The reason is that the bile duct stones found are all very small, and the results shown by choledochoscopy or B-ultrasound and CT are consistent. Small stones will not cause severe cholestasis and lead to systemic jaundice.
The choledochoscope continued to penetrate deep into the liver duct to further confirm whether He Guangyou's conclusion was correct.
The light source rotated in multiple directions and illuminated the right hepatic duct in the patient's body. The gallstones were shocking to look at. They were densely distributed in the hepatic duct, blocking the bile cavity into an airtight place. How could bile continue to exist in such a duct?
Flow smoothly.
Scared! Everyone should be shocked to see such a real scene.
"It seems that it may be caused by gallstones." When He Guangyou and He Jiuliang admitted this, their voices were full of emotion. It can only be said that the human body is too mysterious, and exceptions often appear that overturn the doctor's original understanding. Now
, the usual definition that only large stones can cause jaundice was broken by the special case of Zhao Zhaowei. Small stones may also become a serious killer that threatens the patient's life.
"Why are the stones always small and not big?"
"If the bile composition is abnormal, or there is a problem with dietary intake, it is unlikely that all the stones will be small and not one big stone. It would be too strange."
"Are there any roundworm eggs? It seems that they haven't been found?"
"The strangest thing is that the big stones block the bile duct horizontally, so they may not move. The small stones do not. The mouth of the liver duct opens downward. The small stones should fall down due to gravity. How come they are stuck together."
"Didn't Xiao Song talk about the angle issue?"
A group of people remembered what Song Xuelin said before, and it seemed to make sense.
The angle between the right hepatic duct and the left hepatic duct is wrong, causing bile to reflux. Therefore, even if the stones are small, the bile reflux can only go backwards, resulting in more and more stones, and the bile cannot be discharged, and eventually the whole body will suffer from jaundice.
Appear.
"How do you look at the angle?"
When someone raised this question, everyone suddenly realized that this was the most difficult problem to solve.
The human body is three-dimensional, and all the organs and tissues in it are three-dimensional, and the connections between them are all three-dimensional. If doctors want to think about it, they can only think about a three-dimensional structure, and it is impossible to think about a two-dimensional one. So the angle problem mentioned by Song Xuelin,
It must be an angle in the three-dimensional world.
It is equivalent to doing the most complex geometric mathematics problem.
The surgeons stared at the pictures on the screen in a daze. Some of them touched their foreheads, wishing they could think faster.
The anesthetist and nurse glanced in the direction of the surgery department and turned back: They would never join in the fun, it was too unthinkable.
The expressions of everyone at the scene showed that most doctors could only surrender to this. Don't blame the doctors, only math geniuses can imagine this kind of problem in a short time. Therefore, various things that assist doctors in their work are often used for practical needs.
was invented.
Laparoscopes, such as choledochoscopes, belong to the category of medical instruments, which are equivalent to the hands of doctors. The 3D modeling software Cao Yong taught her before can be regarded as another brain that assists doctors in thinking. It plays a role in the doctor's surgical path planning for patients.
Crucial role.
It's just that auxiliary tools are only auxiliary, and ultimately it depends on the doctor himself. The equipment may not be used, and the three-dimensional modeling may be wrong.
The biggest problem now is not not to clear it up, but to figure out why the patient has so many small stones. Otherwise, the patient will continue to relapse in the future, and the operation will be meaningless.
When everyone was thinking hard, they saw that the choledochoscope had entered the intrahepatic bile duct to explore and stopped moving.
