world famous doctor

Chapter 143 Calculus cholecystitis
Zhou Chen inspected the clothes of the old man and the peasant woman.

Needless to say, they are most likely from rural areas, and their economic conditions are not very good.

Once these inspections are completed, it is estimated that at least 800 yuan will be required.

Zhou Chen has a famous medical system, so he thought it would save some money for patients.

So, he immediately turned on the famous doctor system to check and scan the old man.

The system responded:
"The system is checking and scanning the patient...please wait..."

This time, the system prompts to consume 800 likes.

But there is still a row of fine print below.

Take a closer look, it's a countdown.

48 hours.

Take a closer look, it is the cooling time for the patient's physical examination.

Cooldown?

Is it possible that since the famous doctor system was upgraded to version 2.0, there will be a certain cooling time for physical examination of patients?

That is to say, within these 48 hours, he can no longer perform physical examinations for the next patient with the famous medical system.

Zhou Chen frowned and thought secretly.

This undoubtedly formed a restriction on Zhou Chen.

"The system inspection is complete, the inspection report is being reviewed... printing..."

In just a few minutes, the famous doctor system completed the physical examination for this elderly patient and gave the examination results.

"Due to the interference of excessive gas in the gastrointestinal tract, a sound cluster of about 0.87.*0.7 in size can be detected in the gallbladder, with sound shadows behind it, showing that the diameters of the gallbladder are normal in size, the wall is not thick, and the sound is good.

CDF1: No abnormal blood flow signal in liver and gallbladder

System prompt: cholecystitis combined with gallstones. "

Zhou Chen nodded.

Through the examination results of the patient, a definite diagnosis of calculous cholecystitis can be made.

Once the diagnosis of chronic cholecystitis with gallstones is established, cholecystectomy is a reasonable fundamental treatment.

During the systematic examination of the patient by famous doctors just now, Zhou Chen did not find that the patient had serious diseases such as heart, liver, and lungs, or that the patient's general condition could not tolerate surgery or other surgical contraindications.

Therefore, surgery can be performed.

He raised his head and said to Doctor Zhang Jian who was opposite him:
"It appears that microscopic cholecystectomy should be performed on him."

In the past, Zhang Jian would definitely ask why immediately.

Without any examination, Zhou Chen characterized the patient's abdominal pain as calculus cholecystitis.

Generally speaking, it is very dereliction of duty for a doctor to draw conclusions rashly and arbitrarily.

However, Zhou Chen had repeatedly diagnosed the patient's condition without going through the examination.

This time, it is estimated that it will not be wrong.

After the diagnosis was established, they worked together to determine a treatment plan.

Then, they ordered the nurse to push the old man into the operating room.

The peasant woman looked worried.

When Zhou Chen entered the operating room, the peasant woman pulled Zhou Chen and said:
"No... nothing will happen, right?"

"Are you the patient's daughter?..." Zhou Chen asked casually.

"No, I'm a vegetable farmer who sells vegetables. The old man and his children are all away from home. Some are busy with work and some are busy with business. I can't come back for a while. No, I brought him to the hospital..."

After listening to the peasant woman's story, Zhou Chen was a little angry.

The old man became so sick, and the children refused to go home for various reasons, sent a non-relative vegetable farmer to the hospital, and advanced the medical expenses for the old man.

Turning around, he said to the peasant woman, "Don't worry, nothing will happen."

Enter the operating room.

Zhou Chen also performed laparoscopic cholecystectomy for the first time.

Standing on the operating table, he first familiarized himself with the laparoscopic machinery, looked at the display screen, the flow rate, total volume, pressure and other values ​​of the insufflation machine, and temporarily learned from the system of famous doctors.

According to the regulations of the hospital, regular training doctors who have just entered the hospital cannot directly perform operations on patients.

However, Zhou Chen, who has a well-known medical system by his side, can largely avoid the risk of surgery, which greatly guarantees the safety of the patient's life.

Zhou Chen once again spent 2000 likes to exchange laparoscopic cholecystectomy techniques and separation techniques in the famous doctor system.

Everything is ready.

Right now, the resection begins.

When the insufflation was established, Zhou Chen raised his head and observed the pressure display on the insufflation machine monitor.

Zhang Jian nodded at him, indicating that the puncture had entered the abdominal cavity.

As the camera entered the abdominal cavity, Zhou Chen probed other structures very skillfully.

Because sometimes during exploration, unexpected discoveries will be made.

Of course, it's best not to have accidental discoveries.

For patients, every slight unexpected discovery is bad news.

Later, Zhou Chen turned the camera to the gallbladder.

I carefully observed the overall gallbladder, and after that, I looked at the course of the common bile duct.

Zhou Chen skillfully peeled the duodenum down.

Because the patient was a bit obese, Zhou Chen pawed vigorously a few more times, and then the common bile duct was exposed.

Next, is the next step - the separation of the cystic duct.

Zhou Chen first judged the direction of travel, and used the safe triangle method to separate.

This method can be said to be simple or complex.

But for a regular trainee who just graduated and came to the hospital for regular training, this is undoubtedly an impossible task.

Of course, Zhou Chen is always an exception.

Doctor Zhang Jian acted as Zhou Chen's medical assistant while looking at him with incredible eyes.

Zhou Chen skillfully used the electrocoagulation hook to cling to the ampulla of the gallbladder to open the anterior and posterior serosa of the triangle.

"Follow your guts."

Zhou Chen muttered to himself.

It can be seen that he is calm and confident.

His technique is close to the gallbladder, at most it will burn the gallbladder, and generally it will not damage the bile duct.

After the serosa was opened, Zhou Chen immediately changed the suction device and bluntly pushed and pulled it apart.

Fortunately, this elderly patient was loosely organized.

Zhou Chen easily exposed the cystic duct.

Then, he skillfully used the pushing technique.

The so-called pushing technique is to push up the ampulla of the gallbladder, and after seeing the bundle-shaped connective tissue, switch to the electrocoagulation hook.

Immediately afterwards, the gallbladder blood vessels were clearly exposed in the operative field.

Generally speaking, if the right posterior branch vessel is exposed first, the vessel can be separated and treated first, and then the cystic duct can be treated.

Zhou Chen handled each step in an orderly manner.

He also raised his head and gave Dr. Zhang Jian a look.

That look seemed to be proudly asking the other party:

Look... Is my surgical technique awesome or not?

He has the air and style that a doctor who has been a surgeon for decades should have.

The next step is to deal with the cystic duct.

At this step, Zhou Chen suddenly encountered a difficult surgical problem.

Because before dealing with the cystic duct, it is necessary to determine the relationship between the three duct structures of the patient.

But right now, Zhou Chen tried his best several times, but he couldn't confirm the relationship between the patient's three-tube structure.

(End of this chapter)