Cholangiocarcinoma is very difficult to operate.

Cholangiocarcinoma is located in the portal area of ​​the liver. The tumor will grow along the common bile duct, hepatic duct, and pancreatic duct, and can easily invade the pancreas and duodenum. Therefore, it is necessary to remove the gallbladder, part of the bile duct, pancreatic head, duodenum, etc.

Organs.

Some cancer cells may invade the transverse colon, and an additional section of intestine may need to be removed. In addition, as a radical surgical resection for cholangiocarcinoma, regional lymph node dissection must be performed.

Therefore, Director Guo’s surgical incision is quite large, reaching tens of centimeters.

This makes the operation more difficult and increases the chance of postoperative infection and complications. In ordinary people's words, it is difficult for the body to recover.

Zhang Jun didn't understand the meaning of Dean Guo's words at all.

If it is just bile duct inflammation, there is no need for surgery at all. The surgical incision only takes a few centimeters.

However, radical resection of cholangiocarcinoma not only requires a large surgical incision and improves the level of surgery, but also has a negative impact on the patient's prognosis. If it is wrong at the time, it will be a big trouble.

Who is responsible?

Zhang Jun thought it was Dean Guo who was encouraging him, so he was still confident. He felt that he had received the attention of the big boss and his future was promising.

Dean Guo also sighed inwardly.

Even as the "Mr. One Surgeon" of the Vietnam-China People's Hospital, he was not sure whether the soft tissue shadow was a tumor or an inflammation. So even though he was inclined towards inflammation in his heart, he ultimately decided to perform surgery for cholangiocarcinoma based on the results of the department discussion.<

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You can’t risk your reputation, right?

He is not an intern like Zhang Jun and Chen Qi. As a dean, he is under greater pressure, needs to think more, and cherish his feathers more.

To put it bluntly, in 1982, there were too few advanced examination instruments in hospitals, especially in China, where there were even fewer instruments and equipment for clinical diagnosis.

Major laparotomy, the operation process was very slow, everyone held their breath.

When Dean Guo drove all the way to the common bile duct, he suddenly made an involuntary sound:

"Huh?"

The people in the operating room were all professionals, and they immediately knew that the answer had been revealed. Jin Peilin and Shen Zhemin, as surgical assistants, were on a first-come, first-served basis and immediately stretched their heads to take a look.

The two looked at each other and stepped aside. This made Li Jun, the third assistant, very anxious. But the dean and director were both here. How could he, a young doctor, be so arrogant?

So while he was obediently preparing the surgical machinery, he was so anxious that his butt was getting oily.

Dean Guo didn't even raise his head and said to the side: "Lao Zhu, Lao Qi, come on, you all come and take a look at this surgical field."

Zhu Huoyan and Qi Damin couldn't bear it anymore. The nurse brought two benches. They stood on them and looked at them, and they also said:

"Huh?"

Zhang Jun stood outside with his head full of questions and anxious at the same time. He wanted to take a look but did not dare to move. Relatively speaking, Chen Qi was much calmer. He had a hunch that these "eh" sounds meant that something went wrong during the operation. .

What accident?

The biggest surgical surprise is that this is not cholangiocarcinoma at all. The surgical plan based on radical resection of cholangiocarcinoma is completely wrong!

Dean Guo spoke again at this time:

"Come on, Director Jin, Director Shen, you two get out of the way for now, classmates Xiao Zhang and Xiao Chen, you two come over and have a look. Maybe my old eyes are dim and I can't find the tumor."

Zhang Jun moved the fastest and was the first to arrive at the operating table, his eyes widened.

At the confluence of the left and right hepatic ducts, there is indeed obvious stenosis of the bile duct, but no tumors or anything are seen around it.

Zhang Jun was so shocked that the decibel level of his voice increased:

"Where are the soft tissue shadows shown in the B-ultrasound? Where are the medical records? Where are the examination sheets? This shouldn't be the case."

Dean Guo looked at Chen Qi, who looked indifferent: "Xiao Chen, can you tell me where the tumor is?"

Chen Qi wanted to laugh but didn't dare, so he pretended to be serious and said:

"I have judged before that it is not a tumor, so there is no tumor. The soft tissue shadow that Zhang Jun was misled by is basically this. Look, here, this is fibrous hyperplasia caused by scar contracture of the bile duct for some reason. B-ultrasound looks like It’s like a malignant tumor.”

The doctors and people watching in the office let out a gasp.

Qi Damin couldn't help but exclaimed: "This is troublesome, it was misdiagnosed."

At this time, Zhu Huoyan looked at Chen Qi with overwhelming admiration in his eyes. This kid is so amazing and awesome.

Zhang Jun almost went crazy after hearing this, "It's impossible, how is it possible?"

Dean Guo didn't say anything. He just asked Zhang Jun to be his assistant and conduct a comprehensive investigation of the bile duct, but still found nothing.

Now, the truth has come to light. Zhang Jun's diagnosis was wrong. The doctors who supported his diagnosis collectively made a misdiagnosis. The result of this misdiagnosis was that Factory Director Zhu suffered such a big knife in vain.

The doctors in the operating room are all a little numb. If Director Zhu knows the truth, there will definitely be a fuss. In the future, the supply of food ingredients in the canteen of the People's Hospital will be a problem.

At the critical moment, Jiang was still too old. Dean Guo did not criticize anyone and just continued the operation silently.

"Zhang Jun and Chen Qi, you two step aside first. Director Jin and Director Shen will continue to take over. We will first remove all the bile duct tissue in the stricture and send it to freezing immediately so that the pathology department can issue a report as soon as possible.

In addition, biliary stricture exists objectively and will affect the patient's future health sooner or later, so next we need to perform a cholecystectomy, remove the hilar bile duct stricture together, and finally perform a cholangiojejunostomy."

As a physician, Qi Damin did not understand the meaning of these words for the time being. Just when he was about to ask a question, Director Zhu next to him explained:

"What the director means is that we have removed the biliary stenosis for him, so that there will be no systemic infection caused by cholestasis and obstruction in the future, and the hidden danger has been completely solved. As for whether it is cancer, this depends on the pathological examination report. Anyway, our surgery is

Successful."

Qi Damin reacted immediately:

"Oh, yes, yes, the operation was successful. The problem of bile duct stricture was solved and the diseased area was removed. It was not the best for the cancer, but the cancer was eradicated."

The tense atmosphere in the office suddenly eased, and everyone began to laugh and talk softly.

Chen Qi glanced at Dean Guo and thought that he was indeed an old fox. In this way, he avoided the important and ignored the minor, and wiped out his mistakes of misdiagnosing cholangiocarcinoma and enlarging the incision and surgical scope.

Anyway, the patient and his family were confused, thinking that this is how the surgery should be done, and the incision should be this big.
Chapter completed!