Chapter 2653 If You Want to Develop a Large Amount, You Will Have to Trouble Boss Zheng Sooner or Later

Insert an endoscopic ultrasonoscope to show the location of the cyst, select a suitable puncture point, and display the adjacent vascular structures with a color blood flow map.

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

He knows that his level is constantly increasing. Every time I come into contact with and learn a new technique, there will be such an exciting process, and this feeling is also Professor Yang's favorite.

Growth, joy, is really intoxicating.

The puncture needle was retracted into the outer sheath, inserted into the endoscopic ultrasonic tube, and then Professor Yang sent the puncture needle into the stomach, carefully extending the needle tip so as not to poke a hole in the stomach wall before the surgery.

Although the hole is a bit sensational and the stomach wall is recovering well, Professor Yang still pays close attention to every step of the 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 you feel a clear void, the needle has entered the cyst. Professor Yang felt at ease, it was because the capsule wall didn't make trouble for him. If the puncture is difficult, the puncture needle should be connected to high-frequency electric cutting, and a pure electric cutting current should be passed. If that's the case, it will be very troublesome.

I was lucky today, and Professor Yang had the idea that the cystic wall puncture would not go well during the preoperative assessment.

Everything went well, and he almost hummed a light song.

A 19G puncture needle successfully punctured the cyst wall and a 0.035inch guide wire was inserted. After dilating the puncture channel with 4mm and 6mm diameter dilators, a 24mm double-lumen metal stent was successfully placed under the guidance of a guide wire.

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

very smooth! The corners of Professor Yang's mouth under the mask slightly raised.

The patient in this operation was almost the largest pancreatic pseudocyst he had ever seen and had done. If it is laparoscopic surgery, it is difficult to ensure that there will be no complications.

However, endoscopic ultrasound-guided drainage of pancreatic pseudocyst has few complications, it is just an internal drainage, and there are no complications. Professor Yang believes that the biggest risk lies in the puncture procedure. God knows whether there will be bleeding from the puncture when there are no blood vessels on the B-ultrasound.

If that's the case, it's fucked.

People who engage in medical treatment are very cautious, and Professor Yang can be regarded as a moderate kind of person.

In other words, when I first started working, pancreatic pseudocyst was a serious disease, and the surgical grade was very high, and the postoperative risk was extremely high. After the laparoscopy is carried out, the operation procedure and postoperative complications of this operation are reduced accordingly.

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

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

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

"Professor Yang, will pseudocysts be able to do this in the future?" the anesthesiologist asked.

"How could it be!" After the operation, Professor Yang became more emotional. He said casually: "The pseudocyst is closely attached to the wall of the gastrointestinal tract, and there is no obstruction of large blood vessels. The part of the digestive tract is compressed and raised by the cyst. It is obvious that the color change is more ideal. This is a necessary condition now, if you want to use minimally invasive procedures in any situation, it is at the level of Boss Zheng. Me? I don’t want to in my next life.”

"You are too modest." The anesthesiologist laughed.

"Self-knowledge is the most important thing in a person." Professor Yang said seriously: "This is not modesty, but the truth. Boss Zheng is so awesome, I don't want to think about it."

"Hey." The anesthesiologist didn't know what he was thinking, so he let out a muffled laugh.

"If you don't believe me, let's talk about this operation. Whether the stent is blocked or not after the operation will require an interventional angiography. I am lucky, and the patients are screened very well. If it is really carried out in large quantities, I will definitely trouble Boss Zheng sooner or later. "Professor Yang said.

Professor Yang has carefully analyzed the indications for pancreatic pseudocyst drainage under the guidance of endoscopic ultrasound and how to treat it after the accident. When I was in Toyo, I also consulted my mentor.

The reason why the operation can go smoothly, it seems simple and easy, is actually for a reason.

No success can be obtained inexplicably, Professor Yang firmly believes in this. He saw that the cyst had shrunk and began to withdraw the guide wire.

While pulling the guide wire, he said kindly: "Don't tell others what you said just now, Boss Zheng..."

Speaking of this, Professor Yang was taken aback.

The guide wire... can't be pulled! Normally, at this time, you should hold the guide wire in your hand and take it out smoothly.

It can't be pulled, what the hell is this!

Where is it stuck? No, the guide wire is thin and slippery, how could it get stuck?

What complication is this? What kind of accident is this? Professor Yang was stunned.

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

Professor Yang panicked.

He immediately used B-ultrasound to check, but B-ultrasound has its own advantages and disadvantages. At this time, it is really necessary to use P.

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

"..." Professor Yang felt like crying.

You really can't show off at all, just after showing off, something will happen right away.

The most important thing is that I didn't show off, but the anesthetist praised me a few words, and I talked to him sincerely.

The anesthetist realized that something was wrong, he stopped the movement of his hands and did not push the medicine to the patient. But don't let the patient wake up, but something went wrong in this operation, and there is no way to explain it.

He looked into Professor Yang's eyes, waiting for him to explain the situation.

"Well... I really think the guide wire is stuck."

The anesthesiologist suddenly laughed.

"Professor Yang, don't make fun of me." The anesthesiologist said, "The guide wire is not something else. If you say that the stent is stuck, I will believe it. The guide wire is stuck? How is it possible?"

Professor Yang cursed inwardly, I don't believe MMP.

He tried again, but still couldn't pull the 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 operation, and there is an empty operating table. Wait a moment, I'll take a look." After the anesthetist finished speaking, he ran out quickly.

Professor Yang stood on the operating table, wanting to cry but not crying.

What happened, he was also confused. Is it because I am not careful enough? Is there any operational error? yes……

neither!

At this moment, he had no idea what happened.

...

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Note: Cited from the Journal of the British Society of Gastroenterology, Gastrointestinal Endoscopy, September 27, 2015.