Doctor’s Life Simulator

Mirizzi syndrome is a rare complication of gallstones, and its incidence accounts for 0.7% to 1.4% of gallstones.

Mirizzi syndrome refers to a series of syndromes in which the cystic duct and the common hepatic duct are too long or the confluence is low, or the common bile duct is narrowed due to the impact of gallbladder neck stones, causing biliary colic, obstructive jaundice and other symptoms.

Clinically, Mirizzi syndrome is difficult to detect preoperatively and can only be diagnosed intraoperatively.

Zhuang Tong's complexion was also ugly. Although double enhancement was performed before surgery, Mirizzi syndrome was still something that modern medicine could not accurately detect before surgery.

According to the Csendes classification method, Mirizzi syndrome is divided into five types.

If type III must add a puncture hole in the abdomen, as for type IV and V, in order to ensure the safety of the patient, it has to be converted to laparotomy.

Once the puncture hole and laparotomy are added, it means that the first X-CONE single-channel laparoscopic cholecystectomy in Hecheng First Hospital failed.

Lost the meaning of minimally invasive.

Obviously this situation is not what everyone wants to see.

When Zhuang Tong and Professor Huang were in a low mood, the equipment nurse was still heartless. After all, they had done so many surgeries with Qin Lang, so there were no surgical procedures and patients that Dr. Qin could not handle.

There is a certain sense of trust in this young and handsome doctor.

The only thing that made her dissatisfied was that Dr. Qin did not understand Lianxiangxiyu. Because of her high concentration, she was dripping with sweat after each operation.

"Professor Huang, what do you think?"

Zhuang Tong deceived himself and asked Professor Huang, hoping to give him a different judgment from him. After all, there is still a bit of luck in his heart.

"If I went into battle in person, I would be able to judge which type it is based on experience and touch, but now it is only through the screen, and pure vision is wrong. If the judgment is wrong, the consequences will be disastrous. To be on the safe side, I think it is better to transfer to open belly. safe!"

Of course, Professor Huang does not want to convert to laparotomy, but if he insists on single-channel operation and misjudgment leads to postoperative infection and complications, he would rather choose a safe and complete cure for the patient than a little minimally invasive cosmetic surgery.

Zhuang Tong frowned. Although he was very reluctant, it was indeed the most correct choice. After all, it is impossible to expect a doctor as young as Qin Lang, who happened to have studied such a rare Mirizzi syndrome, to be able to survive such an unexpected situation. down, keep calm and discern the right.

"Qin Lang, Professor Huang has the same opinion as me, turn to abdominal surgery. You have done it perfectly before, but encountering such a small probability of Mirizzi syndrome is the life of the patient and our life."

"Qin Lang, turn your belly to open."

After hearing Zhuang Tong's order, Li Ming saw that Qin Lang was still observing the patient's hepatic duct. He had no intention of giving up, and urged him.

Seeing that Qin Lang was still concentrating on designing the next surgical plan, completely ignoring him, Li Ming frowned and reminded again:

"Professor Huang and Director Zhuang have both come to a conclusion, let's not waste any time, and quickly turn to the abdomen."

"Mirizzi syndrome is classified according to Csendes: type I is the impact of gallbladder neck or cystic duct stones compressing the common bile duct, also known as the prototype of Mirizzi syndrome."

Qin Lang ignored Li Ming's question and looked directly at Professor Huang and Zhuang Tong.

Listening to what Qin Lang said, Li Ming seemed to understand something, but he seemed to have a little impression, but he was not very familiar with it.

"Type II cystic duct-common hepatic duct fistula is formed and the fistula is less than 1/3 of the circumference of the common hepatic duct, and type III is formed and the fistula is less than 2/3 of the circumference of the common hepatic duct. I have carefully examined the patient's common hepatic duct fistula. It has been confirmed that it is less than 1/3 of the circumference of the common hepatic duct, which means it is confirmed to be type II."

Li Ming is really confused now, such accurate data and definition range, so easy to come by?

Of course, the equipment nurse didn't understand anything, but she thought that Dr. Qin was very good.

Professor Huang's dark eyes lit up. If Qin Lang was just plain and innocent, he would certainly not be able to convince him, but now there is a rationale, and it is clear that Qin Lang has done a lot of research on Mirizzi syndrome.

Zhuang Tong was also a little surprised. When did this stinky boy secretly know the symptoms of Mirizzi syndrome that ordinary doctors never encountered in a lifetime.

Professor Huang also came to the spirit: "Xiao Qin, continue."

Of course, Qin Lang learned about the patient's condition through diagnostic techniques before the operation, but Mirizzi syndrome could not be demonstrated through representation, so he could only keep it in his heart, and didn't explain it to Professor Huang and Zhuang Tong until this moment.

As well as coming up with a foolproof best solution:

"For Mirizzi syndrome type II, in principle, try to repair the stenosis and defect of the bile duct after removing the impacted stone. In view of the patient's symptoms, I think Roux-en-Y anastomosis of the common hepatic duct and jejunum can be selected."

"Counting the steps that have been carried out, my entire process is arranged: laparoscopic cholecystectomy + Roux-en-Y anastomosis of common hepatic duct and jejunum + T-tube drainage."

Qin Lang spoke out his surgery plan very confidently and confidently.

Li Ming looked at Qin Lang in a daze, as if at this moment, this young man was shining!

Professor Huang pondered for a while, then looked at Zhuang Tong: "Director Zhuang, I think Xiao Qin's plan is theoretically feasible, but performing Roux-en-Y anastomosis of the common hepatic duct and jejunum in a single channel will not affect the surgeon's needs. Suture technology is extremely demanding, constantly requiring strength, accuracy, and stability, and the flexibility of the fingers requires a lot of physical strength.”

Zhuang Tong naturally has his own judgment. He is not worried about Qin Lang's stitching technology, but can it really be done in a single-channel operation?

"Director Zhuang, I am the chief surgeon. I know the direction of this operation best, and I also have the right to decide whether to continue."

Qin Lang continued to fight, under the aura of the main sword, every word was pearly.

Zhuang Tong hesitated for a while, and finally said, "Qin Lang, just do your best, don't force it. If it doesn't work, just turn your stomach."

"T-tube..."

Qin Lang went directly to the next step and gave instructions directly to the equipment nurse.

Crowd: …

"okay."

Li Ming stabilized his mind and began to cooperate with Qin Lang.

"Scalpel..."

"Needle forceps, microscope glasses..."

"4-0 Absorbable Line..."

When Qin Lang was sewing, Zhuang Tong still had a pleasing feeling even after watching it so many times.

Not to mention Professor Huang who saw Qin Lang suture for the first time, this is still the difficult Roux-en-Y anastomosis that stumped countless novices?

The problem of common hepatic duct fistula and stenosis is solved, and the simple operation of the next T-tube drainage will be done by Li Ming.

At this stage, it has basically been announced that the first X-CONE single-channel laparoscopic cholecystectomy in Hecheng First Hospital was successful!

Next, it is the routine finishing, which is handled by its own assistants.

Professor Huang sighed as he looked at Qin Lang who was about to leave the stage.

"What's the matter, Professor Huang?"

"Director Zhuang, this little doctor Qin under your command is really amazing!"

[Congratulations to the host for completing the task: saving the field, the first case of single-port laparoscopic cholecystectomy performed by the First Hospital of Hecheng City, and was also appreciated by Professor Huang. Mission reward: 1.1 life simulation points]

ten minutes later.

The first X-CONE single-channel laparoscopic cholecystectomy in Hecheng First Hospital was successful!

Lai Meiyun naturally heard all the arguments in the operating room, and was very grateful to Qin Lang. If it wasn't for Dr. Qin's persistence, she might have left some regrets in her career.

"Doctor Qin, thank you."

Lai Meiyun thanked her very sincerely.

On the way to the ward, Tang Qichen, the surgery organizer, was so excited that he had already arranged a photographer to shoot some important moments.

Tang Qichen walked up to Professor Huang and Qin Lang: "Professor Huang, this surgery was a success, thank you very much for coming. Of course, it was all up to Dr. Qin to turn the tide. You didn't know that during the operation, it was said that the abdomen would be diverted. How nervous I am."

"Fortunately, fortunately, everything is complete."

Tang Qichen recalled the thrilling operation process that day, his heart was still thumping:

"Nothing is more propaganda than such a tumultuous operation."

Tang Qichen looked at Qin Lang's face after taking off his mask, and was more and more impressed.

With good looks and strength, Qin Lang is a veritable star doctor!

Feeling Tang Qichen's burning eyes, Zhuang Tong frowned slightly: "Manager Tang, in the publicity of today's operation, I hope that Professor Huang will be the main focus, and Qin Lang's pen and ink can be brought over."

Professor Huang naturally understands Zhuang Tong's good intentions. After all, the promotion of this technique is promoted at the level of Professor Huang, and it is worthy of the name and convincing in the medical field.

If Qin Lang was the protagonist, it would be nondescript, hard to convince, and even cause unnecessary controversy. On the contrary, it is not good for Qin Lang and the First Court of the City.

After all, Qin Lang is really too young! Let a young doctor perform X-CONE single-channel laparoscopic cholecystectomy and resolve Mirizzi syndrome during the operation, even if it is a fact.

I am afraid that I will still be sprayed to death by those old professors!

Sometimes being too good is a mistake.

Tang Qichen had already thought about how to describe Qin Lang's efforts to turn the tide, how to be such a young genius, and it came to an abrupt end.

I was a little disappointed, but I was still very excited when I thought that the operation was successful~www.readwn.com~ As the leader of Hecheng's medical field and the vane of the city's first hospital, once X-CONE single-channel laparoscopic cholecystectomy was carried out, Then it will be smooth sailing to other hospitals.

Tang Qichen had already seen the wonderful scene where the tigress at home was about to get a promotion and a raise, and the tigress carried herself from the sofa back to the big bed she hadn't slept in for a long time.

Professor Huang looked at Qin Lang with a smile: "Xiao Qin, today's surgery was done beautifully."

"Are you interested, come to our provincial military hospital for advanced study in general surgery, and there is a doctoral student quota under my name."

Professor Huang followed suit.

Zhuang Tong's face darkened, Qin Lang was like a red rabbit among horses, and Lu Bu among people, all coveted.

Ah bah, Lu Bu is a professional family of Ke father, Qin Lang is his own blessing, different, different.

When Zhuang Tong finished his mental journey in an instant, Qin Lang gave his answer: "Thank you, Professor Huang, for your appreciation. I'm still studying as an on-the-job postgraduate in Zijingang First Academy. I'll think about it later."

After listening to Qin Lang's words, Professor Huang was a little disappointed, but his evaluation of Qin Lang was a little higher in his heart.