Chapter 62 Swollen Gallbladder

Intraoperative exploration showed no abnormal changes in the stomach and small intestine. The liver was normal in size and smooth, without the nodules seen in patients with cirrhosis.

However, the gallbladder was congested and edematous, and it was the size of a fist of half an adult man.

The swollen gallbladder is like an inflated balloon. Looking at that posture, a gallbladder who is not careful will have to explode into the sky with a "bang".

[Wow, how many stones are in this gallbladder? 】

[It is not necessarily a stone, it may be a parasite. 】

[Why do I feel that the gallbladder will burst when I touch it, and then a large amount of bile flows into the abdominal cavity, and the operation is so polluted? It's over, I can't watch it, and if I continue to watch it, I'll probably have a nightmare, the kind of nightmare that I can't finish after a night of surgery. 】

The unknown doctor who said he didn't look at him was very honest in his body. No one left the live broadcast room, and people kept coming in to watch the operation of the legendary Daniel who had become a legend in Xinglinyuan.

At a distance of 0.5cm from the liver, Zheng Ren made a small incision with the tip of the knife, and then started his signature movement - blunt separation.

The people watching the live broadcast are all professional doctors, and those who have not performed more than a dozen operations are embarrassed to post a barrage in the live broadcast room.

But no one can achieve the blunt separation of Zheng Ren.

After repeatedly watching the "performance" of 49+1 appendectomy performed by Zheng Ren, some people began to try a wider range of blunt dissection, but the outcome was depressing, and there was no medical accident of tearing the intestines.

During this time, a post appeared in Xinglinyuan, which focused on the speeches of all those who tried surgery after watching the live broadcast for everyone to discuss.

Some people thought it was because of their poor level, but when I saw the post, everyone was a dick.

It seems to be a problem of cognition. Daniel does not know how many practical operations he has done before he has cultivated this skill.

When Zheng Ren used hemostatic forceps to bluntly separate his fingers intermittently, the live broadcast room was quiet.

Many people's fingers trembled slightly with Zheng Ren's movements in the live broadcast.

But...that kind of state of being a cook who understands the bull and is at ease, at a glance, you know that you can only watch, and absolutely cannot learn.

The gallbladder was congested and edematous to the size of a fist of half an adult man, and the surface tension was extremely high. Not to mention blunt dissection, everyone present had to be careful when performing simple open cholecystectomy.

But the surgeon in the live broadcast didn't think about it at all. The middle-curved pliers penetrated under the serosa layer of the gallbladder surface cut by the blade and quickly separated.

This speed... is just killing me.

But no one would say that.

Why? Because all the people who have said it before have been beaten in the face, and there are screenshots of the good people to prove it, and put them in the discussion thread for future generations to whip the corpse.

After a few seconds or ten seconds, the blunt dissection has reached the neck of the gallbladder. The surgeon begins to dissociate the gallbladder triangle, which is surrounded by inflammatory stimuli into a mess of connective tissue.

The techniques are skilled and the movements are not fast, but every step seems to be without thinking, and many doctors present are frightened.

This is like walking a tightrope, a professor from a tertiary hospital...why is it a tertiary hospital? Why a professor? Because hospitals below the top three do not dare to perform such operations, the risk of medical malpractice is extremely high.

Even if it is a tertiary hospital, ordinary minor attending and hospitalization will never touch it.

At least you have to lead a group of professors to have enough confidence to do such a difficult operation.

Do it, do it carefully. Absolutely will not be like the big bull in the live broadcast room, without even thinking about it, blunt separation with the forceps.

In fact, the operator's movements are not so fast, but very accurate. The anatomy of the gallbladder triangle is like a painting, gradually presented to the public.

This guy absolutely has to dissect a few general teachers, no! A few are definitely not enough, at least a dozen or twenty.

In China, the number of general teachers is so small that some medical universities have only one general teacher for each class for anatomy.

A group of eight or the legendary group of four dissects a general teacher, which is a treatment that only a few medical universities have.

For example, in a certain northern frontier town, the school is still a medical school, but it has preserved the corpses of countless Kwantung Army soldiers decades ago for autopsy. The doctor from that medical school never knew what a general teacher was.

This kind of honorary title can never be used on the Kwantung Army, even if it has been soaked in formalin liquid for decades.

Because the number of teachers in general is scarce, many doctors above the clinical level are willing to go to part-time forensic medicine.

Of course, this is only a special treatment for doctors who want to be motivated in cities where there are no full-time forensic doctors in the third and fourth tiers.

The live surgery must have dissected a large number of general teachers. This is gradually revealed in the gallbladder triangle. After it is completely exposed, the doctors have such an idea in their hearts.

The cystic duct and cystic artery were clearly exposed, ligation and cutting were started, and the gallbladder was removed retrogradely.

The removal of the gallbladder just announced that the curtain of this operation has been pulled.

[The laparoscopy is very good, I didn’t expect that open cholecystectomy can be done to this extent. 】

In the Xinglin Garden, a doctor blankly expressed his thoughts.

As soon as the expert reaches out his hand, he will know if there is any. Don't look at anything else, just a gallbladder removal, everyone already believes that the surgeon will definitely finish the operation beautifully.

As for how much you can learn from it, it depends on your talent.

[You are stupid, you can't even do open surgery well, where can you go for laparoscopic surgery? 】

[Not necessarily, many junior doctors at the level of attending physicians have started to practice laparoscopic surgery. The two of you just now, you have inadvertently revealed your age. 】

[The gallbladder has been removed, and I feel that there will be at least three or five stones over three centimeters in the gallbladder. 】

Zheng Ren's anatomy was too clear. After the gallbladder was removed, the common bile duct and the common hepatic duct were clearly exposed in the surgical field, and one could tell which one was which at a glance.

But he still put an end to all accidents and asked for a 5ml syringe, punctured and extracted bile, and confirmed that it was the common bile duct.

Making a traction wire and stretching the common bile duct, Zheng Ren stretched out his hand, and the suction device in the sleeve was gently patted on his hand.

As soon as the common bile duct was incised, the suction device was inserted into it.

There was no space at all, and the large amount of bile accumulated in the common bile duct was sucked away by the suction device before it could be ejected by the huge pressure.

This detail aroused the attention of doctors in Xinglin Garden.

In general surgery, more or less protection near the common bile duct is required, because it is inevitable that bile will flow out.

However, the surgeon in the live broadcast room did not provide any protection at all. The incision in the cystic duct was the same size as the suction device wearing a sleeve, and no bile could flow out at all.

Everything is just right, it looks simple and easy to the extreme. Only those who have actually done this technique will know the difficulty.

[Suddenly a little sad, I had an incision and drainage of acute obstructive suppurative cholangitis a few years ago, and the bile flowed out during the operation, which induced postoperative infection, first bacterial, then fungal, and it took a month to get better . 】

[I feel the same way, the operation of the surgeon is really stable, that knife, the incision is as big as the suction machine, is this kind of hand feeling and eyesight trained? 】

[That is a talent, you should stop dreaming. 】