Chapter 975 Found the Problem! (Add 2 for Qingyan Xiaoguan)

Cholangiojejunostomy is an important part of the reconstruction of digestive tract function. Although it cannot be said to be very difficult, it is definitely very important.

In the reconstruction of the digestive tract, the most difficult operation is the pancreaticogastric anastomosis, and the pancreaticoduodenectomy is one of the most difficult operations.

The difficulty of reconstructing the digestive tract actually revolves around the small intestine!

The difficulty is naturally in the processing of the small intestine.

Small bowel anastomosis seems to be the easiest, but as the central link, it is the most difficult.

Because he connects the stomach, biliary tract, pancreas,

These three important digestive organs, plus the small intestine, already constitute 90% of the digestive tract.

As for colorectal anastomosis, it seems that everyone has not paid much attention to it.

At first, Chen Cang thought that the reconstruction of the digestive tract was not very difficult, but with the in-depth understanding, he became more and more aware that the difficulty seemed to be much higher than he thought!

Otherwise, it would not have troubled digestive surgery for hundreds of years, and there is no better solution so far.

At this time, when Chen Cang looked back, he suddenly realized that the expansion pack of pancreatic surgery skills he had obtained was a huge advantage.

The most difficult problem seems to let him solve it first.

After the operation, Chen Cang meticulously held the mirror.

Laparoscopic gallbladder surgery is actually very challenging.

For example, in this patient at this time, the reason for the stenosis of the bile duct was that during the original cholecystectomy, the bile duct was accidentally damaged, so that the bile duct narrowed, resulting in cholestasis and jaundice.

Under endoscopic surgery, damage to the bile duct seems to have become a very serious problem.

This is no longer a matter of one person, and has even become an industry issue.

Thinking of this, Chen Cang is no longer anxious to think about stealing a teacher or doing something. He hopes to use his mirror-holding skills to observe the gallbladder to see if it can reduce the chance of biliary damage!

Chen Cang calmed down and began to watch Oster's surgery.

After laparoscopic exposure of the bile duct, careful dissection is required.

Because of the dense blood vessels surrounding the bile duct, caution is required during the passage of multiple blood vessels.

When Oster underwent surgery, he did not relax his vigilance because it was an operation he was good at, but was extra serious.

At this time, Chen Cang suddenly said, "Professor Oster, what do you think is the main reason for bile duct damage during biliary tract surgery and gallbladder surgery?"

This question made Oster suddenly silent!

Extrahepatic bile duct stenosis accounts for about 80% to 90% due to damage to the extrahepatic bile duct during surgery.

Inflammation, infection and ischemia secondary to the peribiliary duct after surgery only account for 10% to 20%.

So why the damage?

This is a very important question!

Since the damage rate is so high, why not conquer it?

Thinking of this, Oster couldn't help but say, "This is a problem!"

In a word, Ma Yuehui couldn't help rolling his eyes!

What do you think you can say about it?

At this time, He Zhiqian, who was acting as an assistant, also thought about it.

The operation to deal with the stenosis of the damaged bile duct is all repeated biliary operation, and some even more than 10 times, which is a very difficult operation.

It is definitely not an operation that can be successfully completed, including the patient at this time, who had done it once three years ago!

The four of them thought at the same time.

After a while, Oster said: "Maybe it's because of the problem of the field?"

He Zhiqian also nodded: "Well, even in open surgery, when dealing with the gallbladder, because of the dense liver and blood vessels, when dealing with the gallbladder triangle, it is easy to damage the bile duct."

When Oster was dealing with the common bile duct, Chen Cang suddenly said, "Wait a moment, I'll give you a different angle, you can deal with it again!"

Just when it was separated and entered the lesser omental foramen, Chen Cang took the lead to follow the endoscope. At this time, Chen Cang turned the optical fiber, and soon, the line knot left by the previous operation and the scar nodule at the stenosis of the bile duct appeared on the TV. in the screen.

After seeing the original narrowness, Chen Cang fell into contemplation.

Why damage here?

Thinking of this, he hurriedly said, "I'll take a look at the place where the punching operation was performed last time."

Suddenly, Oster's eyes lit up.

Imprints from several operations on the abdomen appear.

Chen Cang looked at several marks, and Oster quickly distinguished which one was the operation hole and which one was the assistant.

And Chen Cang widened his eyes, looked at the four-dimensional map, and kept thinking...

At this time, he discovered the power of his four-dimensional map!

This is clearly an analog structure diagram.

Through three cavities, even began to simulate the surgery at that time.

After a few minutes, Chen Cang had already thought of dozens of possibilities for damage.

This...and did not expect any difference.

Dozens of surgeries are obviously not representative, and he needs to find a commonality of injuries!

Thinking of this, Chen Cang understood that this is no longer a problem that can be solved by a single operation, and more operations may be needed to verify it.

Chen Cang simply said: "Professor Oster, you can deal with it, I will give you a vision!"

Aust nodded, and the question raised by Chen Cang also caused him to fall into contemplation.

The surgery went by every minute.

Chen Cang continuously exerted his endoscopic skills, taking into account all structures and tissues as much as possible.

Oster's cholangiojejunostomy went well!

This is the first time that Auster has been supported by Chen Cang himself, and he truly feels how powerful Chen Cang's mirror-holding skills are!

Chen Cang could even think of each step in advance.

Blood vessels, ligaments, liver, bile duct... Any tissue that may be damaged, Chen Cang will use the endoscopic technique to illuminate the field of vision in advance, and then act as a warning!

Laparoscopy is like the eyes of the surgeon, and as the holder of the mirror, Chen Cang abruptly turned the eyes of the surgeon into a 360-degree camera with no dead ends!

So that Oster's next operation went very smoothly!

Auster also felt that his operation today was unprecedentedly smooth, and that every detail could be grasped in place.

All of this is naturally thanks to Dr. Chen.

For a time, Oster had a hunch, could Chen Cang perform this kind of operation more powerful than himself?

Thinking of this, Oster raised his head and glanced at Chen Cang, only to see that his brows were tight, and he didn't know what he was thinking!

Suddenly, Oster suddenly felt a shudder in his heart, and there was a little more worry in his eyes.

Could it be that... Dr. Chen was dissatisfied with his performance in this operation?

Thinking of this, Oster suddenly felt uneasy, and the operation became more and more rigorous!

Surgery is over soon!

However, Chen Cang still didn't say a word, which made Oster even more uneasy!