"Who is in charge of this patient?"

Ahead, Xu Qiu stopped and asked in an unhurried tone.

"It's Dr. Chen Jia."

"Ask her to turn the patient over.

Ma Pingchuan, I'll take over."

After leaving these words, Xu Qiu left without looking back.

Only people with shocked faces were left.

"Doctor Xu...can actually handle severe acute pancreatitis?!"

"This is the most critical acute abdomen in gastroenterology, with a mortality rate as high as 40% and a high chance of various complications..."

…

Soon, news spread throughout the hospital that a patient with severe acute pancreatitis was admitted to the emergency department.

This is a serious disease that often kills people!

therefore,

The hospital urgently notified that a hospital-wide consultation will be held in half an hour!

In the Department of Gastroenterology, many doctors felt their hearts skip a beat after seeing another case of severe acute pancreatitis.

"Ah... why are you here again?"

"Last week, we admitted a patient with severe acute pancreatitis. The director personally took action, but the patient died in the end..."

"I heard that Academician Chen's student is performing a surgery in our city? Can you invite him to come and perform an operation?"

"Yes, Academician Chen is a top expert in the field of pancreas and intestines. His 'Chen's Pancreaticoenterostomy' has created a new technique for pancreatic surgery. The words of his students... may be able to save this man.

!”

After receiving the news of the hospital-wide consultation, Director Xiao from the Department of Gastroenterology immediately thought of Academician Chen's students.

He quickly asked the medical department to contact him.

Soon after, the medical department gave a reply.

"Professor Gao Pei'an said that he specializes in robotic duodenum, total resection of large liver cancer, and severe acute pancreatitis is not his area of ​​expertise... However, he can come and participate in post-operative suturing."

Gao Pei'an is Academician Chen's favorite student.

I am fifty-two years old this year, and I am either flying knives or on the road to flying knives.

This time, he had just completed a large liver cancer resection at the Municipal People's Hospital, and Linhai No. 1 Hospital happened to catch up with him when he was free.

Director Xiao slapped his thigh: "Okay, how much does it cost there?"

"Three thousand."

Director Xiao felt a little itchy after hearing the quotation.

Just from the flying knife surgery, the other party probably made ten thousand to twenty thousand.

To make extra money after finishing the work, drop by and spend 20 minutes doing a "Chen's Pancreaticojejunostomy", and I'll quote you 3,000!

But by chance, the other party has the qualifications of a lion to open his mouth!

Chen's pancreaticojejunostomy is the best anastomotic method in the industry.

Currently, doctors specializing in hepatobiliary, pancreatic and other fields are studying this suture technique.

only--

Nowadays, the only people who can really master this technique are the doctors from the hospital where Academician Chen is affiliated.

There are no experts in this technique like Linhai No.1 Hospital!

Therefore, they can only practice on A.V. quality surgical videos.

Chen's pancreaticojejunostomy is naturally difficult to achieve.

Spending 3,000 yuan to hire an on-site teacher to give general practitioners the opportunity to learn is quite cost-effective!

Director Xiao thought about it for a while, and finally nodded: "Who said we don't have an expert on Chen's pancreaticojejunostomy here... Prepare a car and pick up Professor Gao!"

…

On the other side, Ma Pingchuan has been transferred to the ICU for monitoring, and a dedicated person is closely observing the changes in his condition.

Includes general condition;

Vital signs and abdominal conditions, etc.;

In addition, there are dynamic analysis laboratory test results,

Such as white blood cell count, hematocrit, blood and urine amylase, electrolytes, blood sugar, bun and creatinine, carbon dioxide binding capacity...

After urgently obtaining various examination data, Director Jiang took the results and prepared to participate in the joint consultation in ten minutes.

…

The consultation was finally scheduled in the emergency department.

medical record display,

Report on inspection results...

After a series of processes, we entered the most intense discussion session.

Director Xiao of the Department of Gastroenterology frowned and said: "The patient underwent endoscopic ultrasound and no common bile duct stones were found. This is good news.

However, the patient’s TG level is too high and lipid-lowering treatment must be performed as soon as possible!

If conditions permit, the blood should be purified first."

The director of the hepatobiliary department said: "First decompress the gastrointestinal tract and use proton pump inhibitors and pancreatic enzyme inhibitors! The patient is in so much pain that we must also pay attention to the patient's subjective feelings!"

Director Jiang from ICU said: "Now the patient has signs of respiratory failure. In addition, the patient also has intra-abdominal hypertension and is rated as a high-risk disease. Putting aside everything else, intra-abdominal pressure monitoring must be done before treatment... I

I’m afraid he will develop abdominal compartment syndrome!”

"It is really not possible to try non-invasive ventilation for a short period of time!"

"How about going to ECMO..."

The discussion became more and more intense, and finally, the surgical plan began to be discussed.

Director Xiao, who is still the Department of Gastroenterology, spoke,

He said: "We have invited Professor Gao Pei'an, a student of Academician Chen, to come over.

He also agreed with the surgical plan drawn up by our department: percutaneous puncture drainage, visual endoscopy-assisted debridement and drainage, and a step-up treatment plan until the final surgical debridement and drainage!”

After saying this, the conference room became quiet.

Everyone said they had no objection.

on the one hand,

Professor Gao Pei'an's name is well-known in the Department of Hepatobiliary and Pancreatic Surgery, and "Academician Chen's student" has given him a layer of gold.

on the other hand,

What Director Xiao proposed is a surgical plan that is widely used in clinical practice.

First, percutaneous puncture is performed. If it doesn't work, endoscopy is performed. If that doesn't work, the only option is to open an operation directly into the abdominal cavity for debridement.

Severe acute pancreatitis is complete necrosis of the pancreas, causing complications including organ failure and severe infection.

The treatment method is, of course, to clean up the dead tissue.

The three-stage escalating therapy is impeccable.

At this moment, a young voice broke the silence in the conference room.

Xu Qiu stood up, but her expression did not change when faced with the gazes of many directors.

He said slowly: "ecmo is not needed."

The ECMO startup fee is RMB 100,000, and the subsequent daily cost is also around RMB 10,000.

The patient's family really cannot afford such a luxury.

"Step-up therapy is also not advisable."

Percutaneous puncture is definitely not feasible.

Endoscopic debridement and drainage treatment does have the advantages of “minimally invasive, low complications and low mortality rate”.

However, this surgery requires repeated debridement!

The fatal problem it brings is increased hospitalization days and expenses.

Although transabdominal surgery is risky,

However, as long as the surgical effect is good and the patient stays for about a month, he will be out of danger and transferred to a general ward.

However, minimally invasive endoscopy requires repeated puncture and cleaning, and gradually enlarges the sinus tract. The length of stay in the ICU will soar to more than two months, and the cost of surgery will also rise...

Everyone present was an expert, and they could tell what Xu Qiu meant from his two sentences.

But at this time, Director Xiao stood up again and asked:
Chapter completed!