roccoschili Page 667
Page 667
A gentle voice came from behind.
"Academician Chu." The nurses stood with their hands tied, honestly.
"Let's do our job well. If something happens to me, a brave doctor will come to save me. It would be embarrassing to let people know that we speak ill of them behind their backs." Academician Chu said with a smile.
"Yes, Academician Chu."
Seeing Academician Chu enter the operating room, the nurses didn't say much and started to get busy.
When Academician Chu entered the operating room, his attitude towards the head nurse was not as kind as that of the little nurse, and he asked a little seriously, "Are you all ready?"
"Academician Chu, everything is ready."
The patient was still preparing, Academician Chu was not in a hurry, and asked in a deep voice, "Tell me."
"Assist the patient in a good position, lie on the left side, bend the legs slightly, and lower the corner of the mouth on the left side. After placing the mouth ring, ask the patient to bite, inhale through the nose, and exhale through the mouth."
The head nurse had already memorized all the materials given by Academician Chu, so she knew that she must be tested by academician Chu.
Academician Chu nodded slightly after hearing what the head nurse said fluently.
“术前询问医生，一般情况下在开始手术前10min给予654-210mg、安定10mg、杜冷丁50mg解痉镇静。”
"What about the operation?"
"Strictly aseptic operation should be performed during the operation, assist the endoscopist to insert the duodenoscope into the descending segment of the duodenum, and find the opening of the bile-pancreatic duct at the RT of the duodenum. Insert the catheter along the biopsy duct and inject the contrast agent .”
The head nurse spoke incessantly.
Academician Chu was quite satisfied with her answer.
ERCP surgery can use doctors as assistants, but nurses are also required.In the recent surgeries, the nurses were unable to cooperate, and Academician Chu's temper was quite grumpy.
Every time I go home and think of this, Academician Chu finds it funny.
In the past, I laughed at the surgeon in private many times, and would scold the assistant if the operation did not go well.
But when I operate the guide wire by myself and can't insert it into the large RT of the duodenum, my temper will become inexplicably bad.
His eyes looked right there, but he couldn't get in. How could this make people feel calm.
Anyone who cooperates with the operation makes a little mistake, which will be infinitely magnified on the operating table.
After scolding the head nurse a few times, she really put her heart into it when she went home. Academician Chu nodded in satisfaction.
"Thanks for your hard work."
Hearing Academician Chu's encouragement, the head nurse froze for a moment, with a relieved and relaxed light in her eyes.
It seems that today is a pass, and the head nurse is not moved to tears, but the feeling of being relaxed is real.
Seeing the head nurse's expression, Academician Chu found it funny and blamed himself. He must not be like those rogue surgeons who scolded the people around him when they had problems with surgery.
Because Chu Yuntian is big-hearted, academician Chu knows more about big-heartedness.
Professor Pan Chengpan of the imperial capital has such a habit. It is said that recently the little doctors under him either resolutely go to other groups, or simply resign.
Pan Chengzhong betrayed his relatives, and he didn't even have a little doctor who wrote medical records under his command.
It sounds ridiculous.
I have a bad temper recently, so I can't become Pan Cheng, Academician Chu secretly warned himself.
Last night, I called Chu Yuntian and said that I had a bad temper during the operation, and was laughed at by my son.
The father and son exchanged ideas about surgery, and Chu Yuntian gave a lot of advice.
But there is one thing Academician Chu can't do - once the operation fails, he will immediately find someone to save Taiwan.
There are not many people in the metropolis for ERCP surgery now, and if something happens, I don't know what to do.
Now belongs to the stage of crossing the river by feeling the stones, and we can only grope a little bit.
Therefore, Academician Chu screens patients very strictly, and he personally follows every patient who needs ERCP, which is why he is busy recently.
Only with almost 120% certainty can Academician Chu agree to perform the operation.Although looking at some patients in pain, Academician Chu also felt compassion, but he dared not move.
Now once I think that I can do it, I will do surgery randomly, and experience at most 3-5 failed operations, and my self-confidence will collapse.
Slowly, bit by bit, Academician Chu patiently accumulated experience points.
Today's patients are diagnosed with common bile duct stones after cholecystectomy. In the past, similar patients had no good way to do it, and could only watch the patient's condition worsen a little bit.
If you are lucky, you will survive.If life is not good...
But now that there is a new technology, academician Chu felt happy when he thought of this.
Problems that could not be solved before can be solved now, what is progress, this is it!
"Xiao Sun." Academician Chu greeted the head nurse.
"Academician Chu." The head nurse took a step forward honestly.
"Today's operation may be a bit troublesome. It is also the first time for me to perform stone removal for the Nets. If the operation process does not go well, you must remind me to control my temper."
"..."
The head nurse grinned under the sterile mask, crying in her heart.
remind?Your old man doesn't know what you were like at that time.
Although she thought so in her heart, the head nurse still said softly, "Okay, Academician Chu."
Chapter 1138 Who is not the first time
The head nurse personally arranged the patient's position. Academician Chu put on his gloves, and carefully read the patient's B-ultrasound sheet to make a final confirmation.
The patient's abdominal ultrasonography showed: after cholecystectomy; choledocholithiasis and widening.
Academician Chu did not read the final conclusion, but recalled the B-ultrasound image he saw at the time while looking at the list.
"Academician Chu, get ready." The head nurse said softly.
"Hmm." Academician Chu put the list aside, and the latex of the sterile gloves rubbed against the A4 paper, making a sound that made him a little uncomfortable.
Academician Chu calmed down and tried not to let himself be disturbed.
Because today's operation is different from the previous week, he is a little worried today.
But when it comes to worry, it's only a little bit.
The operation is very simple. The duodenoscope goes in through the pylorus, finds the duodenum, and then inserts the guide wire...
Academician Chu recalled how to do the operation again, and then he came to the operating table pretending to be calm.
It is inevitable to be calm and calm. Every big shot must have a corresponding background music. Academician Chu is not trying to pretend, but he is not a god-like existence in the eyes of ordinary gastroenterologists, but he also needs to be infinitely looked up to. that.
And with a certain amount of successful experience, Academician Chu felt that he was okay.
Although today's surgery was used on patients for the first time, it has been tried many times on 3D-printed mannequins.
The students led by Academician Chu have already inserted the duodenoscope. The Olympus TJF-260V duodenoscope is very useful. The cooperation between Academician Chu and Olympus is quite tacit, and the equipment used is of the same grade as that of Europe and the United States.
After entering the descending part of the duodenum, Academician Chu used the wire-guided method for intubation.
The guide wire is Boston's disposable encapsulated insulating guide wire with a length of 450 cm and a diameter of 0.91 mm.
The operation has been smooth so far, but there are difficulties ahead.
It is simple and simple to say, but it can be complicated...Academician Chu only simulated it. This is the first time he did it on a patient. The more he did it, the more timid he became.
After entering the guide wire, Academician Chu thought of an old joke, both the patient and the operator said that it was the first time for him.
Hey, Academician Chu laughed at himself.
For the first time, who wants to try it on a patient for the first time?
It's not impossible.
You can't do it yourself, and neither can the patient.
If you don't want to do it yourself, you will always feel embarrassed because you take a little risk. If you are tied up, let alone others, the patient in front of you will have to go home and wait to die.
It's not going to be surgical incision to remove stones, even in Shanghai, there are not many doctors with this level, and it is rare to perform similar operations.
The common bile duct, that is the common bile duct, once there is a fistula or something after the operation, the patient's life would be worse than death.
And even if it is cut open, it may not be possible to take out all the stones.
Or ERCP is more scientific, less traumatic but more effective, academician Chu comforted himself.
At this time, under fluoroscopy, it can be seen that the guide wire enters the main pancreatic duct, and a small α-helix is formed at the front end.Academician Chu's students acted as assistants, supporting the guide wire.
Academician Chu tried his best to recall the feeling when he practiced.
Pretty much, there shouldn't be much of a problem.It's just a Nets take a stone, that's all.
Come on!
Academician Chu remembered what Chu Yuntian said to cheer him up on the phone, and the corners of his mouth rose, revealing a slight smile.
"Prepare for imaging." Academician Chu said.
The assistant withdraws the guide wire.
This movement... Academician Chu felt uncomfortable, and it seemed a little wrong.
But before he could stop the student's movement, an accident happened.
The α-helix was not completely unwound, and the front end of the guide wire was broken at the position of the main pancreatic duct.
"!!!" Academician Chu gave an exclamation mark.
For a moment, his mind was blank and his hands and feet were numb.
Academician Chu never expected that a surgical accident would occur so early. A nearly foolproof operation made such a big mistake at the very beginning.
He really wanted to kick his student out of the operating room, and then tell him to go back to his hometown and farm. He never wanted to see this stupid guy who pretended to be a fool for the rest of his life.
But the words of persuading myself to maintain a good temper today are still echoing in my ears.
Besides, the alpha helix itself hadn't noticed it at the time, which was a complete accident.
accident!
Academician Chu didn't hit anyone or curse anyone, but cold sweat was already breaking out.
The guide wire is broken, what should I do?
Maybe it will puncture somewhere and cause heavy bleeding.
I have never encountered a similar situation before, and Academician Chu has no idea what to do next.
In fact, Academician Chu does not know much about ERCP. He is just a rookie who knows the basic operations. How could he have too much clinical experience.
But the name of Jin Cancan, an academician of the Academy of Engineering, was on his head. When everyone realized what happened, they all looked at Academician Chu.
What big bosses and academic leaders want is to make a final decision at this time.
Academician Chu's student was crying, subconsciously dodged aside, for fear that the teacher would scold him.
But he would rather the teacher yell at himself, and then take action to solve the problem.
He looked at the broken guide wire in the pancreatic duct under fluoroscopy, wishing he could grab the ground with his head, as long as the guide wire could come out.
Seeing this scene, the head nurse turned pale and took a few steps back in fright.
Normally, it's just that the operation process is not going well, and academician Chu is about to curse, but today's matter is not bloody?
"Call the brave old Yang and let him take a look." Academician Chu said pretending to be calm.
The patient is not under general anesthesia and cannot speak too much.
The head nurse hurried out of the operating room to call the hepatobiliary surgery department.
……
……
In the operating room.
Director Yang's phone rang in his hip pocket.
"Help me pick it up." Director Yang is doing laparoscopy, and everyone is talking and laughing before the most critical step.
"Director Yang, I read on the Internet that there was a surgeon who answered the phone during the operation, and it seemed that he dropped the phone in the patient's stomach."