Fang Qing greeted Qing Ping as he walked, and Yan Ruoyun walked to the middle conference table.

When passing by the seats in the tenement building, Dr. Fang greeted the tenement building with a smile on his face: "What are you doing standing still? Come on, let's come together."

In his tone, he was completely different from before. After all, the stone that had been weighing on his heart for several days finally fell to the ground, and he was extremely cordial when he saw the tenement building.

Soon, Qing Ping, Yan Ruoyun, and Tang Lou all came to the conference table together and sat together at one end of the conference table.

Fang Qing directly spread the ultrasound image on the table, stood with one hand on his hips, and pointed a stubby index finger on it: "Did you see it! Did you see it?"

"The patient's acute cholecystitis changes, the gallbladder enlarges after eating, 10X4, and fluid accumulates around the gallbladder."

"It's really acute cholecystitis."

Yan Ruoyun was also amazed and looked at Tang Lou, the great contributor to this consultation: "Xiao Tang, it's okay. He's really amazing!"

Tanglou smiled modestly: "After all, I only know some symptoms of acute abdomen, it's just a coincidence, it's just a coincidence."

Fang Qing also looked at Tanglou curiously. This young man was quite humble, but was it really because of his vision that he happened to be blinded?

Fang Qing was a little unsure, but no matter what, as long as he could be diagnosed.

Moreover, now that it was confirmed to be acute cholecystitis, their internal medicine department was relieved.

Fang Qing licked his lips in embarrassment: "Doctor Qing, Dr. Yan, then the patient will be transferred to your general surgery department. The next step is to treat the acute cholecystitis first, and then treat the rest.

Chronic disease.”

Hearing that Fang Qing was going to transfer the patient to the general surgery department, Qingping had no objection. He just looked at the patient's symptoms and vital signs and was a little confused: "Talking to acute cholecystitis is naturally a top priority, but now the patient's heart function is extremely poor.

, and the ejection fraction is extremely low. If a cholecystectomy is performed, even a laparoscopic cholecystectomy, it will still be difficult to bear.”

"Yes, because the patient is too old and has heart problems, open cholecystectomy is risky and invasive, requires a long operation time, and causes a lot of bleeding during the operation, which will cause serious complications.

stress response."

"At the same time, open cholecystectomy can also lead to a variety of complications for patients, such as gallbladder bed bleeding, cholangitis, bile leakage, and peribiliary effusion, which are detrimental to the prognosis."

Yan Ruoyun also flipped through the patient's case information and sighed: "Doctor Qing is right. Conventional cholecystectomy is definitely unaffordable. Our hospital does not have the conditions. There are only two possibilities now. One is

, is to choose a less invasive method, and the second is to simply transfer to a higher-level hospital for further treatment."

Fang Qing was not good at surgical options, so he chose to remain silent.

[Ding, new task: Perform percutaneous transhepatic gallbladder catheter drainage (PTGD) to treat acute cholecystitis in elderly patients. Task reward: 5 gold coins, and the card library is refreshed once. 】

Tanglou directly refreshed the card library:

[PTGD (one star, 2), indirect inguinal hernia repair (one star, 2), PTGD (one star, 2), PTGD (one star, 2), indirect inguinal hernia repair (one star, 2)]

Tanglou directly clicked on three PTGDs (one star, 2):

[PTGD (one star, 2), PTGD (one star, 2), PTGD (one star, 2) automatically synthesizes PTGD (two stars, 6)]

The latest panels of Tanglou:

Level 6: Upgrade 32

Surgery column (6/6): suture (three stars, 9), diagnostic surgery (one star, 3), inguinal hernia repair (two stars, 6), cholecystectomy (two stars, 6), PTGD (two stars, 6)

6), incision (three stars, 9)

Gold coins: 17

...

...

Qingping pondered for a while and then said: "Based on the patient's current condition, there is a method that can be tried, but the residents under me are not very familiar with that kind of surgery. It seems that I can only be the one to perform the surgery."

"Doctor Qing, do you mean percutaneous transhepatic gallbladder puncture and catheter drainage?"

The system boss has already given the task. Of course, Tanglou cannot give up the opportunity for surgery and directly makes it clear.

"Oh, you know?"

Qingping looked at Tanglou with some surprise, he really couldn't understand this young man.

Percutaneous transhepatic gallbladder drainage has the advantages of small surgical trauma, short operation time, and few complications. It is often used in the clinical treatment of acute cholecystitis, especially in the treatment of elderly patients.

Percutaneous hepatic puncture and drainage of the gallbladder can completely remove infected bile from the body, effectively control the toxins absorbed by the gallbladder cavity, and avoid complications.

It is a minimally invasive surgical treatment method that is safe and reliable. However, this type of surgery has relatively high requirements on the surgeon.

Yan Ruoyun also looked at Tanglou, very surprised: "Tanglou, what do you mean?"

Tang Lou nodded and said calmly and calmly: "Dr. Qing, Dr. Yan, I know a lot about PTGD and have studied it in depth. I hope to be able to perform this surgery. I can do it with you guiding me."

Competent."

As he continues to prove himself through surgeries and diagnoses, Tang Lou is now quite confident, and his opinions and other attending doctors have to seriously consider his opinions.

Qingping thought for a moment and realized that PTGD was indeed a bit complicated, but for ordinary residents, it would be simpler than the ERAT and X-E single-channel laparoscopic cholecystectomy that Tanglou had done before.

Moreover, Tanglou had a very deep understanding of the anatomical structure of the gallbladder. After a brief evaluation, Qingping was shocked to find that Tanglou had grown to this point without knowing it.

A PTGD that ordinary residents can't get started with is no longer difficult in Tanglou.

Qingping didn't know whether he should be happy or sad. At this stage of his life in the tenement building, he was grateful to God for being able to have his abdomen closed. If he could just have his appendix cut out, he would be happy for a whole week.

"Then it's settled. Tanglou, please refine the surgical plan and report it to me later. If there are no problems, we will arrange the surgery in the afternoon."

Qingping finally came to a conclusion, and Yan Ruoyun nodded, looking at Tanglou with a look of fear.

Qingping looked at the tenement building and remembered a person, Dr. Wang Chuan, who was once the most outstanding young man under Deputy Director Shen Bingbing. He was equally radiant.

Speaking of which, Wang Chuan was more energetic than Tanglou at that time, and his surgical skills were unmatched by his peers. He was even spotted by a professor at the Imperial Union Medical College Hospital and invited to study for a year and a half, specializing in the field of acute abdomen.

Speaking of which, my training career is almost over.

Wang Chuan is not only proficient in basic surgeries such as appendicitis and cholecystitis, but is also quite accomplished in external abdominal hernia. When he was still in the First Hospital of the city, he performed the classic Bassini surgery. The postoperative pain, discomfort and recurrence rate were comparable to those performed by ordinary surgeons.

Tension-free hernia repair.

Not surprisingly, after Dr. Wang Chuan returns, the General Surgery Department of the First Hospital of the City will have a second deputy chief physician, and he will be a powerful star physician with a halo around his head.

It's just that Wang Chuan is too good and Cheng Jian can't suppress him. To be honest, he doesn't take the entire Department of Surgery of the First City Hospital seriously.

For Wang Chuan, Shen Bingbing has an indescribable feeling. She is like a sister but better than a sister. The feeling is indescribable...

When I think of Director Cheng, Deputy Director Shen Bingbing, and Deputy Director Wang Chuan, the situation in the General Surgery Department will also undergo earth-shaking changes.

Qing Ping was a bit belatedly wondering. Could it be that Director Cheng had this deeper meaning in choosing Tanglou besides establishing a provincial acute abdomen discipline.

Thinking of this, Qingping looked at Tanglou again, and his attitude was different. He became more and more supportive of Tanglou's surgery. He needed to grow up faster.

Of course, Tanglou knew nothing about this. Half an hour later, the surgical plan was reconfirmed and signed by the patient's family.
Chapter completed!