The gallbladder is located in the upper right abdomen and the lower right abdomen of the appendix.

The patient now feels pain in the lower right abdomen, so Dr. Sun firmly believes it is acute appendicitis.

Decades ago, acute appendicitis had to be treated with surgical resection, but with the advancement of medicine, appendicitis can even be controlled by drugs and treated with conservative treatment.

Zhao Yuan did not want to argue with Dr. Sun in public, so he turned his eyes to Tong Zheng.

Tong Zheng did not make an immediate decision and ordered Bai Lu to send the patient to the Color Ultrasound Center.

Time passes by minute by minute.

Dr. Sun found that Zhao Yuan was calmer than he thought, and wondered where did this intern get the confidence?

"Director Tong, if Zhao Yuan's diagnosis is wrong, will he consider changing the main surgery? Is it too dangerous for the patient to hand it over to a doctor who is not sure about the condition?" When Dr. Sun talked to Tong Zheng, he immediately turned into a simple and honest look.

Tong Zheng couldn't see Dr. Sun's thoughts, "Do you want to have this surgery?"

Dr. Sun's face turned red and said quickly, "I don't have to do this surgery either. I just think the surgery should be handed over to a reliable person so that I can be responsible to the patient. Otherwise, the patient's family members may not agree, right?"

Seeing that Dr. Sun was talking in a roundabout way and was not open at all, Tong Zheng felt displeased and said lightly, "When the color ultrasound results come out, I will naturally give you a satisfactory answer."

No one dared to delay the emergency surgery emergency order, and the result was not long after the color ultrasound.

Tong Zheng took the film from Bai Lu's hand, glanced at it, his wrinkled face loosened, and then threw it to Dr. Sun.

"Can you understand the movie?"

From Tong Zheng's tone and attitude, Dr. Sun had already had a bad premonition. He carefully studied color ultrasound and sweated from the tip of his nose and his brain was blank.

"The gallbladder wall is thickened, the gallbladder is enlarged, the internal deposits of the gallbladder, acute cholecystitis!"

"No, did you get the film wrong? The gallbladder is in the upper right abdomen and the appendix is ​​in the lower right abdomen. I'm right!"

Dr. Sun actually doubted the accuracy of color ultrasound.

Tong Zheng glanced at Zhao Yuan and sighed, "Tell him the reason!"

Zhao Yuan knew that Tong Zheng was also taking the exam, so he began to explain patiently: "The pain in the right lower abdomen, and the pain in the fixed area, is generally considered acute appendicitis. However, the general incidence of appendicitis starts around the navel and only moves to the right lower abdomen later. I just asked the patient that she did not experience the pain around the navel!"

"In addition, the gallbladder is located in the upper right abdomen, and there is another possibility that it may cause pain in the lower right abdomen. That is gallbladder perforation! Not only will appendicitis cause pain in the lower right abdomen, but if the gallbladder is perforated, the gallbladder fluid will flow into the lower right abdomen, which will also stimulate the lower right abdomen to cause pain."

Gallbladder perforation?

Dr. Sun couldn't believe it!

Tong Zheng was solemnly next to him, "If it is a gallbladder perforation, the patient's condition is very dangerous and surgery is needed!"

As soon as he finished speaking, Bai Lu shouted, "The patient has lost consciousness!"

Zhao Yuan's eyes fell on the blood pressure meter, only 70/40mmhg.

He quickly touched the patient's stomach, hard and said in a deep voice: "Perforation of gallbladder may cause diffuse bile peritonitis, and surgery must be done as soon as possible!"

In this case, laparoscopic minimally invasive surgery is no longer possible, and open surgery is necessary!

Tong Zheng nodded to Zhao Yuan.

Zhao Yuan made consecutive correct judgments, which made Tong Zheng feel more and more confident. He decided to completely delegate power to Zhao Yuan.

...

Gallbladder perforation is a serious complication of acute cholecystitis. Ten percent of patients with acute cholecystitis will experience gallbladder perforation. The key to the success or failure of treatment is whether the correct diagnosis can be made in time in the early stage.

The patient has already developed shock symptoms, which means that the condition has reached its most dangerous time.

Fortunately, it didn't take too long from the onset of the patient's illness to the diagnosis.

If the treatment of appendicitis is treated with conservative treatment, the timing will be delayed.

Tong Zheng was surprised that the doctor had accumulated enough experience to determine what was wrong with the patient as soon as possible after the physical examination.

High-level physical examination not only follows the steps of the textbook, but also has respiratory rate, heart pulsation, pupil state, muscle reaction, etc.

It’s like a sniper on the battlefield. Before firing a bullet, you have to consider comprehensive factors such as wind speed and humidity.

Zhao Yuanchu was born in the country and could tell that the patient was not suffering from appendicitis by relying on his keen sense of smell alone.

There is only one explanation, he is also gifted in the field of diagnosis!

When the medical department came forward, Zhao Yuan and Tong Zheng told the patient's parents the truth together.

My mother adopted the suggestion and signed the letter with tears in her eyes.

...

Cholecystectomy is not considered a major surgery in emergency surgery, but the special feature of this surgery is the perforation of the gallbladder.

Dr. Sun took the initiative to ask to stay in the operating room. He looked smiling on his face, but in fact he was angry.

He still thought that it was an outrageous decision for Tong Zheng to let Zhao Yuan be the chief scientist.

Tong Zheng personally served as an anesthesiologist, and a good anesthesiologist is the basis for the success of the operation.

Tong Zheng's technique is gentle and accurate. From the details of pushing medicine, Zhao Yuan can see that his level is extremely high.

Zhao Yuan started cutting the skin.

Everyone's attention is all focused on the incision.

The incision is very small, only about three centimeters. You should know that the incision of laparoscopic minimally invasive surgery is usually about three centimeters.

And the location is wrong!

Have you made a mistake?

Tong Zheng was upset, but he decided to believe Zhao Yuan first and wait and see what happened.

Zhao Yuan began to bluntly separate subcutaneous tissues, muscles, and open the peritoneum.

Because the incision is very small, only small pliers are allowed to penetrate it.

Before everyone could react, Zhao Yuan suddenly clamped his gallbladder out.

Tong Zheng's eyes lit up and realized that Zhao Yuan had completed a difficult operation in an instant!

Blind fuck!

Normally, the position of the gallbladder is required to determine the naked eye or the surgical field provided by laparoscopy.

But Zhao Yuan accurately locked the position based on his feelings.

Child administration may be able to do it, but the speed is never so fast!

No wonder I dared to make such a small opening in an unconventional position and have the ability to blindly exercise.

No ability that Zhao Yuan showed was visible to him in the eyes of Tong Zheng, an expert.

I had thoughts before and could give Zhao Yuan any remedies.

Look now, I'm overly worried! Zhao Yuan is too stable!

"Little bend pliers!"

Zhao Yuan slapped Zhong Wan to Bai Lu, and Bai Lu handed Xiao Wan to Zhao Yuan as instructed.

Bai Xiaohu has been in the operating room for more than ten years and has experienced cholecystectomy many times, but today's surgery is unique.

It is wrong everywhere, but it is unusually smooth and smooth.

As soon as you raise your hand, the equipment can accurately land in your own hands.

Zhao Yuan secretly admired Bai Lu's cooperation. He is worthy of being an instrument nurse in a large hospital. Although he cooperated for the first time, he had an extremely tacit understanding.

In the blink of an eye, Zhao Yuan took off his swollen gallbladder and began to sew the arteries.

Next is to clean the abdominal cavity with normal saline.

Although the patient perforated, the patient was found in time, and the patient was young, had strong immunity, and had no other complications, and the inflammation did not exudate on a large scale.

Clean repeatedly until clean...

Before I knew it, I reached the last step...

“5-0 sutures!”

Zhao Yuan’s request was like seeing fog when clearing the clouds.

Solve the mystery lingering in Tong Zheng and Bai Lu's hearts.

No wonder Zhao Yuan opened the incision so small!

The patient is a young woman who has not yet gotten married and had children. If the abdomen is too large, it will definitely affect the appearance and avoid unnecessary misunderstandings in some occasions.

Children's administration generally uses 4-0 absorbable sutures, while higher specifications of 5-0 are basically not available.

The thinner the thread, the thinner the needle, the smaller the stitching window, and the difficulty increases geometrically.

Of course, the better the recovery effect.

After recovery, you can basically not leave any scars.

Zhao Yuan was meticulous and meticulous, and he thought about everything carefully as soon as he cut the skin.

"Okay, the operation is completed!"
To be continued...