Chapter 2396

45 adult worms were taken out from the lower digestive tract. After completion, Zheng Rendao said, "director Luo, Su Yun and I do ERCP. Can you guide us?"

"Boss Zheng is too polite." Director Luo really said, "I can't get such a deep bug."

With that, he paused and said with a smile: "if in the past, the insects in this position could only use insect repellent, and then they would be discharged a little after they died. Many of them could not be discharged, and they would directly become stones."

"If the biliary tract is blocked, it depends on the situation."

"Try, I may not be able to take it out." While preparing ERCP, Zheng Ren said, "no, I can't do it alone. I have to pull Su Yun together."

The patient was lying on the left side. Nurses and anesthesiologists were left in the operating room in lead clothes, and others withdrew from the operation room.

"Director Luo, don't you give me a hand?" Professor Yang whispered.

"Boss Zheng is polite to me." Director Luo said, "if you really want to do ERCP, I can't even compare with the people under my hand."

"You see what you said."

"To tell you the truth, I'm old. I can't do some microsurgery well. Boss Zheng is so old that he can work for at least 20 years!" Director Luo said with envy.

Professor Yang sighed slightly in his heart.

Generally, people of boss Zheng's age are graduate students or doctoral students. It's not a bit exaggerated to say anything, but it must be in the process of learning surgery. There's no way to go on stage to solve difficult and miscellaneous diseases.

It's good that ordinary surgery can be taken down smoothly without mistakes.

But looking at boss Zheng through leaded glass, Professor Yang sighed again. Whether it's interventional or surgical, it's the same. How about liver cancer resection? People first intervene in the operation, and then do the resection. Gradually, people with liver and gallbladder are used to this operation.

The director is preparing to arrange a person to learn interventional surgery with boss Zheng these days.

It doesn't need to be particularly meticulous, just take medicine and embolism. After all, there is no need to do surgery too skillfully.

He has changed a lot unknowingly, and he doesn't feel too clear about being in it. Professor Yang recalled the scenes of contact with boss Zheng. Looking back, he was a little confused.

On the screen, ERCP surgery has begun. Duodenoscopy passes through the esophagus, stomach and into the descending segment of the duodenum to find the duodenal RT.

Professor Yang has seen many ERCP operations, and the next selective intubation is a very difficult step. But he looked at boss Zheng's operation, but he didn't feel it at all.

Boss Zheng should have done it, but it's strange if he couldn't. It's worth discussing with the whole hospital why.

Sure enough, the catheter was inserted through the biopsy hole. Boss Zheng adjusted the angle button and forceps lifting device to make the catheter perpendicular to the RT opening, and then naturally inserted the catheter into the duodenal RT.

Then Zheng Ren began angiography.

Retrograde cholangiography showed an abnormal image of about 15cm near the right hepatic segment of the intrahepatic bile duct. Compared with CT, it can be determined that this is the root cause of severe pain.

The Ascaris lumbricoides was stimulated and crawled all the way from the duodenum to the intrahepatic bile duct. Whenever Ascaris lumbricoides moves, patients will feel the pain of tearing their hearts and lungs.

Why bother? I really believe it's better to eat less and move more with this perseverance.

Professor Yang silently looked at the image and evaluated the patient's condition in his heart. This ERCP operation is quite difficult. Director Luo can't do it anyway.

Is there any precedent for ERCP in China? Near the end, I have an impression. But it's not so deep. It's quite difficult.

"Xiao Yang, take the insects completely. What would you do if you changed?" Director Luo asked.

Although Professor Yang has not done ERCP, he still understands the basic theory and operation. This is equivalent to sitting on the sidelines and providing a certain idea.

"Er..." Professor Yang pondered carefully, but then said with a bitter smile: "director Luo, you are difficult for me."

"Just say it." Director Luo stared at boss Zheng's operation and said casually.

"It's not difficult to catch Ascaris lumbricoides with pliers. At least it's not difficult for boss Zheng." Professor Yang said.

It's not difficult, and it does divide people.

Intrahepatic biliary tract, which is quite thin, can operate ERCP. It is difficult to take stones from intrahepatic biliary tract, let alone live animals.

"The difficulty is that although the Ascaris lumbricoides has no obvious mouth and clings to the biliary tract, its outer layer... Seems to have a protective layer, right?"

When it comes to detail, Professor Yang hesitated.

He was too meticulous to explain clearly. He just chatted with Director Luo based on his memory.

"Well, the outer layer of Ascaris lumbricoides has a cuticle, but its physical strength and corrosion resistance are comparable to that of antelope horn and rhinoceros horn. It is very resistant to mechanical damage, chemical damage and biological damage. Therefore, although Ascaris lumbricoides does not survive in the stomach, it is not digested by gastric juice." Director Luo said.

"It's flexible enough. If I grab the end of the roundworm and pull it out, I'm afraid the worm will break from the middle."

"It's OK when the space is large. Although Ascaris lumbricoides has no suction cup, the outer wall has adsorption capacity." Director Luo said, "the Ascaris in the gastrointestinal tract is easy to take, but the intrahepatic bile duct is too difficult."

"I don't understand."

"I don't understand either." Director Luo said: "at first, I just wanted to ask if boss Zheng has a good way, but now that he has come, it proves that he has an idea. I'm really curious about how boss Zheng wants to take out the insects."

"Surgery? If boss Zheng has an open stomach and cuts off the liver to take insects, it's possible at his level."

"No, if you do surgery, or this level of surgery, boss Zheng's girlfriend will follow on stage." Director Luo said with certainty.

Yes, Professor Yang nodded.

The angiography had already ended, but in the ERCP room, boss Zheng and Su Yun stopped after only a simple operation.

Director Luo was a little strange and pressed the intercom.

Immediately, Su Yun's voice came out of the intercom.

"... metformin, you can eat anything. It can also be used to lose weight. Don't admire human imagination."

"Metformin reduces fat synthesis and body weight by improving insulin resistance and reducing insulin level. But will ordinary people have no problem eating metformin?"

"There must be. A classmate who went abroad for further study two days ago also said that there was an old man who ate metformin to lose weight and was unconscious. There was no one at home. When he found out, he was almost vegetative."

This is all a mess. In the middle of the night, a group of people in the two departments outside are looking at it. Why not have an operation and say metformin here? Professor Yang and director Luo looked at each other and saw deep confusion in each other's eyes.