient's family? If you don't collect money, be tougher. If you take the money, you will feel ashamed.

After this incident, Zheng Ren read a lot of information, and he had grasped the cause and effect of this gallstone disease before the big pig's hooves got on his body.

So when he encountered it today, he directly judged that it was ceftriaxone, the crystalline substance left by gallbladder metabolism, as long as he stopped taking it, it would disappear soon.

From Zheng Ren's point of view, it was a trivial matter, but from Director Xia's point of view, it was miraculous.

Director Xia thought of the medical dispute, and immediately realized that the surgeon at the time also encountered the situation he had encountered.

Without Zheng Ren, and meeting a difficult family member, he would have no way of explaining how he got the gallstones.

But fortunately, I seem to be lucky to meet this young Mr. Zheng.

For clinical doctors, luck is very important.

Director Xia nodded, understanding what Zheng Ren meant. Zheng Ren did not continue to say anything, after all, the death of a rabbit is sad, and things hurt its kind.

Talking about the chief surgeon behind his back, both Zheng Ren and Director Xia would feel a little uncomfortable.

After chatting for a few more words, Director Xia reassured himself, and Zheng Ren also left.

Can surgery be done?

Of course you can.

But Zheng Ren knew that for such a rare disease, it would be difficult for his family to choose Haicheng for surgery. I can only provide my opinions to Director Xia, and then she and the patient's family will explain.

The size of the temple is directly related to the incense of the Bodhisattva.

Moreover, I belong to the type that is too young, and it is difficult for the family members of the patients to have a sense of trust.

If it was changed to the imperial capital or the magical capital, Zheng Ren might directly explain the situation to the patient's family and perform the operation.

On this point, Zheng Ren still had a hard time knowing it.

Not in a hurry, Zheng Ren returned to the emergency ward slowly, looked around at the patients, and then continued to sit down and read a book.