Chapter 930 Monkey

Ling Ran was indeed undergoing emergency surgery.

For a patient under general anesthesia, when the abdominal cavity is opened, a small amount of fluid seeps out, and near the spleen, a large amount of bloody fluid seeps out. Coupled with the adhesion between the spleen and the abdominal cavity, the inside is a mess, like a fast It's like a dry hot pot.

Such a patient, more than two years ago, must have directly called the general surgery department and sent him to add boiled water.

However, today's chief surgeon, Dr. Zhou, thought a little bit more, called Ling Ran over, and asked when they met, "Ling Ran, you can do operations on spleen and peritonitis, right? What about pancreas, can you do it?"

"The pancreas doesn't work, and peritonitis isn't dealt with much." Ling Ran answered very directly.

He has the skills of total splenectomy. It is like playing with the spleen. It is not very difficult to deal with peritonitis. It belongs to the state of self-learning, but the difficulty of the pancreas is high, and he has not touched it much so far.

Doctor Zhou listened and nodded, washed his hands with him, and said: "The patient has had a plain scan of the abdomen and pelvis. The initial diagnosis should be rupture of the spleen, accompanied by perisplenic effusion. In addition, there may be peritonitis and pseudocyst of the pancreatic body. After a while, you will continue to do laparotomy and deal with the spleen and pancreas at the same time. If there is any problem, I will call the general surgeon, and if there is no problem, let it go."

Ling Ran agreed without thinking too much. In his opinion, this was a slightly more complicated emergency operation, and it was within the range of his skills.

Dr. Zhou breathed a sigh of relief. Recently, the relationship between the emergency center and general surgery is not as easy as it seems on the surface.

With the popularity of the emergency center, the proportion of emergency surgery patients has increased significantly, because there are more surgical patients from other counties, districts, and even cities. This is also the subtle influence of the style and reputation of the hospital.

Internal medicine patients who also come from other hospitals, such as myocardial infarction and cerebral infarction, are likely to choose the provincial or army general hospital for treatment. On the other hand, Huo Congjun's strength is mainly concentrated in surgery, and his coverage of internal medicine is not strong, and his willingness to expand internal medicine is not as strong as in surgery.

Coupled with Ling Ran's treatment group, the volume of operations has been greatly increased, making the proportion of surgical patients in the emergency center much higher than the average level, and this naturally encroached on the territory of general surgery.

Although the general surgery department still maintains a relatively calm attitude. After all, they have too many operations and patients to finish, so that they become a burden, but this does not make them turn a blind eye to the invasion of the emergency department.

In the past, emergency operations such as appendix and intestinal obstruction were performed, but the general surgeon not only didn't care, but was happy to see the results.

Ling Ran's achievement of the liver does not affect the development of the general surgery itself,

Gastrointestinal disorders, however, fall on the borderline. For operations such as gastrectomy, general surgery is still fighting with digestive surgery, and emergency surgery is naturally unpopular. That is to say, digestive surgery has not responded yet, and Huo Congjun's suppression has prevented the two sides from conflicting.

However, with the expansion of the emergency center to the present, the attitude of general surgery has naturally changed. If Dr. Zhou encountered such a patient before, he would definitely call for general surgery without hesitation, but now he has to think more .

The ownership of the spleen is also unclear. If the general surgeon took this opportunity to intervene in the emergency spleen operation, the doctor would be in trouble that week.

Thinking about Huo Congjun's appearance when he was in the hospital, Dr. Zhou who was a monkey at that time is definitely still fresh in his memory.

"The spleen can be made, so let's do it ourselves. However, this patient's symptoms are quite special, so you have to pay special attention." Doctor Zhou was thinking about office politics in his head, but when facing Ling Ran, he only talked about the symptoms of the disease.

As long as the symptoms of the disease can be resolved, the office politics can also be resolved naturally. Dr. Zhou also has this confidence.

Ling Ran poured water on his hands, feeling the power of the water flow, and asked, "What's so special about it?"

Doctor Zhou sorted out his words, and then said: "Two months ago, the patient began to experience pain in the left upper abdomen without obvious cause, persistent pain, accompanied by waist pain, and it was more severe. After seeing the doctor in the county hospital, the other party Supportive treatment was given, and the condition was relieved. Shortly after leaving the hospital, the pain recurred again, without any obvious cause, and was hospitalized again in the district hospital. After the symptomatic support was still given, the symptoms could be relieved, but it recurred shortly after leaving the hospital, so I came to Yun Hospital. See a doctor..."

"Do you want further diagnosis and treatment? Then you should register with a specialist..."

"The patient came in an ambulance. He arrived late and couldn't get a number, so he went to the emergency room. He was originally considered for referral, but it turned out that he was working on the road and went into shock, so he had to be sent to the emergency department first. We're in the operating room." Doctor Zhou didn't elaborate on the issue of registration.

For the top three in the region like Yunyi, some expert accounts are full of scalpers, so that before the registration window, they often start queuing up a day in advance.

A patient like the one in front of me had persistent abdominal pain and couldn't get a number temporarily, so he could only rush to the emergency room.

This can also be regarded as a medical treatment technique. If a patient is in need, register to the emergency department and then be transferred to a professional department, which can be regarded as a curve to save the country. Correspondingly, using this method, you can't control where you will eventually be referred. It's more like checking "obey transfer" during the college entrance examination.

And after he was sent to the operating room in an emergency, it was even more out of his control who the surgeon was. Dr. Zhou opened the laparotomy. If it was a general surgery job, he could find a general surgery or Ling Ran or do it himself. If he found other problems, he would naturally call doctors from other departments to do emergency surgery.

Ling Ran listened to Dr. Zhou's introduction to the patient's condition, brushed his hands, and then threw the hand towel into the bucket. With his hands parallel, he held them upright in front of his chest. When he returned to the operating room, he saw Ren Qi, his assistant. He was desperately sucking bloody liquid.

"Is there still fresh blood coming out?" Ling Ran stretched out his head to take a look.

"Yes, the intra-abdominal cavity is very complicated." Ren Qi, as a trainee doctor, is well-informed and belongs to the immediate combat force in Ling Ran's group. In terms of sports, he is equivalent to a blue-collar in his early years with talent. Generally, the technology is average, but because of years of experience and hard work, it is very suitable for temporary use in various occasions.

He is not good at anything, he is just an ordinary doctor, but he has no obvious shortcomings, and there are relatively few mistakes, most of which are easy to be controlled. On the contrary, he has obtained a lot of surgical opportunities in Ling Ran's group.

However, in terms of vision, Ren Qi is very average.

Dr. Zhou looked at the abdominal cavity, turned it gently twice, and said: "The problem now is that the adhesion is too serious, the abdominal cavity and the abdominal wall are adhered, and the body and tail of the pancreas are wrapped by adhesive tissue. The blood should be the spleen... ..."

Ling Ran let out an "En" and followed suit.

Laparotomy can be said to be a bug-level technique in surgery. Like the patient in front of me, various X-ray examinations did not find the cause in the end, but the laparotomy found that the spleen was bleeding and there were so many adhesions. Easy to diagnose.

"It seems to be an old rupture of the spleen." Dr. Zhou sighed, and asked, "The adhesion is so serious, I am afraid that the spleen and the body and tail of the pancreas will be cut off together."

Ling Ran raised his head and said, "I haven't cut it."

"Then...if it doesn't work, I'll call the general surgery department..."

"I can separate the spleen from the body and tail of the pancreas." Ling Ran said another sentence, but it made Dr. Zhou feel like a turning point.

Doctor Zhou was immediately happy, but hesitated for a moment: "Don't force it too much, it will be fine if there is a problem, it will be good if the pancreatic head can stay..."

"I'll give it a try." Ling Ran didn't say anything for sure, the pancreas is notoriously soft and waxy, it's about the same as a pinch of a bag of oil, and the difficulty of separating it can be imagined.

Dr. Zhou felt relieved immediately, and said with a smile, "It would be best if we could separate..."

"By the way, I need to tell Zuo Cidian." Ling Ran reminded Dr. Zhou that once this operation is done, it won't be finished in half an hour.

Doctor Zhou said "Oh" and asked, "What's going on with Zuo Cidian?"

"Principal Bo of Jun'an Clinic invited the chairman of Dongjia Group to come to Yunyi, and he should have almost arrived at the special needs building." Ling Ran gave an explanation.

Dr. Zhou's eyes were about to fly out: "Is it today?"

"Yes. I sent a message half an hour ago and landed."

"Is it today, and now?" Dr. Zhou re-confirmed.

Ling Ran nodded, and continued, "I'm starting to separate."

After saying that, Ling Ran ignored Dr. Zhou and started the operation on his own.

Doctor Zhou stood on the spot and muttered to himself: So, I still got into trouble?