ERCP technology is an amazing revolution, which not only makes the diagnosis of biliary and pancreatic diseases more accurate; At the same time, endoscopic treatment can be carried out, which avoids the disadvantages of high risk, large trauma, slow recovery and many complications.


    In 1968, American doctors successfully intubated duodenoscopy for the first time, marking the beginning of ERCP. After that, ERBD, EST and ENBD technologies were completed by experts from Germany and Japan respectively, and the series of diagnosis and treatment technologies of ERCP were gradually improved.


    In the early 1980s, professors Yu Zhonglin and Lu Huanzhang began to introduce ERCP related treatment technology. After more than 40 years of development, the operation level of ERCP in China has reached or even exceeded that in foreign countries.


    After all, the number of patients in China is huge, and the basic national conditions are different from those in foreign countries.


    The number of people abroad is also large, but whether they can get sick depends first on whether they have money. Many well-known people claim free medical treatment abroad, which is deceptive. Every year, so many people fly home for appendectomy.


    The accumulated experience of ten ercps a week is completely different from that of nearly 100 ercps a week.


    Foreign high-end technology is indeed high, but when it comes to the most basic treatment, there is another situation - the high is too high and the low is too low.


    In Wu Mian''s view, the reason why foreign high-end technology is developing rapidly is because of the needs of the rich. They don''t care how much they spend, but only how many years they can live.


    As for those who have no money... They are all means of production, not people. Mr. Ma has long made various arguments on this point.


    Wu Mian just thought about this idea and didn''t tell anyone about it.


    Because ERCP technology has been basically developed and improved, ERCP has not made substantive progress in recent 10 years, and seems to have entered the bottleneck of development.


    Biliopancreatic duct is called "the last blind area of digestive tract" by doctors.


    Because the pancreas and bile duct are "hidden" by the liver, stomach and other organs, the examination is very difficult. At present, there are still some diseases of biliary and pancreatic duct system that can not be diagnosed by ERCP and MRCP. For complex biliary diseases, it still has limitations.


    In recent years, the emergence of Spyglass is a bright spot. It can carry out bile pancreatic duct biopsy and even lithotripsy under direct vision, breaking through the blind area of the original endoscopic treatment.


    Spyglassds is called transoral choledochoscopic direct vision system, which can be said to be the third eye of endoscopists.


    This system can enter the bile duct or pancreatic duct through the biopsy hole of duodenoscopy to achieve direct vision and accuracy, so that doctors can clearly observe the bile duct and pancreatic duct area at any time, eliminate the visual field blind area of the previous bile duct and pancreatic duct, and improve ERCP technology.


    After listening to Xue Chunhe, Wu Mian said that director Liang of the digestive endoscopy room of the second hospital of Medical University put forward the list and entered a spyglassds.


    After that, he became interested. After all, spyglassds system appeared very late, and it was not popularized even in some slightly inferior hospitals in the United States. Unexpectedly, it has been introduced in Heishan province. He came to see it.


    He changed his clothes at the door and saw director Liang staring at the image of ultrasonic gastroscope in a daze. Wu Mian immediately understood what had happened. He whispered a reminder.


    "Miss Wu." director Liang turned and looked at Wu Mian with surprise and joy.


    I was surprised that my luck was really bad today. A misdiagnosis, coupled with the unclear diagnosis of this old patient, left a bad impression on Mr. Wu.


    I''m afraid I''m getting farther and farther away from the new courtyard of bajingzi.


    Now it''s not his hesitation and choice, but Mr. Wu doesn''t look at himself at all.


    I''m glad that Mr. Wu is here. I can ask for advice on whether it''s my own feeling or whether the patient really has a problem.


    "Well, director Liang, are you thinking about other problems with the patient''s pancreas?" Wu Mian asked.


    After a brief introduction to the patient, director Liang said, "Mr. Wu, there''s nothing wrong, but I still think there''s a problem."


    "What''s the problem?" Wu Mian looked at director Liang with a smile.


    Director Liang was stunned for a moment. What did you ask... Gossip? Or examine yourself?


    Yes, it''s just an intuition under the action of many years of clinical experience. But if you want to make it clear where there is a problem, director Liang is out of his power.


    Wu Mian didn''t speak, just looked at director Liang.


    A breath of embarrassment spread around. Director Liang didn''t know what teacher Wu meant. His anxious back was sweating.


    "That..."


    He was silent for more than ten seconds, which seemed like a year to director Liang. He stammered, "that..."


    "Which?" Wu Mian asked as if joking.


    "Er..." director Liang saw that Wu Mian had no serious expression, but just smiled gently. The smile was really good-looking. He could feel that the eyes of the little nurses around him always focused on Mr. Wu from time to time.


    Alas, no wonder the single nurses went to bajingzi actively. Not to mention anything else, just pleasing the eyes is enough.


    But he asked himself "which", which was a little impolite.


    "Mr. Wu, I have the courage to say, right or wrong, please correct me." director Liang said, "the patient is an old patient. He has been treated here for many years, and I am vaguely impressed by his image data."


    Wu Mian didn''t interrupt director Liang, but just listened.


    "Ultrasound gastroscope shows that the echo of pancreas is thickened and pancreatic duct is dilated. It must be right to diagnose chronic pancreatitis. But the whole pancreas looks a little rough, which makes me feel... Not beautiful." director Liang thought for a long time, but he couldn''t find a suitable word to describe his feeling in his heart. At last, he can only use "not beautiful".


    "Director Liang, your level is very high." Wu Mian nodded and said seriously.


    To director Liang''s surprise, Wu Mian did not laugh at his "ridiculous" statement, but was recognized.


    High level? It doesn''t look like what the doctor said. If it''s not beautiful, it''s a high level?


    Director Liang looked at Wu Mian in surprise. He didn''t know if he was saying the opposite.


    "Where did director Liang learn about the direct vision system through oral cholangiopancreatoscopy?" Wu Mian asked.


    "Magic capital."


    "Well, Mr. Qu from the Department of Gastroenterology in mordu has carried out research on the direct vision system through oral cholangiopancreatoscopy. How many cases have you done yourself?" Wu Mian continued to ask.


    Director Liang was sweating.


    Wu Mian''s eyes were direct and frank, without any hostility, which made director Liang feel a little warm.


    He thought for a while, and finally told the truth, "Mr. Wu, I personally operated three cases in the magic capital. I came back to apply with the support of President Xue. I arrived through the direct vision system of oral cholangioscopy one month ago. I haven''t found a suitable patient recently."


    A new system has just been bought, and the indication we must look for is that kind of very light patients. We should take a chance. From the "practice" of mild patients to becoming more and more skilled, we dare to use it on patients similar to pancreatitis.


    "You do it, I''ll watch." Wu Mian said with a smile.