Chapter 356

"Then ethanol, eh! This operation is tangled. " Lao Zhao also said helplessly. I can't help it. This operation is too bullshit. The insect sac is broken. If you want to kill it completely, it's estimated that the insect didn't kill. People were killed first. If you don't kill it completely, it may relapse after a while.

"Yes." Zhang Fan gently replied. After hemostasis and ligation, Zhang Fan and Zhao Jingjin quickly prepared for entering the abdomen.

"Wash your hands." Zhang Fan said to the itinerant nurse.

The itinerant nurse held the salt water prepared early high and began to rinse Zhang Fan's gloves and Zhao Jingjin's gloves in turn.

This is a general rule, because this kind of surgical gloves is easy for doctors to wear. There is talc powder on them. If this thing goes into the stomach, it can make the patient's intestines stick together after operation. Therefore, it must be washed before entering the abdomen.

When you enter the abdomen, you can't rush for surgery. You should explore first. In short, you should turn over various organs regularly and successively. Open the liver to see if there are insect cysts under the liver and gallbladder, and open the intestines to see if there are insect cysts behind the peritoneum.

Zhao Jingjin worked with Zhang Fan to turn the patient's organs“ Let's do the free ligament first. " Zhang Fan turned for a while and said after finding no obvious insect sac. What is such a thing really? Turning my intestines to find the insect sac sounds very lame, but this is the method of this operation. There is no good way.

If it is multilocular echinococcosis, surgery is the only treatment, and the highest resection rate is 58%. In other words, almost all of them will relapse. Once they relapse, the most thorough treatment is to directly cut off the liver and then change the liver. Therefore, there is a price for eating raw meat.

And this thing has different numbers of testis (a) pills, son (a) uterus and reproductive pores. In other words, it is estimated that this thing can be one to many, or many to one, and the blood will not be disordered. It is a super terrible thing.

After the exploration, Zhang Fan said, "change the gauze, remove all the white gauze, and don't go on the stage again."

"Good!" Baoyin nodded and counted the number of gauze with the itinerant nurse. There must be ten before the upper stage and ten under the lower stage. This is the Ordinance.

The cyst of the skull is shallow and small. The liver is usually deep and large. The insect sac is the largest in the head and is like a small egg. The liver less than 4cm can be treated conservatively, that is to say, it is not surprising that this thing grows into a small ball in the liver.

If the sacs are pearl jelly in the head, they are about the same size as small dumplings in the liver, shiny dumplings and small dumplings mixed with water at the slightest touch.

Little by little separation, found what tissue adhesion, Zhang Fan will open to see if there is a sac hidden. When Baoyin takes the blue dressing on the table. Zhang Fan began to enter, and the separation around the liver was clear.

The liver is too complex. It is not only a synthetic secretory organ, but also an detoxification and decomposition organ. Therefore, this is a super chemical plant. There are various pipes in it, and the insect sac grows here, and then secretes liquid to stick to the liver and various pipes.

Small tubes don't matter. If they stick to the inferior vena cava or hepatic vein, it's super troublesome.

"Probe." After the separation, Zhang Fan said to the itinerant nurse. In this operation, we must see clearly the relationship between the internal structure of the liver and the insect sac. There is still an error in doing color Doppler ultrasound across the belly. Therefore, after dissociating the ligaments and blood vessels around the liver, Zhang Fan began to explore the situation in the liver with color Doppler ultrasound.

Zhang Fan and Zhao Jingjin looked at the color ultrasound screen carefully at the same time. Under Zhang Fan's hand, the color ultrasound probe was slowly moved, and the probe was wrapped by sterile gloves.

"It's OK. I haven't touched big blood vessels. Director Zhao, would you like to have a look again?"

"OK, I'll see it again." Be careful before the operation. When you do the operation, you can rest assured. The cross examination of two people is more guaranteed.

"No big blood vessels." After Zhao Jingjin also did it once, he confirmed.

"OK, let's go, sharp knife." Zhang Fan said.

Holding a sharp knife, Zhang Fan slowly separated from the liver parenchyma boundary along the insect sac. There are many channels in the liver, and the operation is very slow. There are several channels in almost one knife.

Continuous ligation and cutting off is not the worst luck. If you lean on the hepatic vein, you can only pray to God or change the liver.

After cutting off all the blood vessels and bile ducts entering the cyst, Zhang Fan gently took the cyst with liver tissue out of the liver with a blue dressing.

Looking down from the shadowless lamp, the patient's liver was directly a pit, which was gouged out by a knife and was the size of a small bowl. Take down the insect sac. Zhang Fan looked at the situation around one side very carefully for fear that it had another insect sac on one side.

"No!" Zhang Fan read it again and Lao Zhao read it again.

"Come and see Dr. Lu. There are no white insect cysts. " Zhang Fan said to LV Shuyan.

"No!" LV Shuyan said after looking at it.

"OK, let's open the insect sac." This cyst content is very important for treatment. If the cyst fluid is clear and contains small fragments, it indicates that the cyst is active. Drugs must be used to kill the tissues around the cyst.

If the cyst fluid is milk like, it means that the cyst has weakened, but it is still infectious. If the cyst is toothpaste like, it means that the Echinococcus inside has died, so there is no need to kill the surrounding. This is the same as human amniotic fluid.

After Zhang Fan took the insect sac away from the operating table, he cut the insect sac with a scalpel. A stream of milk like liquid flowed out and showed water like. The pressure inside was not small, indicating that there were many reproductive insects.

At the moment of cutting with a knife, it was really like the sugar water dumplings with white sesame stuffing that had not been ground carefully. It opened a small mouth and directly flowed a bend.

"Bag." Zhang Fan directly put the whole plate into the tissue bag. Then he said to the tour, "this must be strictly disinfected."

"OK."

Then, Zhang Fan continued to change his gloves. The cyst has been removed, and no other insect cysts have been found in combination with color Doppler ultrasound. Zhang Fan said to Lao Zhao, "director Zhao, do you use ethanol?" In this regard, his experience is still not as much as Lao Zhao.

"Forget it, the operation was very clean, and no other insect cysts were found. This patient's liver was tested by alcohol. It's too fragile. Use formalin."

"All right!" It's better for Zhang Fan to listen to people's advice to eat a full meal.

Gently wipe the inner wall with gauze stained with formalin. While wiping, I looked at whether formalin remained. If this thing remained, it would be a big trouble.

"Flush!" A lot of saline, more than a dozen bottles of normal saline, washed directly for several minutes, and the original vermilion liver was almost washed white.

After more than five hours, the operation was finally over.