This Doctor is Great
Chapter 89 The gallbladder must not be cut
Next,
The attending doctor Zhou Quan began to conduct a physical examination on the patient.
Hepatic surgery naturally has the inspection methods of liver surgery, Zhou Mo is not so professional.
It took a total of more than 4 minutes to treat Zhouquan, which was more careful.
"Show me liver function, B-ultrasound, and CT..."
Zhou Mo handed it over...
"Why is there no B-ultrasound? Why only CT?" Zhou Quan asked a little dissatisfied. If his students were so sloppy, he would scold him directly.
"I did the B-ultrasound, but I don't have a certificate, so I can't make a diagnosis..." Zhou Mo said.
"Huh? Do you know B-ultrasound?"
Now, Zhou Quan, the attending ruler, couldn't help but look back at Zhou Mo with surprise on his face.
B-ultrasound is very practical, but it is not necessarily how many doctors in each department know how to do it, which shows its difficulty.
Now,
The attendant Zhou Quan looked at Zhou Mo with less contempt.
As a profession of doctors, no matter their age or age, their strength can always win respect.
Teacher Zhou Quan read the CT results carefully, and finally nodded and said: "It is true that gallbladder stones should be removed..."
In a word, 'one size fits all'!
Zhou Mo frowned.
Is it so sloppy?
Don't need to evaluate the gallbladder function, and then consider whether to protect the gallbladder or not?
Could it be that this doctor Zhou Quan is of the 'one size fits all' genre?
Zhou Quan, the attending physician, said to Zhou Mo: "This patient, please transfer to the hepatobiliary surgery..."
Zhou Mo thought for a while and said, "I'll contact the superior doctor right away."
The attending doctor Zhou Quan nodded: "Then I'll go back to the department first. After you finish the formalities here, call me and let me know. I'll come up to pick up the patients..."
Zhou Mo nodded: "Okay."
Zhouquan thought for a while: "Forget it, I'm here to help with..."
Zhou Mo was surprised: "Huh???"
I feel that this teacher Zhou Quan seems to be a little too enthusiastic.
Why?
What Zhou Mo didn't know was that Zhou Quan, the attendant, also had his own thoughts. He felt that today was a lucky day. Cases of "biliary heart syndrome" were still rare, so he could write a paper.
Cut it off with one knife, cure the patient, the case will be complete, and the paper will come out.
He is currently in charge and will soon be promoted to deputy director, but he still lacks papers.
No, here comes the paper.
As for whether to bring Zhou Mo?
Then I definitely don’t bring it with me, and I have to distribute my thesis to others?
Be exclusive!
...
at this time,
On the other hand, Huang Yiming has already started searching the hospital's case database to find cases of gallbladder-heart syndrome, and wrote the beginning of the paper "Clinical Diagnosis and Treatment of Gallbladder-heart Syndrome". .
...
soon,
Zhou Mo found Teacher Huang Li and explained the situation of the 36-bed patient.
Mr. Huang Li did a physical examination for the patient, and after reading the cardiology examinations such as myocardial enzymes, electrocardiogram, dynamic electrocardiogram, B-ultrasound report, etc., he nodded at the end.
"I don't see any problem with the heart at the moment, so let's treat it according to the "biliary heart syndrome" first... let's go to the hepatobiliary surgery..."
"Okay, I'll go through the transfer procedures now."
The hospital has a complete transfer system.
After confirming the need to transfer to another department, Zhou Mo will issue a doctor's order for the patient to transfer to another department, and improve the living conditions of the department.
Hospital medical records.
At the same time, the purpose and significance of transfer treatment should be explained to the patient or family members, and the patient and family members should be obtained.
Consent of the family.
As for other procedures, it is nurses.
Teacher Huang Li glanced at Teacher Zhou Quan who was standing next to him: "Doctor Zhou, you can go back. After the formalities are completed, the patient will be sent out."
Zhou Quan smiled: "There's no rush, anyway, I'm free now, I'll just send the patient down."
Mr. Huang Li is such a good person, he can understand in seconds.
Doctor who is not busy?
Still idle or idle?
hehe,
You see I believe it or not.
It will definitely be profitable to stay here all week.
Huang Li understood that he probably wanted to write a thesis this week, and he didn't want this special patient to be snatched away by other doctors in the hepatobiliary surgery department.
Teacher Huang Li smiled: "Then you are busy first..."
left the consulting room.
Zhou Mo was by the side, secretly observing this 'confrontation', as if he had realized something.
"No wonder, Teacher Zhou Quan is staying here this week. At first I thought it was because of caring for the patients, but now it seems..."
"I'm naive!"
Zhou Mo felt himself rising again.
Next, Zhou Mo first communicated with the patient Liu Mo about transferring to another department, and the patient Liu Tao quickly agreed.
Before leaving, Liu Tao couldn't help feeling anxious, and asked Zhou Mo:
"Doctor Zhou... I think you are very nice, I want to ask a question..."
"What's wrong?"
"Do I have to have my gallbladder removed for this disease?" Liu Tao said a bit embarrassed.
Zhou Mo was taken aback for a moment.
He didn't know the answer to this question for a while.
Cutting the gallbladder is not a trivial matter. After all, the gallbladder is not an organ like the appendix that is useless in adulthood. The role of the gallbladder is still very large.
What are the consequences of not having a gallbladder organ?
After cholecystectomy, there is no place for bile to be stored, and bile cannot be excreted regularly after eating food. Food cannot be digested by bile, which may easily cause indigestion!
To extend it, that is, try not to eat greasy, cold, spicy, and indigestible food...
Otherwise it is easy to suffer from diarrhea!
These are not all side effects. The gallbladder is an important immune organ and cannot be replaced.
In short,
Try not to cut it if you can!
Bold protection is very important!
However, the problem of the patient's gallbladder-heart syndrome must be solved. Because I am afraid that the heart will develop disease in the long run, it will be more troublesome than cutting the gallbladder.
"Doctor Zhou?"
"Um……"
Zhou Mo looked at the anxious patient Liu Mo in front of him, and couldn't help feeling sympathetic.
He glanced at Dr. Zhou Quan at the nurse's station, several meters away.
Zhou Mo said to Liu Mo: "If not, I'll report this situation to the director and see what the director arranges..."
Zhou Mo only said half of it, not the other half - MDT.
Multidisciplinary diagnosis and treatment model.
In the case of patient Liu Mo,
Dr. Zhou Quan of the Hepatobiliary Surgery Department, based on Zhou Mo's knowledge of him just now, Dr. Zhou Quan would most likely cut the gallbladder of the patient directly. It is simple and straightforward, and he can also dominate the patient and write papers.
But from the point of view of gastroenterology, the patient's gallbladder is not too painful, maybe it is not serious, maybe it can be treated conservatively with internal medicine.
Or the "Bill Preservation School" will also support gallbladder protection instead of one-size-fits-all.
From the perspective of cardiology, if the gallbladder is not properly repaired, it will cause certain damage to the heart.
The best way, perhaps, is to conduct a three-subject consultation in the Department of Hepatobiliary Surgery, Gastroenterology, and Cardiology, analyze the pros and cons, and finally let the patient make a decision.
Only then did Zhou Mo realize that it seemed a bit rash for him to ask the hepatobiliary surgery department for consultation.
Gastroenterology should be consulted first.
Headache!
"Thank you, Doctor Zhou!!" The patient Liu Mo didn't know what Zhou Mo was thinking, but he still thanked Zhou Mo for his help!
"Well, I'm calling now..."
Zhou Mo returned to the duty room, found a corner, picked up his mobile phone and called Teacher Niu.
connected.
"Little Mo, what's wrong?"
"Teacher, it's like this. I want to ask your opinion on something..."
Zhou Mo explained the situation of the patient Liu Mo.
Director Niu was silent for a while, and finally asked: "Do you think it is possible for the patient not to have the gallbladder removed?"
Zhou Mo: "I don't know either. After all, I'm not very familiar with gastroenterology...but the patient's symptoms of gallbladder stones are not obvious, and maybe he hasn't reached the stage of gallbladder removal..."
Director Niu smiled heartily: "I'm very happy that you can consider so much for the patient...Since you think it's best to consult the three departments, then I'll call the MDT working group and ask them to take the lead...You first hand over the materials Give it to me, I'll get it... You don't need to say anything about the patient, because even if you want to have an operation, you have to be fasting during the perioperative period, and the operation is not so fast, at least tomorrow..."
"Teacher, will this make it difficult for the Hepatobiliary Surgery Department to step down?"
"Don't be afraid, we don't need to take action on this matter. Several young deputy directors of the Department of Gastroenterology have been opposed to the 'one-size-fits-all' gallbladder. Pai Zai disputes...these people are arguing, it has nothing to do with us..." Director Niu laughed.
Zhou Mo sweated wildly.
Unexpectedly, the teacher is also an old cunt... No, he is both wise and brave! !
———————
ps: Recommendation ticket, monthly ticket feeding port...
Digression:
Endoscopic gallbladder stone removal surgery is a surgical operation with immature concepts and techniques, and it cannot be used as a standard method for the treatment of gallbladder stones at present.
There are many supporters and opponents of "cholesterol preservation" surgery, and each has its own reasons.
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