Is this still digging? Xue Chunhe was quite helpless.


    "If it''s all right, I''ll go first."


    On this day, as if in a dream, director Liang watched Miss Wu leave and was in a trance for a long time.


    I thought I didn''t have much chance. I kept telling myself that the risk of bajingzi was too great. As a result, Mr. Wu threw down a sentence and knocked himself unconscious.


    It must be looking at his high level that moved Mr. Wu. Director Liang sent the patient back and sat in his office thinking happily.


    ERCP + Spyglass is a technology. Even in magic city, what you do with your teachers is not as smooth as today. Is it hard to realize that you have accumulated a lot and suddenly realized it? Director Liang was foolishly happy.


    Every time I make a little achievement in technology, I will be very happy. In particular, director Liang''s own technical level is very strong. I haven''t experienced this pleasant feeling for a long time.


    He must have accumulated a lot. Director Liang recalled the process of ERCP + Spyglass. Every step was so smooth and perfect. Now in retrospect, it''s like drinking manna. My heart is very happy.


    No wonder Mr. Wu didn''t hesitate to go through such an operation. At this level, everything is a piece of gold!


    Director Liang is more and more happy. The progress in technology makes him excited. Like a child who has just got a toy, he is anxious to try again.


    Are there any suitable patients in the ward? Director Liang began to think about it.


    There must be no one in his own group. Director Liang knows it. He thought, picked up his cell phone and contacted his team of professors.


    But after thinking about it, director Liang put down his mobile phone and strolled to the operating room to get familiar with Spyglass''s equipment.


    Now he is just like a swordsman who has just learned peerless swordsmanship. He wipes his sword to the degree of integration of man and sword. It is estimated that he can go to a higher level in the future.


    When he came to the operating room, director Liang heard laughter from the nurse''s duty room.


    "I''ll submit my application this afternoon. It''s no use laughing at me." a voice came out.


    "Miss Wu has a girlfriend. It''s useless for you to go."


    "What''s the matter? It''s good to have a look if you have nothing to do. If you buy a ticket for the concert, you''ll have to pay more than 1000 in the front row. You can''t see anything. Just now Mr. Wu was standing next to me. Although he was wearing a mask, it was also beautiful. The masks were much more pleasing to the eye."


    "Go on, go on, I''m old enough to be a mother powder. Just bless me from a distance." the head nurse''s voice came out.


    Director Liang smiled. The head nurse changed into a real mother powder? This is really a face watching world. If I set up a hospital in bajingzi, let alone a little nurse, I''m afraid the head nurse who has cooperated for many years won''t take it with me.


    Look at Mr. Wu. The most lacking nursing power is taken away with blood.


    Thinking about things in a mess, director Liang went straight to ERCP room.


    There are three ERCP rooms in the second hospital of Medical University. The innermost one is director Liang''s room, which is the quietest and has the best equipment. This is the director''s privilege. No one will beep for it.


    Director Liang walked briskly and hummed a tune in his mouth, ready to check Spyglass equipment like a soldier trying to wipe a steel gun.


    Suddenly the door of the second operation room opened. The operator was Professor Li. He hurried away in lead clothes.


    "Director." Professor Li said hello without saying much and continued to run away.


    "What''s the matter? I''m in such a hurry." director Liang asked.


    "Director, I did ERCP. The choledocholithiasis is much larger than the preoperative image. I can''t do it. I''ll prepare the next plastic stent." Professor Li said, "I''ll explain to the patient''s family."


    Huge stones? Director Liang moved slightly, frowned and said, "what patient?"


    "Director." Professor Li stopped and looked at director Liang Hui''s report. "An 84 year old male patient complained of upper abdominal distension and pain in May, aggravated for 4 days. Physical examination showed that the skin and sclera were slightly yellow, the right upper abdomen was slightly tender, and the liver area was slightly percussive."


    "What about the test?"


    "Tbil189.5umoll, dbil113.2umoll, alt226.4ul, ast458.2ul, ggt1250.8ul, alp1145.3ul, alb24.8gl, crp53mgl, normal blood RT and coagulation. Upper abdominal CT: common bile duct multiple stones with bile duct dilatation, gallbladder multiple stones, cholecystitis."


    Professor Li Hui reported, "director, CT shows that the largest stone in the common bile duct has 3 × 2cm size, it is estimated that it can be taken out before operation. "


    There is an old saying that people are separated from their belly. It is quite accurate in the medical process.


    CT, MRI and other imaging examinations can only provide reference. Sometimes the results of direct vision are completely different from those of imaging. This has little to do with technology, mainly because imaging is not so accurate.


    It is estimated that Professor Li encountered a similar problem.


    "According to the preliminary angiography, the stone is very large, but the development is not very good. The guide wire retreats into the knife. I hook it with the knife and see a stone about 2.5cm wide and 4cm long. There is also a small stone below, which seems to be very different from the preoperative CT."


    three point five × 4cm？ What a big stone!


    Such a large common bile duct stone has exceeded the treatment scope of ERCP stone removal. If you poke it for a long time, you are forced to poke the stone to pieces, which may lead to common bile duct injury.


    Professor Li''s meaning is that the patient is older. It''s almost enough to install a plastic biliary stent to ensure smooth bile outflow. The service life of plastic biliary stent is estimated to be longer than that of patients, and there is no problem of taking it out.


    In the past, director Liang would certainly make such a choice when he met such a large common bile duct stone.


    But!


    Now he feels he has upgraded! After playing wild for a long time, upgrading directly can completely adopt a new way to solve this problem.


    Yes, a new way, the upgraded version of yourself is about to debut!


    "Professor Li, I''ll talk to the patient''s family later," director Liang said.


    "Ah?" Professor Li was stunned.


    "You go and push the Spyglass machine." director Liang said with a smile.


    Gravel with Spyglass laser? Professor Li looked at director Liang, just a little stunned. After understanding his meaning, he immediately answered and pushed the Spyglass equipment.


    After two hands, director Liang saw ERCP and evaluated the patient''s condition in his heart. He felt that what Professor Li had done was not enough. He directly came up to block the RT opening with a stone taking balloon and did another angiography.


    Because the RT port was blocked, the length of the common bile duct stone displayed this time was longer than that seen by Professor Li, about 5cm.


    This kind of stone can be called a huge stone. If the patient is more than ten years younger, he can choose endoscopic bile duct incision for stone removal. But the patient is 84 after all. At such an old age, Professor Li''s practice is not wrong.


    But now there is a better choice. Director Liang smiled and was ready.