Back in 2002 as a doctor

"Xiao Zhou, what you said is true?" Chen Houkun was an outsider, quite calm, so he didn't really believe it.

"There are many complications of laparoscopic surgery." Zhou Congwen slowly explained, "Non-biliary abdominal complications include intraoperative complications, such as intestinal injury, liver injury, diaphragm rupture and bleeding, and postoperative complications, such as intestinal Obstructions, trocar hernias, etc.”

"Professor Wen was not very lucky, and encountered the rarest intestinal ischemic necrosis."

"..." Chen Houkun was speechless.

"According to literature reports, Dr. Singh encountered 8 similar cases, and 6 of them died."

death!

This word brought Chen Houkun back from his carelessness.

8 patients, 6 deaths!

This probability is too high, so high that Chen Houkun was a little confused for a while.

"However, this patient was discovered relatively early. I hope that Professor Wen can hurry up and take the stage as soon as possible."

Zhou Congwen said while walking to the office of the academician workstation.

Chen Houkun asked, "How did it come about? I think Professor Wen did a good job in laparoscopic surgery. There has never been a similar situation before."

"It's a matter of probability," Zhou Congwen said, "it's usually elderly patients who are prone to it. When people are old, their physical condition is much worse than that of young people, especially when intra-abdominal pressure increases for a long time, leading to intestinal ischemia and necrosis."

Chen Houkun's lips moved, but he didn't speak and remained silent.

"Intra-abdominal pressure increased during laparoscopic surgery, resulting in decreased mesenteric perfusion and cardiac output, while CO2-induced local pneumoperitoneum caused mesenteric vasoconstriction, these are considered to be the possible causes of intestinal ischemia after laparoscopic surgery."

"Elevated intra-abdominal pressure can cause compression of the mesenteric veins and increased intestinal permeability, leading to bacterial translocation and multiorgan failure."

"Despite normal systemic oxygen saturation, levels of intra-abdominal pressure routinely imposed during laparoscopic surgery may result in visceral hypoxia."

Zhou Congwen followed one sentence after another. As soon as he walked to the door of the office, Chen Houkun's back felt chills. He felt that laparoscopic surgery was just a big hole, and it would be better not to do it.

"Such complications often occur in elderly patients with cardiovascular disease, so it is speculated that these physiological changes can be compensated in people with normal cardiovascular function, and have clinical significance in patients with atherosclerosis."

"The patient's myocardial enzymes had changes before the operation, and they continued to rise after the operation. In addition, the abdominal plain film showed abnormalities, which could prove a problem with a high probability."

"But the patient is not in great pain." Chen Houkun argued.

He put himself in the role of Wen Yuan, and immediately wanted to escape, hoping that what Zhou Congwen said was not true.

"Because there are few abdominal signs, it is difficult to make an early diagnosis until intestinal necrosis occurs. Although the symptoms and signs of abdominal pain are not completely consistent, as the only possible early symptom, it should be paid attention to and actively treated."

Zhou Congwen said seriously.

"..." Chen Houkun was dumbfounded.

"The reason why 8 of the 6 patients died was because the previous attention was not enough, and there was no immediate laparotomy after abdominal pain occurred."

Chen Houkun sighed, and a sadness of the rabbit's death and the fox's sorrow surfaced in his heart.

Chapter 0641

Chen Houkun asked a lot of things, and his tone of voice was a little trembling. Zhou Congwen knew very well that Professor Chen was also afraid.

That's what being a doctor is all about.

After all, medicine is a flawed science. Who knows when it will encounter rare situations, such as Professor Wen's patient today.

This is also to meet oneself.

If it is delayed for a period of time, even a day later, the patient's situation will be completely different.

At that time, at least 30-50cm of the intestine will be cut off. Whether the patient can survive is really a matter of opinion.

But now less than 24 hours after surgery, there is still time.Zhou Congwen knew it well and was not in a hurry.

Treatment and surgery are not just the relationship between doctors and patients. There are many complicated things in it.

If the operation is successful, hello, hello, everyone, there is nothing to say; but if the operation fails, the doctor will face countless accusations.

Sign before surgery?

That's a piece of butt wipes, and there's no way to count them.

Medical accidents are divided into technical accidents and liability accidents. No matter how the judgment is made, both doctors and patients will suffer extremely serious injuries.

The patient obviously had cholecystitis, but somehow his intestines were cut off, and he didn't cry out. This is an organic injury and is irreversible.

The chief surgeon clearly did not make any expected mistakes, and successfully completed an operation with caution and walking on eggshells, but something went wrong after the operation.

He suffered countless psychological injuries and critical blows, and some surgeons even changed careers because of this.

One is a physical attack, the other is a magical attack, and everyone has their own opinion on who suffers more damage.

Everyone is wronged, but there is no perfect solution.

"Dong Dong Dong~"

Zhou Congwenzheng and Chen Houkun were talking about the points that need to be paid attention to in establishing an inflated abdomen, when there was a knock on the door suddenly.

"Please come in."

A squat man pushed open the door and entered.

Zhou Congwen smiled when he saw him. This wretched fat man was an old acquaintance—Director Han of the Medical Affairs Department of the Second Hospital of Medical University.

"Han Chu, hello." Zhou Congwen stood up and extended his hand enthusiastically.

The wretched fat man was slightly taken aback, and rolled towards Zhou Congwen like a ball, "Professor Zhou, do you know me?"

"When a doctor needs surgery, the first thing to do is to visit the dock. You should visit the medical office. I just came here, and I haven't visited yet. Don't be surprised. But Han Chu's name is very famous. I've heard a lot about it, and I admire it." Zhou Congwen smiled and said to Han Chu shook hands.

Han Chu could hear that Zhou Congwen's words were false, and everyone put up with it.

"Professor Zhou, look at what you said." Han Chu smiled all over his face, "Professor Wen called me and said to consult with the Academician Workstation. He thought the patient had intestinal necrosis. Are you sure?"

"Not sure." Zhou Congwen's words almost stunned Director Han.

"The operation performed on the stage is a laparotomy, and I don't know if it can ensure the safety of the patient."

Director Han looked Zhou Congwen up and down with great interest.

He received a call from Wen Yuan and rushed over to deal with this "suspected" medical accident.

On the way here, Director Han thought that this matter is not easy.

The establishment of the Academician Workstation Director Han followed Zhou Congwen back and forth for a long time, and Director Han wanted to come down to Zhou Congwen's office under the banner of the dean.

This workstation added a lot of brilliance to the Second Hospital of Medical University, especially the National Cardiothoracic Surgery Annual Meeting some time ago. This was the first time that the Second Hospital of Medical University held a national-level annual meeting. It can be said to be full of splendor.

At the annual meeting, Director Han didn't communicate with Huang Lao. He knew that his identity and status were not enough.

But Director Han paid attention to it all the time, and later had a different understanding of Zhou Congwen.

This young man can be said to be a blockbuster, soaring into the sky, and his future is boundless.

Just taking advantage of this incident to get closer to Zhou Congwen, Director Han has his own plan.

"Professor Zhou, please be polite." Director Han said with a smile, "Director Deng greeted me with the Provincial Department of Health. I have already finished the business of practicing license. I just finished it. You said it was just a coincidence."

Zhou Congwen smiled slightly, "It's hard work."

"Director Deng told me at the time that it would be best to apply for a general practice certificate. I didn't believe it, thinking I had heard it wrong. But I did it as soon as I did it. The greeting from the above, Director Deng, was all done, so I just ran errands."

"I'm also good at general surgery, whether it's gastrointestinal or hepatobiliary surgery, I'm pretty good at it." Zhou Congwen said seriously.

"Hahaha, I know." Director Han smiled, "I didn't know it before, but I know it now. Otherwise, Professor Wen would not specifically say that you made the diagnosis, and talk about the patient's condition..."

"It's okay now. It's less than 24 hours after the operation. Chu Han, what are you going to do?" Zhou Congwen asked.

Because of my own rebirth, things have changed, and many things have changed.

So he wasn't sure that Director Han in front of him was exactly the same as the wretched fat man he had befriended in the previous life.

"Process? Why do we need to deal with it?" The smile on Director Han's face became more sincere, "There must be accidents in the development of new technologies! If there is no accident, it means that there are not enough surgeries. If you do too much, don't talk about new technologies, it's like a big surgery." Something happened." (Note)

"If there are too many surgeries, accidents will definitely happen. This is an inevitable law. We are all materialists, and we don't talk about those strange things, but only objective laws."

Zhou Congwen smiled happily, it seemed that the fat man was still the same as in his previous life.

"What if something goes wrong? The new technology is there, and you can't stop thinking about it and practicing it just because of something going wrong. There are still people who are killed by a car while walking on the road, don't you think so?" Han Chu said with a smile.

"Ha ha."

"Some time ago, there was a patient who underwent combined pancreaticoduodenectomy. The condition was very good and the stitches were removed. The patient was unwilling to stay in the ward for even a second, so he followed his family members to go through the hospitalization procedures. "

"I didn't expect the crowd to be crowded. I was touched and fell down immediately. There was no chance of rescue."

"The more operations you do, the more you see this kind of thing. It's okay." Director Han said with a smile, "Talk to the patient's family, the matter has already happened, and the hospital will lose money. It can't be that Professor Wen Just grab him and shoot him, right?"

"If there is an accident and a doctor is shot, it doesn't take long, and the second hospital of the medical university will collapse in at most three months. Not to mention the second year of the medical university, all hospitals in the country will be ruined. More people will die by then. Do you think it makes sense? .”

Zhou Congwen nodded, "That's good, Chu Han has worked hard. I've thought about this matter for a while. I hope it's not intestinal necrosis. I'll do a switch operation. I'll take care of the misdiagnosis."

"Look at what you said!" Director Han looked at Zhou Congwen angrily, "I am the director of medical affairs, so I must bear the responsibility!"

Zhou Congwen was a little happy in his heart, he was still the same person in his previous life, he hadn't changed, not at all.

There are very few people who can do this kind of thing of grabbing the blame, and the fat man is one of them.

……

……

Note: If you do too much, something will happen... This is a relatively pessimistic fact.

Chapter 0642

"Then trouble Professor Zhou." Director Han folded his hands together and nodded to Zhou Congwen humbly.

"You're welcome, you should." Zhou Congwen said, "We'll go on stage after Professor Wen and the patient's family have finished explaining."

"Can you not cut your intestines?" Han Chu asked tentatively.

"Try it, I can't guarantee it. But in any case, if the patient has an extra anesthesia and an extra knife, he still has to pay for it." Zhou Congwen said with a smile.

"It's much worse." Han Chu said, "One is to pay 10,000+, and the other is to pay no hospitalization fee, and just pay another ten thousand yuan."

As he spoke, Han Chu clasped his palms together again, and a round sphere shook slightly, like Pikachu, "Professor Zhou, I'm sorry."

……

In Zhou Congwen's heart, Director Han is an old acquaintance; in the heart of Director Han, Zhou Congwen is a young and cutting-edge.

The angle of observation is different. Zhou Congwen also knows this kind of dislocation. He didn't talk too much about the old days with Director Han, but talked lightly about the work of the academician workstation and what kind of support he needs.

Within half an hour, Wen Yuan called Director Han, saying that the patient's family members agreed to the operation.

Congwen will definitely not participate in these specific work weeks, because every doctor, patient, and family member of the patient has his own way of communication, and he believes that Professor Wen can handle it.

After receiving the news, Zhou Congwen and his team went to the operating room. Not only Han Chu followed, Chen Houkun was also very curious, and followed Zhou Congwen to see if there were any serious complications as he had judged.

However, no matter what Chen Houkun thought, he felt that the possibility was unlikely.

Came to the operating room to change clothes, sitting in the locker room Zhou Congwen and Han continued to exchange pleasantries.

Both of them have the intention of making friends with each other, and the chat is relatively harmonious.

When the patient was brought up, Wen Yuan came in to change his clothes. Zhou Congwen saw that his face was rather ugly, so he smiled and comforted him, "Professor Wen, it's okay."

"..." Wen Yuan looked at Zhou Congwen with the eyes of an idiot.

If he judged wrongly, the patient was fine, at most he would have to undergo an on-off operation, but Zhou Congwen and himself would definitely have a problem.

If he judges correctly, the patient's intestines are necrotic, and a few tens of centimeters of intestines can be directly removed...

No matter from which point of view there is a problem, Wen Yuan doesn't know how to be all right.

"Go up and have a look." Zhou Congwen waited for Wen Yuan to change his clothes, put out the cigarette, put on a sterile cap, and walked inside while fastening the mask strap.

Except for Zhou Congwen, everyone remained silent.

The patient's condition was complicated and confusing, and Wen Yuan and Chen Houkun, who had rich clinical experience, and Han Chu, who had dealt with countless medical disputes, could not see clearly.

But soon the truth will come out, as long as the patient's abdominal cavity is opened, seeing is believing.

Chen Houkun felt a little uncomfortable, and after thinking about it, he still thought that Zhou Congwen was troublesome.

In the academician workstation, the academician is Mr. Huang, a highly respected old academician. He is an academician of cardiothoracic surgery. Has a relationship with general surgery, liver and gallbladder, and gastrointestinal surgery?

Zhou Congwen did this, and the skilled dog meddled with the mouse.