Professor Huang's expression immediately darkened.

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

Mirizzi syndrome refers to a series of syndromes in which the cystic duct and common hepatic duct are too long or have a low confluence, or stones in the neck of the gallbladder are incarcerated and compress the common bile duct, causing stenosis of the common bile duct, causing biliary colic, obstructive jaundice and other manifestations.

Clinically, Mirizzi syndrome is difficult to detect before surgery, and it can only be diagnosed during surgery.

Cheng Jian's complexion was also ugly. Although he had undergone double enhancement before surgery, Mirizzi syndrome was still something that modern medicine could not accurately detect before surgery.

According to the des classification method, Mirizzi syndrome is divided into five types. If it is type I and type II, it can barely be treated through a single channel.

For type III, a puncture hole must be added to the abdomen. For types IV and V, in order to ensure patient safety, laparotomy surgery has to be performed.

Once the puncture hole and laparotomy are added, it means that the first X-E single-channel laparoscopic cholecystectomy in Hecheng City No. 1 Hospital failed.

The meaning of minimally invasive surgery has been lost.

Obviously this situation is not what everyone wants to see.

When Cheng Jian and Professor Huang were in a low mood, the instrument nurse was still heartless. After all, he had performed so many surgeries with Tang Lou, and there were no procedures or patients that Dr. Tang could not handle.

I have a certain sense of trust in this young and handsome doctor.

The only thing that made her dissatisfied was that Dr. Tang didn't know how to care about women. Due to his high concentration, he was dripping with sweat after every operation.

"Professor Huang, what do you think?"

Cheng Jian deceived himself and asked Professor Huang, hoping to give him a different judgment. After all, there was still a trace of luck in his heart.

"If I were to go into battle in person, I would be able to judge which type it is based on experience and touch, but now it is just through the screen, and pure vision has errors. If the judgment is wrong, the consequences will be disastrous. To be on the safe side, I think it is better to transfer to abdominal dissection.

safe!"

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

Cheng Jian frowned. Although he was very reluctant, this was indeed the most correct choice. After all, it was impossible to expect that a young doctor like Tanglou, who happened to have studied such a rare Mirizzi syndrome, could still treat such an unexpected situation.

Next, stay calm and make the correct judgment.

"Tanglou, Professor Huang has the same opinion as me, switch to laparotomy. You have already done it perfectly, but encountering such a small probability of Mirizzi syndrome is not only the patient's life, but also our life."

"Tanglou, turn to open the belly."

After Lin Dong heard Cheng Jian's order, he saw that Tanglou was still observing the patient's common hepatic duct and had no intention of giving up, so he urged him.

Seeing that Tang Lou was still concentrating on designing the next surgical plan and completely ignoring him, Lin Dong felt a little confused on his face:

"Professor Huang and Director Cheng have already made up their minds. Why are you wasting your time? Do you really think you are better than the professor?"

"Mirizzi syndrome is classified according to the des classification: Type I is a stone incarcerated in the gallbladder neck or cystic duct that compresses the common bile duct, also called the prototype of Mirizzi syndrome."

Tanglou ignored Lin Dong's questioning and looked directly at Professor Huang and Cheng Jian.

Lin Dong listened to what Tanglou said and seemed to understand but not understand. He seemed to have some 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. Type III is formed and the fistula is less than 2/3 of the circumference of the common hepatic duct. I have carefully diagnosed 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."

Lin Dong was really confused at this moment. Such precise data and defined scope could just be found at his fingertips?

Of course the equipment nurse didn't understand anything, but she thought Dr. Tang was amazing.

Professor Huang's originally dim eyes lit up. If Tang Lou was just doing it for no reason, of course he wouldn't be able to be convinced, but now that he has reason and evidence, it is obvious that Tang Lou has done a lot of research on Mirizzi syndrome.

Cheng Jian was also a little surprised. How could this brat secretly know Mirizzi Syndrome, a symptom that ordinary doctors would never encounter in his life?

Professor Huang also became energetic: "Xiao Tang, continue."

Of course, Tanglou understood the patient's condition through diagnostic techniques before the operation, but Mirizzi syndrome could not be demonstrated through symptoms, so he could only keep it in his heart and did not explain it to Professor Huang and Cheng Jian until this moment.

And a mature plan that he has deduced several times:

"For Mirizzi syndrome type II, in principle, after removing the impacted stones, try to repair the stricture and defects of the biliary tract. In view of the patient's symptoms, I think Roux-en-Y common hepatic duct jejunostomy is an option."

"Including the steps that have been performed, my entire process arrangement is: laparoscopic subtotal cholecystectomy + common hepatic duct-jejunostomy Roux-en-Y anastomosis + T-tube drainage."

Tang Lou spoke out his surgery plan with great confidence and certainty.

Lin Dong looked at the tenement building in a daze, as if this young man was shining brightly at this moment!

Professor Huang pondered for a while and looked at Cheng Jian: "Director Cheng, I think Xiao Tang's plan is theoretically feasible, but the common hepatic duct-jejunostomy Roux-en-Y anastomosis in a single channel requires the surgeon's suturing

The technology is extremely demanding, constantly requiring strength, accuracy, and stability, and it requires a lot of finger flexibility and physical strength.”

Cheng Jian naturally has his own judgment. He is not worried about Tanglou's sewing technology, but can it really be completed in a single channel?

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

Tanglou continued to fight, and under the aura of the chief surgeon, every word was written like a pearl.

Cheng Jian hesitated for a while and finally said: "Tanglou, just do your best, don't force it. If it doesn't work, just open the abdomen."

"T-shaped tube..."

Tanglou went directly to the next step of the operation and gave instructions directly to the equipment nurse.

Everyone:…

"Okay."

Lin Dong calmed down and began to cooperate with Tang Lou.

"Scalpel..."

"Needle-holding forceps, microscope glasses..."

"4-0 absorbable thread..."

When the Tang Tower was being stitched, Cheng Jian still felt that it was pleasing to the eye even after watching it so many times.

Not to mention Professor Huang who saw Tanglou suturing for the first time. Is this still a difficult Roux-en-Y anastomosis that has stumped countless novices?

The problems of common hepatic duct fistula and stenosis were solved, and the following simple operation of T-tube drainage was done by Lin Dong.

At this point, the success of the first X-E single-channel laparoscopic cholecystectomy in Hecheng City No. 1 Hospital has been basically announced!

Next, there is the regular finishing, which will be taken care of by your own assistant.

Professor Huang looked at Tanglou who was about to leave and sighed.

"What's wrong, Professor Huang?"

"Director Cheng, this Dr. Tang under you is really amazing!"

[Ding, new mission: rescue completed. Successfully performed the first single-port laparoscopic cholecystectomy in Hecheng City No. 1 Hospital, and received Professor Huang’s appreciation. 5 gold coins were awarded, and the card library was refreshed]

Tanglou looked at the card library:

[Indirect inguinal hernia repair (one star, 2), Indirect inguinal hernia repair (one star, 2), Indirect inguinal hernia repair (one star, 2), Choledochoduodenostomy (one star, 2

), choledochoduodenostomy (one star, 2)】

Seeing that indirect inguinal hernia repair can be directly upgraded to a two-star rating, and it is a very popular surgery in general surgery, Tanglou was excited and clicked:
Chapter completed!