Chapter 2651

Endoscopic ultrasonography was inserted to show the location of the cyst, the appropriate puncture point was selected, and the adjacent vascular structure was displayed by color flow diagram.

The shape is ideal. The position and image performance are what Professor Yang imagined, and there is almost no deviation.

He knows that his level is growing. Every time you contact and learn a new technique, there will be such an exciting process. This feeling is also Professor Yang's favorite.

Growth, joy, really intoxicating.

Shrink the puncture needle into the outer sheath and insert it into the endoscopic ultrasound tube. Then Professor Yang sent the puncture needle to the stomach and carefully stretched out the tip of the needle, so as not to poke a hole in the stomach wall before surgery.

Although the hole was sensational and the stomach wall recovered well, Professor Yang still paid careful attention to each step of operation.

Then, he identified the position of the needle tip on the ultrasound image and inserted the needle into the cyst cavity under the guidance of the ultrasound image.

When there is an obvious sense of frustration, it indicates that the puncture needle has entered the cyst. Professor Yang was calm. This was the wall of the bag. He didn't make trouble for himself. If the puncture is difficult, connect the puncture needle to high-frequency electric cutting and turn on pure electric cutting current. In that case, it would be a lot of trouble.

I'm lucky today. Professor Yang had the idea that the puncture of the capsule wall was not smooth during the preoperative evaluation.

Everything went well and he almost hummed a brisk song.

19g puncture needle successfully punctured the capsule wall and inserted 0.035inch guide wire. After expanding the puncture channel with dilators of 4mm and 6mm in diameter, a 24mm double cavity parallel metal stent was successfully inserted under the guidance of guide wire.

The operation was basically over here. Professor Yang carefully observed the pancreatic pseudocyst with a B-ultrasound probe. It was found that it began to shrink, which meant that the fluid accumulated in the cyst was led into the stomach and then into the intestine.

It's going well! The corners of Professor Yang's mouth raised slightly under his mask.

The patient of this operation is almost the largest pancreatic pseudocyst he has ever seen. If endoscopic surgery, it is difficult to ensure that there are no complications.

However, there are few complications in endoscopic ultrasound-guided drainage of pancreatic pseudocyst. It is just an internal drainage. What complications can there be. Professor Yang believes that the biggest risk lies in the puncture steps. God knows whether there will be puncture bleeding when there are no blood vessels under B-ultrasound.

If that's the case, you'll fuck.

People engaged in medical treatment are very cautious. Professor Yang is a man of the golden mean.

When I first went to work, pancreatic pseudocyst is a serious disease with high surgical grade and great postoperative risk. After laparoscopy, the procedure and postoperative complications of this operation have been reduced accordingly.

But now, surgery is like "playing". Professor Yang is a doctor who has personally experienced these stages, so his feelings are extremely profound.

"Professor Yang, the operation is over." The anesthesiologist asked with a smile.

"Well, almost." Professor Yang was not in a hurry. He observed for a few minutes and determined that the pancreatic pseudocyst had become smaller. He said with a smile, "it's over."

"Professor Yang, can pseudocysts do this in the future?" Asked the anesthesiologist.

"How!" After the operation, Professor Yang was in a high mood. He said casually, "pseudocysts are close to the wall of the gastrointestinal tract without large blood vessels. The digestive tract is compressed and uplifted locally by cysts, and the mucous membrane has obvious color changes. This is a necessary condition now. Minimally invasive surgery is used to do everything, which is at the level of boss Zheng. I don't want to do it in my next life."

"You are too modest." The anesthesiologist smiled.

"The most important thing is self-knowledge." Professor Yang said seriously, "it's not modesty, it's the truth. Boss Zheng is so awesome, I don't want to."

"Hey." The anesthesiologist didn't know what he was thinking, so he smiled.

"If you don't believe it, just say this operation. If the stent is blocked after the operation, you should intervene in angiography. I'm lucky and the patient screening is powerful. If it is carried out in large quantities, I'll have to trouble boss Zheng sooner or later." Professor Yang said.

Professor Yang has carefully analyzed the indications of endoscopic ultrasound-guided drainage of pancreatic pseudocyst and how to treat the child after the accident. When I was in Dongyang, I also consulted my mentor.

The reason why the operation can be smooth, looks simple and easy, in fact, there are reasons.

No success can be achieved for no reason. Professor Yang firmly believes in this. He saw the cyst shrink and began to pull back the guide wire.

While pulling the guide wire, he said kindly, "don't tell others what you just said, boss Zheng..."

At this point, Professor Yang was stunned.

The guide wire... Can't be pulled! Normally, the guide wire should be taken out smoothly with the guide wire in hand.

I can't drag it. What the hell is this!

Where's the card? No, the guide wire is thin and slippery. How can it get stuck.

What is this complication? What was the accident? Professor Yang was stunned.

I had made full preparations, but I didn't expect an accident when the operation was "over".

Professor Yang panicked.

He immediately used B-ultrasound to see, but B-ultrasound has its own advantages and disadvantages. At this time, P didn't use it.

"Professor Yang, what are you going to do?" The anesthesiologist asked strangely.

"..." Professor Yang felt like crying.

It's really special. I can't show it off at all. I just showed it off and something happened right away.

The most important thing is that he didn't show off. The anesthesiologist praised himself and told him with great sincerity.

The anesthesiologist realized that something had happened. He stopped his action and didn't push the medicine to the patient. Don't let the patient wake up, but something happened to the operation. There's no explanation.

He looked into Professor Yang's eyes and waited for him to explain the situation.

"OK... I think the guide wire is stuck."

The anesthesiologist laughed.

"Professor Yang, don't joke with me." The anesthesiologist said, "the guide wire is nothing else. If you say the bracket is stuck, I believe it. The guide wire is stuck? How can it be?"

Professor Yang scolded in his heart that I don't believe MMP.

He tried again, but he still couldn't pull the guide wire.

"It's really stuck. I'm not kidding." Professor Yang calmed down and immediately said, "is there anyone in the hybrid operating room?"

"There is an orthopedic surgery, and the remaining operating table is empty. Wait a moment, and I'll have a look." The anesthesiologist finished and ran out quickly.

Professor Yang stood on the operating table, crying without tears.

He also looked confused about what had happened. Are you not careful enough? Is there any operational error? Yes

None of them!

At this time, he had no idea what had happened.

……

……

Note: quoted from Journal of British Gastroenterology Society, gastrointestinal endoscopy, September 27, 2015.