Chapter 232： Laparotomy for suspected pancreatitis

Operation begins.

Chen Qi had a vague feeling that this patient was not as simple as reflux cholangitis. Perhaps this was the intuition of a hepatobiliary and pancreatic surgeon in his previous life.

Unfortunately, in view of the lack of auxiliary inspection methods, he has no evidence, so he can only tell Director Zhu his intuition:

"Mr. Zhu, I always feel that something is wrong. The patient had an operation 8 months ago. I only knew that he had obstructive jaundice and the distal end of the common bile duct was obstructed, but the entire medical record did not indicate the cause of the obstruction and which organ occurred. disease caused."

Director Zhu asked calmly: "What is your suspicion?"

"I suspect that the liver or pancreas next to the common bile duct will have any space-occupying lesions?"

Shen Zhemin next to him gasped when he heard it

Chen Qi's point of view almost completely overturned the diagnosis made at the county hospital 8 months ago.

At the same time, if this space-occupying diagnosis is true, then today’s operation may be overturned, and it is simply not something a regional hospital like Yuezhong can do.

Whether it is the liver or the pancreas, general surgeons really don’t want to touch it, because it means that the difficulty of the operation will increase exponentially, and if there is a slight carelessness, a patient will die on the operating table on the spot.

Besides, this is still a deputy county magistrate. Anyone who involves officials must pay more attention to it.

If it was Shen Zhemin's own assistant or student, he would definitely go crazy and curse nonsense at this time.

Zhu Huoyan just glanced at Chen Qi lightly, and asked coldly as usual:

"What's your suggestion?"

"The surgical incision is enlarged, and the abdomen is explored, and the target is not limited to the bile duct."

Shen Zhemin didn't dare to say a word, and cursed again in his heart.

Everyone in the operating room also looked at Director Zhu. Of course, everyone was thinking that this Chen Qi was going to take the lead, and making an exception for him to be an assistant was still so blah.

Who knew that Zhu Huoyan took the scalpel and said to everyone in the operating room without raising his head:

"Then let's conduct a thorough investigation today to find the cause, so as not to need a third operation."

Hiss~~~~

Everyone in the operating room gasped again. When did this famous "Cold-faced Hades" become so talkative?

Now everyone looked at Chen Qi with sympathy. You said that there is such a great teacher, but he was sent to the "frontier". How unlucky is that?

Chen Qi himself didn't pay much attention to other people's eyes and opinions. During the operation, the doctor's brain must be running very fast, and at the same time, the speed of the hands must keep up with the speed of the brain.

Director Zhu didn't say anything more, and directly made a reverse L-shaped incision on the patient's upper right abdomen, and began to explore the abdomen.

Shen Zhemin and Chen Qi hurriedly picked up the surgical instruments and performed auxiliary work. After a while, only Shen Zhemin's voice was left in the operating room, so that the assistant could record the operation process with pen and paper.

"No ascites, no cancerous nodules on omentum..."

"The liver is brown-red in color, smooth in surface, without fish-like nodules, liver cancer is ruled out..."

"The biliary-enteric anastomosis is narrow, the outer diameter of the common bile duct is about 1.8cm, the left and right borders of the hepatoduodenal ligament are all enlarged lymph nodes, hoarse..."

Shen Zhemin's originally calm voice suddenly trembled, hissed like a toothache, and looked at Chen Qi, who was on the opposite side of the second assistant, thinking that the kid's crow mouth really guessed it.

At the same time, seeing these abnormally swollen lymph nodes, director Zhu's eyes flashed coldly.

Abnormal lymphatic enlargement, lymphatic metastasis is one of the very common ways of cancer metastasis,

Usually, cancer cells can fall off and invade the lymphatic vessels, and with the lymph fluid can reach the local lymph nodes, forming metastatic cancer of the lymph nodes.

Seeing swollen and multiple lymph nodes indicates that there is a "malignant tumor" and has already metastasized. Once metastasized, it is almost always in the middle and late stage.

This is the last scene doctors want to see.

Chen Qi was close, and young people had better eyesight. Once he saw so many swollen lymph nodes, which had even formed a mass, he knew that today's operation would not be easy.

The liver has been preliminarily checked just now and there is no problem. The gallbladder has been removed in the previous operation, so there is only one organ left with the largest possibility of cancer.

Pancreas!

Pancreatic cancer, known as "the king of cancer"

In terms of survival rate, the 5-year survival rate of pancreatic cancer is only about 5%, which is the worst among all cancers. Even the 5-year survival rate of liver cancer, which everyone talks about, is still about 12%.

Shen Zhemin looked at the livid Director Zhu, and swallowed:

"Director, do you want to continue this operation?"

Zhu Huoyan was already sweating profusely with the naked eye.

Chen Qi was still a little strange, thinking that this old Comrade Zhu was usually quite calm, and he had the demeanor of a general who was in front of the mountain collapsed and remained unchanged. Why was he suddenly nervous today?

If it is really pancreatic cancer, he is not to blame. The problem is also misdiagnosed and went to the county hospital. As for it?

Seeing that he didn't respond, everyone in the operating room looked over, and Chen Qi had to whisper beside him:

"teacher Zhu?"

Zhu Huoyan said coldly at this time:

"First, I went to talk to my family members, and said that pancreatic cancer is very likely, and the operation is very difficult and dangerous. I asked them for their opinion, whether to continue the operation or shut down the abdomen?"

Shen Zhemin nodded when he heard it: "I'll talk about it!"

Outside the operating room, all the family members of the deputy county magistrate were waiting. In addition to his wife, there were a lot of sons-in-law, daughters-in-law

Shen Zhemin came out of the operating room. As soon as the door opened, family members quickly surrounded him, all of them with nervous expressions:

"Doctor, how is the condition of my old man? Why is the operation so fast?"

"Doctor, is my dad okay?"

Shen Zhemin pressed his hands and signaled everyone to keep quiet, and then said:

"The patient's condition is not very ideal. After laparotomy, we found a large number of enlarged lymph nodes at the hilum of the liver. The most likely possibility is that there is a tumor in the pancreas, and it is malignant.

Now we need to seek the opinions of your family members, should the surgery continue? If you continue to do it, although there is a certain probability of successful resection, the biggest possibility is that you will not be able to get off the operating table. This needs to be confirmed by your family members. "

The old lady cried when she heard it: "No, no, no, we won't do this operation."

Suddenly the eldest son next to him shouted:

"Mom, we have to try. Next year, I will be a deputy department cadre at a critical moment. Without my father's relationship, I can't do it!"

The second son also jumped out:

"That's right, mom, I'm still in the process of being transferred to the regional finance bureau. My younger sister's promotion to vice principal has not yet been confirmed. I can't do it without my dad!"

Family members suddenly talked about it.