BSI Chapter 172 Vicryl Line
Chapter 172 Vicryl Line
Chapter 172 Vicryl Line
For patients with mirizzi syndrome type II, since the disease is defined, the operation method basically remains the same.
Or,
someone wants to change,
But no one has successfully improved the technique,
For the treatment of the mouth of the common hepatic duct,
Until now there was only one way,
That is, it is blocked with the wall of the gallbladder or the wall of the gallbladder duct.
Maybe someone has thought of doing it another way,
But there is no doubt that using the wall of the cystic duct or the wall of the gallbladder is the best and most advantageous.
but,
In this patient,
Yu Wenxing was flexible.
And with this little twist,
It's a world of difference.
two floors,
he can't sew,
But if there is only one layer, just sew this very small mouth together,
He is confident he can do it.
The control after a needle breaks through two layers is indeed far greater than the control after breaking through one layer.
This is common sense.
"Have you already thought of it?"
Pete was so shocked that his speech was a little knotted.
"No, I just thought about it, and I'm not sure if I can sew it, I have to discuss it with everyone."
Yu Wenxing smiled wryly,
He really didn't know if he could sew like this,
After all, the hepatic duct he came into contact with,
Really too few.
Peter nodded, lost in thought,
Gu Jianjun put on his gloves and fell into thought.
At least until today,
No one has proposed the method of directly suturing the opening of the common hepatic duct on a formal occasion.
No one has published even a little article on this aspect.
In normal times, it is absolutely wrong to directly suture the opening of the common hepatic duct.
Because after all, there is a mouth of the basket, if you want to sew the mouth of the basket directly, it will inevitably form a stretch, and after stretching, it will inevitably form wrinkles.
The existence of folds will inevitably lead to deformation of the common hepatic duct, leading to stenosis of the common hepatic duct.
And the stenosis of the common hepatic duct,
That is the consequence that no one can accept.
but,
This patient is something special,
Or rather special,
His time to form a crate is extremely short,
this basket,
very very small,
Just like the eyes of two needles.
Is it really necessary to cover the mouth of the pinhole with another layer of gallbladder wall?
Nobody knows the answer.
everyone is thinking,
Including the beauty of going to bed,
Although he wanted to see Yu Wenxing make a fool of himself, he wanted to see Gu Jianjun make a fool of himself,
But the problem,
Also raised his interest.
Can you sew directly,
this is a problem.
If the safest way is to paste the gallbladder wall on the hole, but it is not possible to fix the gallbladder wall with one or two stitches.
Although the direct suture method is not safe,
But it's not an idea,
At least it gave him an idea.
"Are you sure, can you sew this place with confidence?"
Peter spoke up.
The mouth of the basket is not terrible,
The terrible thing is that it is not sewn properly,
Although the slot is small,
But no matter how small the mouth is, it may lead to unpredictable consequences.
"If it's just pulling the basket together, I'm confident;" Yu Wenxing estimated, "But I'm not very confident about how far it will be pulled."
"Actually, it's a good idea."
Pi De nodded, "But the operator needs to have a strong grasp of the common hepatic duct, and needs to know how far it has been stretched. Too much stretching will not work, and wrinkles will form. Too little stretching will not work. The opening of the basket is not sewn properly. Let's open the abdomen. .”
"I think it's best to open your stomach."
Another expert agreed.
"I think it's best to open your stomach."
Shang bed beauty also agreed to the practice of laparotomy.
next moment,
All eyes were on Gu Jianjun,
After all, this is China,
This patient, after all, was a patient brought by Gu Jianjun.
Everyone has the power to propose, but not the power to make decisions.
Gu Jianjun also wanted to open his stomach,
Opening the stomach is really the safest.
but.
When his eyes flashed past Yu Wenxing, Gu Jianjun paused.
In Gu Jianjun's heart, Yu Wenxing has always been a doctor with his own thoughts.
This is extremely rare,
As a profession of doctor, there are too many things to memorize,
When I was young, my mind was active, but I knew too little and had too little experience, so I couldn't practice medicine independently.
And when you can practice medicine independently, if you memorize too much, you will be dull again, and you will not have the ability to innovate.
And Yu Wenxing,
But as an intern,
Not only has high technology,
And it will innovate.
This is a talent that Huaguo's medical community needs very much.
Gu Jianjun's heart is also full of twists and turns at the moment.
open your stomach
It is indeed the safest,
but.
"Yu Wenxing, how sure are you?"
Gu Jianjun asked a layman's question in a deep voice.
How sure are you?
This is really a very layman's question,
No doctor dared to say how sure he was,
There is no theory of probability in a surgery with only one operation.
Succeeded,
That is 100%,
no success
That's 0%.
Yu Wenxing was dumbfounded,
Of course, he also knew that Gu Jianjun should be in a mess at the moment,
This is the most difficult point of this operation,
Just sew up the mouth of the basket,
There is even no need to place a common bile duct T-tube,
Just put the abdominal drainage tube directly.
After all, the purpose of the T tube is to drain the water, and the other is to support the mouth of the basket.
But now it's just patching up the gap,
Then you don't need support.
This is Yu Wenxing's idea.
"I'd like to try that!"
Yu Wenxing replied.
"Okay! Anyway, there are only two more needle holes. At worst, it will be treated as Mirizzi syndrome type III later."
Gu Jianjun smiled pretentiously.
Yu Wenxing also laughed,
next moment,
The smile disappeared, and Yu Wenxing looked at the monitor with a serious and terrifying expression.
Surgery continues.
There was no compression between the cystic duct and the common hepatic duct, and the gap came out. Yu Wenxing continued to dissect the cystic duct without stopping.
Clamp the cystic artery, cystic duct, cut off,
After the gallbladder is pulled out of the body,
Everybody knows,
The most important step is coming.
No one realized that it took only 10 minutes for Yu Wenxing to finish all this. Everyone held their breath and waited for Yu Wenxing's next operation.
If successful,
That really redefines the surgical approach for mirizzi syndrome.
"Use the Vicryl thread."
Yu Wenxing said something.
Yu Wenxing has always been very repulsed by these devices,
But this time,
no way,
Use the safest way.
Needle,
Slowly approaching the hepatic duct, everyone dared not make a sound, and stared at it firmly.
The mouth of the basket is about 2mm,
Appears infinitely large at this moment.
needle, near the common hepatic duct,
Needle, pierced in,
Yu Wenxing's movements were extremely gentle, but at the moment when there was a sense of breakthrough, Yu Wenxing's hand stopped instantly!
It is indeed much less difficult to break through the first level.
At this moment,
The stitching of the mouth of the basket,
It should be fine,
The next difficulty,
It is just how tight the knot is to be pulled.
(End of this chapter)