Dean Guo and the others were not in a hurry, drinking tea and chatting, while waiting for the major medical records to be sent in.

About half an hour later, Zhang Jun knocked on the door and came in, holding a major medical record he had just finished.

When Qi Damin saw Zhang Jun coming in, he asked, "Have you finished writing?"

"Report to Section Chief Qi, I have written all the major medical records and first-time medical course records. Please ask several teachers to read them."

Qi Damin took the iron clip and handed it to Dean Guo who was sitting in the middle.

Dean Guo was not polite, and when he opened the medical record, he looked at it. He was a college student with standard writing, clear handwriting and clear order. He was indeed a two-hand brush.

Dean Guo nodded and looked around until he turned to the diagnosis page, his hands and eyes stopped.

"Sir Xiao Zhang, your diagnosis is cholangiocarcinoma, right?"

Zhang Jun swallowed nervously: "Yes, President Guo."

"Oh, then tell me what is your diagnosis?"

"My main diagnosis is based on B-ultrasound. The patient has dilated intrahepatic bile ducts, empty gallbladder, and soft tissue shadows in the upper part of the common bile duct, but the extrahepatic bile duct diameter is normal. This can basically be judged as hilar cholangiocarcinoma, and it is already in the middle and late stages."

Dean Guo smiled and said nothing, but handed the medical record to Qi Damin next to him, signaling everyone to circulate it.

Just when Jin Peilin finished reading the major medical records and had no time to praise Zhang Jun, Chen Qi also knocked on the door and came in.

"Director Guo, Section Chief Qi, Director Zhu, and Director Jin, I have written my major medical records."

Qi Damin nodded: "Sit next to you for a while first."

When Dean Guo got Chen Qi's major medical record, the first thing he wanted was the beautiful pen handwriting, and the pen tip was strong and powerful, which made him nod in his heart when he saw it.

The entire medical record was written in more detail than Zhang Jun's, but if you really want to score, the scores of the two were similar. However, Zhang Jun was a college student and Chen Qi was a technical secondary school student. If the scores of the two were the same, Zhang Jun was actually defeated first.

Dean Guo did not express his opinion, turned to the diagnosis page, and then his eyes lit up:

"Student Xiao Chen, did you diagnose it as hilar cholangitis and cholangitis?"

As soon as these words were said, they instantly aroused the interest of everyone in the office. Everyone was already in a dull mood and became active.

Because Chen Qi and Zhang Jun's diagnosis was completely different, it means that this is destined to be a game of chess. There must be someone who wants to lose completely, and then there will be a good show.

Zhang Jun was also a little surprised when he heard Chen Qi's diagnosis:

"Chen Qi, you didn't see the ultrasound that there was a soft tissue shadow in the upper part of the common bile duct, such a obvious tumor."

President Guo handed the medical record to Qi Damin next to him and asked with a smile:

"Yes, why did you eliminate such a big thing? Show you two more test reports. This was done by the patient in the outpatient clinic in the morning, but it just came."

Dean Guo handed over two pieces of paper.

One is a B-ultrasound contrast report, indicating that the lumen at the bifurcation of the left and right liver ducts is narrow. After the contrast agent is injected into the general liver duct, a 2.7cm*1.4cm clump can be seen at the common liver duct.

The other is an X-ray report, indicating that the stenosis of the hilar bile duct is repeated, and the upper intrahepatic bile duct is widely dilated, and there is no stenosis or dilation of the common bile duct and pancreatic duct.

After seeing this, Zhang Jun looked even more proud and felt that his diagnosis was stable.

After seeing this, Chen Qi just gently placed two report sheets on the table, without a frustrated expression on his face.

President Guo looked at Chen Qi with a playful look and asked with a smile:

"How is it? After seeing these two reports, do you need to modify your initial diagnosis?"

Zhang Jun shook his head firmly: "These two reports confirm that my diagnosis is correct, so there is no need to change it."

Chen Qi smiled: "Yes, these two report sheets have made me more determined to eliminate malignant tumors."

President Guo leaned back on the back of the chair, looked at the many doctors inside and asked, "Come on, you all talk about it, which diagnosis do you agree more with?"

Li Jun was the first to stand up: "Director Guo, I agree with Zhang Jun's diagnosis. This is a very obvious placeholder, and it is also at the liver hibernation, and the possibility of malignant tumors is the greatest."

Several other young doctors also nodded, obviously everyone agreed with Zhang Jun's diagnosis.

President Guo looked at several veteran doctors again: "Old Qi, Lao Zhu, and Director Jin, you all talk about it. Today I will treat it as a major discussion on the department case."

Qi Damin is from an internal medicine department and has read several reports and major medical records, which tends to have cholangiocarcinoma.

Zhu Huoyan looked carefully at several reports and looked at Chen Qi again. Obviously, he was inclined to Chen Qi's diagnosis, but because Chen Qi had not specifically stated his diagnosis basis, he did not speak up for it.

Jin Peilin was silent. A few big guys were there, so he, the small department director, should not be too ill.

When Dean Guo saw that everyone in the office was inclined to Zhang Jun's opinions, he said with a smile:

"Student Xiao Chen, I saw it. Everyone's diagnosis is likely to be cholangiocarcinoma. If you insist on saying it is ordinary cholangitis, then you can tell me the basis for your diagnosis. Be careful, don't talk nonsense. Our doctors must take a realistic attitude."

Chen Qi let out a breath. As a hepatobiliary surgeon in his previous life, he was confident that his diagnosis would not be wrong. After all, he had taken over too many cholangiocarcinoma before.

"Director Guo, several teachers, I judged it from these perspectives.

One is that the patient's clinical manifestations are inconsistent. He has no jaundice. Neither the test form nor the face of his own, it shows no jaundice. In addition, the patient has no symptoms such as itching in the skin, weight loss, indigestion and upper abdominal discomfort."

Chen Qi began to say that he had the basis of his diagnosis, and the office quickly became quiet.

Everyone is a professional doctor. Although they have a tendency in their hearts, they also understand the principle that if you listen to both sides, you will understand it.

Zhang Jun was determined to object, thinking that not every cholangiocarcinoma will have the above clinical manifestations, but he held back. He interrupted others when reporting the condition. Whether it is right or wrong, it will leave a bad impression on the leader.

Chen Qi said whatever he thought, following his own ideas:

"In addition, the two lists that President Guo just gave suggested that if it is cancer, there is no intrahepatic metastasis or associated lesions, no vascular invasion is found, and the hilar lymph nodes of the liver have not enlarged, so inflammatory lesions cannot be ruled out.

Another basis is the tumor index on the physical examination form. As you can see, carbohydrate antigen 19-9 is normal. So just a bile duct stenosis and a soft tissue shadow are said to be malignant tumors. I don’t think it’s possible.”

As soon as these words came out, everyone began to ponder.
Chapter completed!