Doctor’s Life Simulator

ercp+est+lc combined spell, the first step is to first ercp.

"Duodenal side view mirror..."

Under the talent and concentration, Qin Lang quickly entered the rhythm and steadily controlled the camera to enter the duodenum.

"Guide wire, tube preparation..."

Qin Lang calmly gave orders, and at the same time controlled the equipment in his hands.

Since he has done dozens of erats, Qin Lang, the ercp of the same ancestry and origin, is naturally at ease.

Cooperating with Qin Lang's operation, Li Ming was very shocked. Since the last time he saw his operation, he clearly felt Qin Lang's progress.

He is really proficient in the structure and anatomy of the gallbladder and common bile duct.

Li Ming is very clear that although more than 80% of the bile and pancreatic ducts have a common channel in anatomy, the length of the common channel, the angle of the opening of the rt, and the angle of the junction of the bile and pancreatic ducts are different. It is difficult to achieve selective angiography, and it can only be mastered by continuous practice.

At Qin Lang's age, he obviously has only a handful of surgeries. To be able to do this, one is that he usually spends a lot of effort on studying anatomy, watching surgical videos, and even learning the experience and skills of Dr. Daniel. Another aspect is pure talent.

"This kind of learning ability is too terrifying."

Li Ming had to admire.

"Ercp intraoperative diagnosis: the patient's common bile duct stones, one of which is larger than 20mm, requires mechanical lithotripsy under the endoscope, and five are less than 10mm, which can be cut through the est and then removed through the mesh basket."

Under ercp, the patient's condition in the common bile duct is naturally invisible, which also avoids inaccurate preoperative physical examination and lays a solid foundation for subsequent stone extraction.

The next step is to perform est+lc. Compared with conventional laparotomy, the incision of laparotomy is too large, and stone forceps are generally used during the operation, which often leads to damage to the sphincter of Oddi.

The use of LC combined with EST is very suitable for the stenosis of the terminal segment of the common bile duct like Hu Jie, and this program can cure the gallbladder and narrow-diameter common bile duct stones with one-time surgery, and can also preserve the function of the Oddi sphincter to the greatest extent.

"Shockwave gravel preparation..."

Qin Lang gave a non-stop order, even the well-informed Li Ming was a little stressed.

This kind of high-speed efficiency is only available with a partner at the chief physician level.

"Get the stone basket ready..."

Under the combined operation, since the first step of angiography can accurately locate the number and size of the stones, not only the stones in the common bile duct are removed, but also the impacted stones in the ampulla are also cleaned.

As an expert, Li Ming naturally pays close attention to Qin Lang's operations.

When pulling the stone, he obviously controlled the force precisely. Li Ming once encountered a low-level resident doctor who exerted too much force when pulling the stone, causing the patient's ampulla to be torn and injured. What a pity.

Moreover, Qin Lang's movements were very rhythmic, and the more he looked at Li Ming, the more frightened he became.

I saw that Qin Lang inserted the mirror, turned right, and downward, and the joint action was always in the same direction as the axis of the bile duct.

This kind of operation is naturally very beneficial to the removal of stones, and in the order of stone removal, Qin Lang is also very calm and rigorous in accordance with the principle of "lower first, then upper, first small and then large".

In Li Ming's memory, the first time he took a stone was because he was too nervous and forgot this principle, which led to the extraction of too many stones at one time, which caused the stone basket to be incarcerated in the rt part.

One operation has been successful for the most part, and the next step is regular lc, which is naturally no difficulty for Qin Lang.

In the next operation, as expected by Qin Lang, the blood loss during the operation was very small due to the combined method.

Moreover, since there is no need to use a t-tube for drainage, the negative effects of bile duct bleeding, injury, electrolyte and bile loss caused by the t-tube are avoided.

This made Hu Jie, who had just undergone the rescue, barely survived the operation, and the rest was the recovery after the operation.

"Qin Lang, congratulations."

As an assistant, Li Ming, of course, monitors the patient's vital signs at all times, but if the amount of bleeding is larger, the patient may experience a second shock, which shows how accurate Qin Lang's prediction was.

If he were the main surgeon and used conventional LC, the consequences would be unimaginable due to the excessive bleeding and Hu Jie's current physical condition.

When Li Ming pushed the flat cart out of the operating room, Hu Jie's husband was still communicating with Faxiao. Regarding this complicated operation, in his prediction, the level of the first hospital in the city was at least at the same level. Two and a half hours.

Hu Jie's husband looked at the time within a few minutes. It had only been an hour and a half, and he was both restless and uneasy.

While he was suffering, Qin Lang and Li Ming came out with a flat cart.

Hu Jie's husband confirmed the time again, his mind was blank, and he was so panicked that he didn't see the patient on the flat car behind Li Ming:

"Doctor, why did you come out so quickly? You didn't do surgery inside, why did you run out?"

Li Ming turned his head, pointed at Hu Jie on the flat car, and motioned to him: "The operation is complete, very successful."

"What did you say! It worked, really!"

Hu Jie's husband followed Li Ming's guidance and saw Hu Jie who was still recovering from anesthesia on the flat car.

"Don't come over to help and take the patient to the ward."

"Ah, ah, good."

Hu Jie's husband hurried over, holding the car with one hand and holding Hu Jie's hand with the other: "It's alright, it's alright."

Hu Jie lay on the flat car, the corners of her mouth moved slightly, and she blinked.

"Doctor Qin, I used to be a bastard. I had a bad attitude and questioned you. You are just Hua Tuo alive, and you are rejuvenating."

After Hu Jie's husband comforted his wife, he saw Qin Lang at the back. At this moment, he was ashamed and ashamed, and full of gratitude.

His Faxiao told him the difficulty of this combined technique. Even the most powerful treatment in his Faxiao department would take at least two hours to complete. They belonged to the provincial capital hospital, so this Doctor Qin only used one. Half an hour is not better than the experts in the provincial capital hospital.

"It's so lucky."

Recalling what happened on this day, Hu Jie's husband became more and more afraid. Fortunately, he met Dr. Qin, otherwise his wife might not be able to survive.

Qin Lang glanced at Hu Jie's husband, who nodded his thanks and scolded him for being blind to Mount Tai.

After Qin Lang and Li Ming sent the patient to the ward, they asked a few more words.

This time, Hu Jie and her husband were naturally respectful about Qin Lang's words, and took them down seriously.

Before Qin Lang and Li Ming left, Hu Jie got up slightly and said to Qin Lang:

"Doctor Qin, thank you."

Qin Lang and Li Ming did not look back, and quickly walked out of the ward, especially because Li Ming had seen too many patients with such arrogance.

For gratitude, I have peace of mind to accept it, and I will not forgive my previous vitriol.

Seeing that the two doctors walked out of the ward without looking back, Hu Jie was slightly stunned.

In the rest of the matter, there will naturally be interns to assist~www.readwn.com~ What Qin Lang and Li Ming have to do is to check the room regularly.

...

...

The next day, Qin Lang received a call from Tang Qichen early in the morning, and Professor Huang from the provincial capital was already on his way to the First Hospital of Hecheng City.

Professor Huang expressed that he was very satisfied with their early physical examination, CT enhancement and contrast-enhanced ultrasound.

I have to say, Lu Yu still has two brushes.

After he arrives, he will personally see the patient and communicate. If there is no problem, he can carry out the operation and let Qin Lang and the others prepare.

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