When a doctor opened a plug-in

Biliary-enteric anastomosis is an important part in the reconstruction of digestive tract function. Although it cannot be said to be very difficult, it is definitely very important.

In the reconstruction of the digestive tract, the most difficult operation is the pancreaticogastric anastomosis, and pancreaticoduodenectomy is one of the most difficult operations.

The difficulty in the reconstruction of the digestive tract actually revolves around the small intestine!

The difficulty is naturally in the handling of the small intestine.

Intestinal anastomosis seems the simplest, but as the central link, it is actually the most difficult.

Because he connects the stomach, biliary tract, pancreas,

These three important digestive organs, plus the small intestine, already constitute 90% of the digestive tract.

As for colorectal anastomosis, it seems that everyone has not paid much attention to it.

At first, Chen Cang felt that the reconstruction of the digestive tract was not difficult, but after in-depth understanding, he became more and more aware that the difficulty seemed to be much higher than he thought!

Otherwise, it will not have troubled digestive surgery for hundreds of years, and there is no better solution yet.

At this time, when Chen Cang looked back, he suddenly realized that the pancreas surgery skill expansion package he had acquired was a huge advantage.

The most rare problem seems to be solved by him first.

After the operation started, Chen Cang held the mirror meticulously.

Gallbladder surgery under laparoscopy is actually very challenging.

For example, in this patient at this time, the reason for the biliary stenosis was that the bile duct was accidentally damaged during the cholecystectomy, so that the bile duct was narrowed, resulting in cholestasis and jaundice.

Under laparoscopic surgery, damage to the bile duct seems to have become a very serious problem.

This is no longer a personal matter, and has even become an industry issue.

Thinking of this, Chen Cang is no longer anxious to think about stealing the teacher or what he can do. He hopes to observe the gallbladder with his mirror-holding skills to see if the chance of bile duct injury can be reduced!

Chen Cang settled down and began to watch Oersted's operation.

After the bile duct is exposed under the laparoscope, it needs to be separated carefully.

Because the blood vessels around the bile duct are dense, there are multiple blood vessels that need to be cautious.

During Oster's surgery, he didn't relax his vigilance because it was an operation he was good at, but took it seriously.

At this time, Chen Cang suddenly said: "Professor Oster, what do you think is the main reason for damaging the bile duct during biliary tract surgery and gallbladder surgery?"

This question made Oster suddenly silent!

Extrahepatic bile duct stenosis accounts for about 80% to 90% of extrahepatic bile duct damage during surgery.

The inflammation, infection, and ischemia secondary to the bile duct after surgery account for only 10% to 20%.

So why the damage?

This is a very important question!

With such a high damage rate, why not conquer it?

Oster thought of this and couldn't help saying: "This is a problem!"

In a word, Ma Yuehui couldn't help rolling her eyes!

I thought you could say anything good?

At this time, He Zhiqian, who was acting as an assistant, also thought about it.

Surgery for the treatment of traumatic biliary strictures is the second biliary tract operation, some even more than 10 times, which is a very difficult operation.

It is definitely not an operation that can be successfully completed, including the patient at this time, which has already been completed three years ago!

Four people think at the same time.

After a while, Oster said, "Maybe it is because of the problem with the field?"

He Zhiqian also nodded: "Well, even for open surgery, when the gallbladder is treated, because of the dense liver and blood vessels, it is easy to damage the bile duct when the triangle of the gallbladder is treated."

When Oster was dealing with the common bile duct, Chen Cang suddenly said: "Wait a moment, I will give you a different angle, and you will deal with it again!"

Just when it separated and entered the small omentum, Chen Cang took the lead to follow the endoscope. At this time, Chen Cang turned the optical fiber, and soon, the thread knots left by the previous operation and the scar nodules of the bile duct stricture appeared on the TV In the picture.

After seeing this narrowness, Chen Cang fell into contemplation.

Why would it hurt here?

Thinking of this, he hurriedly said: "I will look at the place where the hole was punched last time."

Suddenly, Auster's eyes lit up.

Marks from several operations on the abdomen appeared.

Chen Cang looked at a few marks, and Oster quickly distinguished which was the operation hole and which was the auxiliary.

But Chen Cang opened his eyes wide, looked at the four-dimensional map, and kept thinking...

At this time, he discovered the power of his NavInfo!

This is clearly an analog structure diagram.

Through the three holes, I even began to simulate the operation at that time.

After a few minutes, Chen Cang had already thought of dozens of possible injuries.

This... is no different from not thinking of it.

Dozens of operations are obviously not representative, he needs to find a common injury!

Thinking of this, Chen Cang understood that this is no longer a problem that can be solved by one operation, and more operations may be needed to verify it.

Chen Cang simply said, "Professor Oster, you can handle it, and I will give you a vision!"

Osman said, the question raised by Chen Cang also made him fall into contemplation.

The operation passed by.

Chen Cang continues to use his skills in endoscopy, taking into account all structures and organizations as much as possible.

Ost's bile duct jejunostomy was done very well!

This is the first time Oster has been assisted by Chen Cang in person, and it is also the true sense of how powerful Chen Cang's skills in holding a mirror are!

Chen Cang could even think of every step in advance.

Blood vessels, ligaments, liver, bile ducts...any tissue that may be damaged, Chen Cang will use endoscopic techniques to illuminate the field of vision in advance, and then act as a warning!

The endoscope is like the eyes of the surgeon, and Chen Cang, as the lens holder, abruptly turned the eyes of the surgeon into a 360-degree camera with no dead ends!

So Oster's next operation went smoothly!

Oster also feels that his surgery today is unprecedentedly smooth, and every detail can be grasped in place.

All this is naturally due to Dr. Chen.

For a while, Oersted had a hunch that Chen Cang might perform this kind of surgery more powerfully than himself?

Thinking of this, Oster raised his head and glanced at Chen Cang, only to see that his eyebrows were tight and he didn't know what he was thinking!

Suddenly, Oster suddenly felt a little bit in his heart, and his eyes became more worried.

Could it be that... Dr. Chen was dissatisfied with his performance in this operation?

Thinking of this, Oster suddenly felt anxious, and the operation became more rigorous and serious!

The operation is over soon!

However, Chen Cang still did not say a word, which made Oster even more uneasy!