The surgeon opens a cheat

Chapter 155 Do You Want to Change Jobs?

Seeing Zhang Gu's reaction, Yao Yusen knew that Zhang Gu had a solution.

For this kind of misjudgment of the common hepatic duct, what is most needed is an expert in anastomosis and suturing.

Just like Zhang Gu.

Zhang Gu's sudden appearance made Yao Yusen feel more at ease in an instant!It even feels more at ease than Director Xiang and Director Ning.

Change Zhang Gu to stand on the operating table.

Yao Yusen was on the side as a deputy, and at the same time explained the details of the patient to Zhang Gu, as well as the reasons for the difficulties they were unable to remedy.

The deputy chief physician with trembling hands stepped back from the operating table in a daze, looking at the wounds of the patients on the stage from time to time, expecting a miracle to happen there.

"Doctor Zhang Gu, what should we do?" Yao Yusen also had no idea.

With gloved hands, Zhang Gu was already doing an in-depth examination, looking at the patient's wound.

"Don't worry, find the patient's common hepatic duct first."

Yao Yusen nodded, the most urgent thing now is to stop the bile leakage.

Zhang Gu checked the stump of the hepatoduodenal ligament, and soon found a protruding white round hole, which was continuously leaking bile.

Zhang Gu confirmed: "This is the common hepatic duct that was misdiagnosed."

"This is the liver manager? Can't it?" Yao Yusen was stunned, and the surgical team next to him was also a little confused.

There is a saying in everyone's mind, are you really discerning right?
There is a probability of making mistakes in the identification during the operation. The wrong cut off just now, on the one hand, is of course an operation error, on the other hand, it is a wrong identification.

Everyone doubted whether Zhang Gu was also wrong.

Zhang Gu said firmly: "This is the common hepatic duct, but the stump of the common hepatic duct in this patient is thinner, so it doesn't look like it."

Yao Yusen was horrified, he had seen a case of the liver duct being so thin before.

Why did I forget this time!

Don't be careless!Yao Yusen's back was sweating.Empiricism can really kill people!
After carefully identifying it, a fine layer of sweat appeared on his forehead, and he confirmed: "That's right! This is the common hepatic duct. This patient is quite special, and the common hepatic duct is too thin."

He was afraid for a while, but fortunately Zhang Gu recognized it, otherwise, a medical accident might really happen this time.

After completing this step, it means that a new, more difficult problem has emerged.

The common hepatic duct is too thin, how to match it?

Yao Yusen looked worried: "Doctor Zhang Gu, is this match even more difficult?"

Even if Yao Yusen does not specialize in anastomosis, he also knows that the two parts of the stump anastomosis should have the same opening and similar diameter, and the anastomosis effect will be the best.

In this patient, the gap between the two sides is too large, and anastomotic leakage is prone to occur.

Zhang Gu said in a calm tone, "It's enough not to do the end-to-end anastomosis."

Everyone looked puzzled, so what should we do?
In Zhang Gu's mind, he consumed a blank skill card "jejunum-portal anastomosis."

Another 3 primary cards and 4 intermediate cards were consumed to upgrade to the advanced level.

Zhang Gu: "The end-to-end anastomosis of the common hepatic duct that is too thin cannot be forcibly done, which will cause tissue damage and edema in the operative field, which will bring great disadvantages to wound healing."

"The way to deal with this kind of too thin common hepatic duct is to directly perform jejunum-common hepatic duct anastomosis."

Everyone reacted differently, some were thoughtful, some had a flash of inspiration, and some were at a loss.

Yao Yusen recalled that when he went to the provincial capital hospital for advanced studies, the teacher used to give an example of such a marginal subject of jejunum and hepatic duct anastomosis in class.

This is an interdisciplinary borderline subject involving hepatobiliary surgery and gastrointestinal surgery at the same time. It is an emerging subject, and the teacher pointed it out in class.

It's a pity that at that time, Yao Yusen's mind was not in the field of matching, so he didn't listen carefully.

Looking back now, he really regrets it.If one more technique could be learned at that time, perhaps one more patient could be saved.

But now there is a new learning opportunity.

Since Dr. Zhang Gu said so, it must be that he also knows this kind of jejunohepatic duct anastomosis!
Yao Yusen cheered up, his eyes showed anticipation and eagerness to learn.

While Zhang Gu was speaking, he had already started suturing, sealing and embedding the stump of the super-thin common hepatic duct.

"Bougie No. 4. Director Yao, help me expand the liver duct."

As soon as Zhang Gu spoke, Yao Yusen immediately prepared his assistant.

As soon as the equipment nurse handed over the bougie, Yao Yusen began to fully expose the liver duct.

After sealing and embedding.

Zhang Gu began to perform jejunum-hilar anastomosis.

Yao Yusen and the others stared carefully, for fear that they might miss a crucial operation in the blink of an eye.

Zhang Gu cut off the jejunum, freed the mesentery, and preserved the blood supply of the stump.At the same time, a long silicone tube was built into the porta hepatis, and it was led out of the body from the jejunum wall, and the distal end of the jejunum was connected to the porta hepatis.

While Zhang Gu was doing it, he also saw Yao Yusen's eyes eager to learn.

He intentionally mentioned Yao Yusen: "Director Yao, there are a few key points in this anastomosis. One is that the external opening of the hepatic surface of the common hepatic duct needs to be sutured with a flared flare."

"Secondly, the difficulty of inserting the needle during the operation is the key point, too deep or too shallow will not work."

Yao Yusen nodded repeatedly.

He subconsciously asked: "Doctor Zhang Gu, what will happen if it is too deep or too shallow?"

As soon as he asked this question, he regretted it!

At such a critical moment of surgery, who can answer his questions?

Dr. Zhang Gu is not his teacher, and has no obligation to answer his questions.

More importantly, once Zhang Gu answered his question, it would definitely affect the actual operation of the operation, which is definitely a taboo in surgery!

What's more, this operation almost caused a medical accident, and at this moment, there must be no more mistakes.

Zhang Gu calmly operated while explaining.

He didn't slow down the movements in his hands at all because of the need to explain, the movements in his hands were still fine, and there was no mistake.

"If the needle is too deep, it is easy to ligate the intrahepatic bile duct. If it is too shallow, it will rupture due to the fragility of the liver tissue, resulting in failure of the suture. You need to practice more and carefully figure out the strength."

When Zhang Gu answered, Yao Yusen stared at Zhang Gu's hands in fear.

I was afraid that Zhang Gu would make a mistake because of distraction, and it would be his fault.

In the end, the facts proved that he was obviously worrying too much, Zhang Gu's hands were like iron pliers, motionless.

After listening to Zhang Gu's explanation, Yao Yusen and several senior doctors nodded deeply.

The biggest difference between the liver and other organs is that there are bile ducts in the liver, which need to be handled very carefully.

Under the operating table, a doctor suddenly had a ridiculous idea.

Even Yao Yusen, the director of the Department of Hepatobiliary Surgery, needs to carefully study and practice the technique of intrahepatic stitching. How can this Dr. Zhang Gu, who performs gastrointestinal surgery in the general surgery department, be so proficient?

Who is the director of hepatobiliary surgery?

(End of this chapter)