Come on, Dr. Wu

Chapter 205 Moltke’s Nemesis

Office of the Deputy Director.

Mao Qi seemed to be waiting for Wu Xiaofu, but as soon as Wu Xiaofu entered the office, Mao Qi got up.

"Doctor Wu, is there anything urgent? I still have an operation, I'm afraid I'll have to wait until after the operation."

Wu Xiaofu was also a little helpless. He would not leave sooner or later, but leaving at this time was probably not an expression of dissatisfaction. However, as an old comrade, even if he was dissatisfied, it was normal.

Forget it, just think of it as coaxing old comrades.

Who is Wu Xiaofu? In just a short time, he has almost figured out the affairs of the two directors. There is no need to worry about Zuo Hui for the time being. The main thing is that Director Mao is probably a bit difficult to deal with.

However, we like to face difficulties head on.

"There is an operation. I have long heard that Director Mao is very good at surgery. Now that I have this opportunity, I wonder if I can be an assistant to Director Mao?"

assistant!

Who would look at the blood flow density? What's more, the blood flow density decreases.

The postoperative recurrence rate is also much lower than that of other people, which shows that the incision was very clean. Even Yu Shifu admired Mao Qi's surgery. There is no doubt about the level. However, Wu Xiaofu came today not with him. Mao Qi is more skilled. He came here today just to lower his attitude and let Mao Qi feel his sincerity.

However, the situation was unclear at this time, and He Yuanhao and Guo Tao did not dare to say anything. They just watched quietly. For a while, the atmosphere in the operating room was strange and solemn, which made the nurses and anesthetists in the operating room confused. The teachers were a little uncomfortable with it.

Let Mao Qi know that he came to the Hepatobiliary Surgery Department to really do a good job, not to mess with other people. Just let him not target him. After all, according to his investigation, Mao Qi doesn't seem to be a big deal. Bad guys are just a little stubborn at best and don't need to be treated as enemies.

Wu Xiaofu was not polite when he heard Mao Qi ask him. He originally meant to say it, but now that Mao Qi took the initiative to ask, he had no taboos anymore.

The possibility of the biliary tract being involved is not small.

The lesion was in the right inner lobe. According to Moltke's original idea, the right liver and half of the left liver were removed, while the bile duct was preserved.

Since Wu Xiaofu took the initiative to send it here, don't blame him for giving Wu Xiaofu a slap in the face. They are all doctors, and Mao Qi doesn't like the shady methods of intrigue. It would be best if the surgery is done with real rules.

Mao Qi looked at Wu Xiaofu and took the initiative to show his kindness? Sure enough, he knows how to do this, Mao Qi thought to himself, but considering Wu Xiaofu's surgical skills, Mao Qi did not refuse. Wu Xiaofu's surgical skills were not bad, and he was more than enough to be an assistant.

By the way, he also wanted to see Wu Xiaofu's surgical skills up close. It would be better if there was a chance to teach him.

Thinking about the film in his mind, Mao Qi recalled it over and over again. There seemed to be nothing wrong with it?

"What do you think about this operation?"

When asked to put down the mirror and go over to watch a movie, Mao Qi was really embarrassed.

Blood flow signal!
Mao Qi looked at Wu Xiaofu with a speechless expression. You look at blood flow signals on CT. Who would look at blood flow signals on CT? Blood flow is a high-density shadow on CT. This is CT for liver cancer. Doctors usually Look at the location of the lesion and whether there are other cancerous lesions around it.

Well, one assistant becomes the second assistant, and the second assistant becomes the third assistant. Who can I argue with?

Wu Xiaofu wants to use this to diagnose his illness?

Wu Xiaofu was not so particular and walked directly towards the developing plate. Now that the steps were given, Mao Qi lost his reserve and hurried to follow.

Liver cancer resection surgery, after Wu Xiaofu saw the patient's imaging examination, he knew that liver cancer resection surgery was Mao Qi's specialty. Over the years, Mao Qi's liver cancer removal was almost always clean, and he rarely needed to perform a second surgery. Two swords.

When he came to the imaging board, Wu Xiaofuxu pointed to the porta hepatis and said, "The blood flow signal here seems to be weak. Compared with the blood flow signal in other places, the density seems to be lower."

Mao Qi felt that he was not an unreasonable person. If Wu Xiaofu was really capable of managing these five beds and running them well, then he was not the kind of person to bully newcomers, so he would give them five beds.

The patrol nurse nudged He Yuanhao and asked, and He Yuanhao shrugged, indicating that he also wanted to know.

What's more, the emergency department is an emergency department, and the hepatobiliary surgery department is a hepatobiliary surgery department. These are two completely different departments. If you can do well in the emergency department, you may not be able to do well in the hepatobiliary surgery department. Wu Xiaofu still needs to adapt.

"Director Mao, I don't know if you've noticed, but there seems to be something wrong with the patient's liver hilus on the CT scan."

Didn't Director Mao look a little unhappy before? Everyone said that Director Mao couldn't stand Wu Xiaofu and wanted to give Wu Xiaofu some power. How long has it been since the two of them got so good that they started to work together for surgeries?
They were gone for such a short time, what happened?

No, Mao Qi seemed to have thought of something. Even if he looked carefully, it seemed that the density of blood vessels was a little lower than that of other places. However, this was not an angiogram, and it was not clear at all.

Thinking of this, Mao Qi nodded.

"What's going on?"

However, such surgeries can account for only a few cases among all cancer surgeries. After all, they are mainly ordinary surgeries. When it comes to ordinary surgeries, he does not believe that Wu Xiaofu can really compare with those of them who have been doing them for decades. A doctor suitable for mass surgery.

In this case, liver cancer resection surgery might be more complicated, but he thought there should be no problem.

If Wu Xiaofu had the ability, he could even take care of his bed, but I'm afraid Wu Xiaofu doesn't have that ability.

Porta of liver!
When Mao Qi heard this, he did not refute immediately, but remained silent for a while. After all, he has been a doctor for so many years, and the patient-oriented concept has long been engraved in his mind. With Wu Xiaofu's ability, he should not do that kind of sensational thing. Maybe you really saw something?
I was thinking about the patient's CT scan. Although the film was still hanging on the wall, I couldn't see clearly. The distance between the operating table and the developing board was really awkward.

It just happened to let Wu Xiaofu know that there was no one in the Hepatobiliary Surgery Department, and he would not know how to restrain himself in the future.

The operation was about to begin, Mao Qi suddenly asked. At this time, the disinfection and draping had been completed, and the laparoscope had begun to be connected.

Want a bed? The director has already given five beds, so that's enough. How many more beds are needed? Wu Xiaofu and his two newly-resident doctors may not even be able to handle five beds. How many more beds are needed?

He Yuanhao and Guo Tao were also a little confused at this time. They were both in Mao Qi's group. The operating room was vacated, so they were arranged by Mao Qi to come over and make preparations. However, they did not expect that Mao Qi would even bring Come with Wu Xiaofu.

In the operating room.

The reason for being so cautious is that if there is a problem with the portal of the liver, the previous surgical plan cannot be used, because if the portal of the liver is also involved, the possibility of involvement of the portal blood vessels is very high.

They are not used to doing this in such a cheerful environment, okay?

Mao Qi admitted that Wu Xiaofu did have some talents. Both his brain and hands were very flexible. The first laparoscopic extended radical surgery for gallbladder cancer had already demonstrated Wu Xiaofu's ability.

Looking at Wu Xiaofu, "What exactly do you want to say?"

The patient undergoing this surgery is a 62-year-old man. He had alcoholic liver disease for 20 years and gradually transformed into cirrhosis. Until half a month ago, he was diagnosed with liver cancer again, advanced liver cancer. This time, most of the liver cancer was planned to be removed. Of the liver.

They didn't bring the color ultrasound in, and I didn't see it either, but it must have been visible on the color ultrasound.

Color Doppler Ultrasound!

Mao Qi looked at the anesthesiologist and said, "Help me adjust the patient's color ultrasound."

The anesthetist also became nervous at this time. Don't cause trouble. He is already anesthetized and there is nothing wrong with him.

I quickly called the patient's color Doppler ultrasound and saw that Wu Xiaofu and Mao Qi both came over to take a look.

"A solid mass can be seen in the liver, with an approximate range of approximately 100,000 square feet, irregular shape, and unclear boundaries. Blood flow signals can be seen within it...the blood flow signal in the hilar region of the liver is weakened..."

Good guy, it really pays off!

In fact, weakened blood flow signals can be caused by many conditions, such as fatty liver disease, alcoholic hepatitis, viral hepatitis, liver damage, cirrhosis, etc., and these conditions already account for the majority of patients. However, these conditions cause The weakened blood flow signal should be present in the entire liver, not just in the porta hepatis.

If this is really the case, it can only mean that there may be more serious lesions in the liver portal, for example, cancer invasion?

Thinking of this, Moltke also groaned, empiricism kills people.

Very few people will notice this problem on CT scan, and few doctors will see this prompt on color ultrasound. Doctors will see it, and basically only the following diagnostic opinions on color ultrasound will be given.

After all, for hepatobiliary surgery, such as the gallbladder and appendix, a color ultrasound is enough. If it is confirmed to be gallbladder stones, then surgery will be done directly. If the color ultrasound indicates the possibility of cancer, then further examination will be conducted directly.

Needless to say, color ultrasound, the most direct, convenient and fastest examination, is being ignored more and more.

At this time, Moltke was also hesitant. If it was really the hilar part of the liver that was invaded, it must have been in the early stages during the initial examination. Even the examination was not too obvious, but after half a month, it was not necessarily clear now. , so the previous check can no longer be trusted.

But it is impossible to check again at this time. After all, the patient is lying on the operating table and is still under general anesthesia. If the anesthesia is continued for a while, the risk will increase.

But if he was really woken up and asked to go for a check-up, it would be a minor loss of face, and he would probably end up in the hospital or go to court.

But it’s not possible to do it just like that. Whether the hilar part of the liver is invaded by cancer is still unknown. There is no direct evidence. It is just a suspicion at this time. If it is treated as if it is invaded, more cuts will be needed, but What if after cutting it off, it is found that the hilar part of the liver has not been invaded?

That's not what I was told a few days ago. With so much cut off, I'm afraid the court will inevitably have to make a trip. For a moment, Mao Qi was really in a dilemma.

At this time, Mao Qi didn't know whether to thank Wu Xiaofu or curse Wu Xiaofu. He was so numb that such a problem had arisen. He originally wanted to give Wu Xiaofu a blow, but now it's better to hang himself on the stage. Oh, I'm afraid Wu Xiaofu was laughing at him in his heart at this time.

Thinking of this, Mao Qi felt even more annoyed. He was not annoyed with Wu Xiaofu, but annoyed that he didn't take a good look before the operation. In fact, if he was a little more careful, he could also notice this. After all, as his experience increased, he became more and more aware of it. So arrogant.

Looking at He Yuanhao and Liu Chen, he didn't look at them. Even these two guys didn't look at them. It was really a waste of time to train them.

At this time, He Yuanhao and Liu Chen did not dare to speak. Listening to the conversation between Mao Qi and Wu Xiaofu, how could they not know what Mao Qi was struggling with now? This must have been their oversight, but how much work do they have to do every day? Thing, how could I notice such details.

The anesthesia teacher couldn't help it.

"Director Mao, what are you going to do? The patient is numb right now."

Instead of doing surgery, I started studying CT. Shouldn’t this be pre-operative work? What, the way of working has been changed now, and pre-operative seminars are held in the operating room instead? Or have a meeting after hemp, when did you develop the habit? How come he didn't know.

The anesthesiologist secretly complained that Moltke had some experience, otherwise, the anesthesiologist would have just started spraying.

At this time, I was thinking a little bit about the patrol table and instruments. You must know that as long as the patient gets on the operating table and starts the operation, he is not only the patient of the surgeon, but also their patient.

Hearing the anesthetist's words, Mao Qi also looked a little ugly. He gritted his teeth and was about to say something, but he heard Wu Xiaofu speak.

"Director Mao, how about I come?"

Ah!
Mao Qi looked at Wu Xiaofu, his face full of question marks, what do you mean? He couldn't be sure, could Wu Xiaofu be sure?
"What do you think?"

"Director Mao, there is actually no need to check anything else. If this situation occurs, what else can it be besides cancer invasion? If it were me, I would definitely act according to the cancer invasion."

Mao Qi was a little speechless. There were many other things that could still be done. It could not be that the patient originally had a hilar blood vessel problem, or a gallbladder and bile duct problem affected the hilar blood flow, etc. It was not impossible.

If there is nothing left after cutting, who will bear the responsibility? Although, as Wu Xiaofu said, more than 90% of the patient's condition is caused by cancer, but what if it is not the case?

"What if it's all done?"

Wu Xiaofu immediately smiled and said, "I did the surgery, not the surgery. Of course it's my problem."

Seeing that Wu Xiaofu could still laugh, Mao Qi also rolled his eyes. Did Wu Xiaofu really not know how serious this problem was? Medical relations are so tense nowadays. If the incision is wrong, it is not an ordinary mistake.

However, his mood was a bit complicated. At this time, Wu Xiaofu actually wanted to take the blame for him. He was not short of an operation, but if something went wrong, he would probably lose all his wisdom.

To show him favor?

Is the price too high?
He shook his head. Regardless of whether Wu Xiaofu was showing his kindness or he was sure that the patient had liver hilar invasion, it was impossible for him to let Wu Xiaofu do this operation. What kind of person was he, Mao Qi, why would he let Wu Xiaofu do it? He takes the blame.

He was the one who sent the patient here. If something went wrong, he would naturally be responsible.

"Then we'll do it based on porta hepatis transfer, and I'll be the surgeon."

Mao Qi said categorically, which made Wu Xiaofu take a high look. He was indeed right. Mao Qi can still deal with it. Unfortunately, he is not a shady person. Otherwise, he would just say nothing and wait for Mao Qi. After the operation, a post-operative check-up showed that there was an explosion at the porta hepatis. Let alone a bed, Mao Qi was afraid that he would be no better than Zhang Feng in dealing with his family members.

Mao Qi and Wu Xiaofu stood in front of the operating table again. He Yuanhao and Liu Chen were a little worried. Are they really so reckless? In fact, it is not impossible to wake up the patient and do an examination. At most, we can choose a day for the operation, and then find a way to appease the patient and family members. Well, at most, he will be scolded, so it shouldn't be a big deal.

Mao Qi may have to pay some face, but it's better than gambling on such a big deal.

"Doctor Wu, how confident are you?"

He Yuanhao hesitated and asked Wu Xiaofu. Wu Xiaofu had already started drilling holes, "Of course it's 100%."

Wu Xiaofu cheated and looked for evidence based on the results. Otherwise, Mao Qi would not have looked at it so carefully, so why not him? Not only he and Mao Qi, but almost all surgeons had this habit.

It's not because they are irresponsible, but because they are really too busy and can only save time out of habit. If a person is responsible for one patient a day, he will notice even the smallest details, let alone such small details.

hundred percent!

What kind of crazy self-confidence is this?

He Yuanhao was speechless, and the others were also a little confused. How dare you? That's 100%.

Mao Qi looked at Wu Xiaofu. He was so confident. He had long heard that Wu Xiaofu was very confident, but this confidence must have its time. But looking at this situation, he dared to say it was 100% and dared to take over everything. Well, Mao Qi Qi believed it, this guy seemed to be always confident.

Moreover, before this guy gave him a chance to hesitate again, he had already punched the hole and started to have pneumoperitoneum.

Well, this time there is absolutely no chance to regret it. If we could revive the patient just now and comfort him, we can no longer do it now. His eyes are all broken, just one eye. How much compensation are you prepared to give him?
However, Wu Xiaofu became more confident. During this period, his mental strength seemed to be stronger. He could see the general situation without opening the abdomen, but it was still clearer than when the scalpel was inserted into the abdominal cavity after the abdominal opening.

Nowadays, drilling a hole into the abdomen is directly equivalent to a re-examination and diagnosis.

Looking at Mao Qi next to him, Wu Xiaofu smiled and said, "Director Mao, why don't you give me a chance? You will guide me. My name is still written 伱. If I do well, it's mine, if I do bad, it's yours." "

Good guy, you still have the heart to joke.

The most important thing is that Wu Xiaofu has already given the mirror to Mao Qi. Wu Xiaofu can see that Mao Qi still has concerns. In this case, he might as well do it. After this operation is completed, it can be regarded as a favor and it is always worth it. Five beds.

Mao Qi looked at Wu Xiaofu who had already started drilling other holes, and was a little speechless. He had already done it, so what else could he ask him?

However, his current mentality is indeed unstable. He might as well leave it to Wu Xiaofu. He looked at the nurse on duty and said, "Write my name as the surgeon."

Naturally, the patrol nurse would not have any objections. After all, in her opinion, it does not matter whose name is written. What is important is that the operation must be done well. Wu Xiaofu's operation success rate is 100%, and he has a good reputation in the operating room. Mao Qi was still hesitant, but Wu Xiaofu decided to perform the surgery. After a comparison, they actually felt that Wu Xiaofu was more reliable.

He Yuanhao and Liu Chen looked at Mao Qizhen letting Wu Xiaofu do it, and their expressions were a little uncertain.

You are so big-hearted, Director Mao, you have openly put on others' shoes, and now you dare to write your name and let Wu Xiaofu do it, so you are not afraid that Wu Xiaofu will trick you!
However, this was in front of Wu Xiaofu. Mao Qi offended Wu Xiaofu, but He Yuanhao and the others were not offended. If he said anything at this time, he might offend Wu Xiaofu. Therefore, silence is golden, so just watch Wu Xiaofu's performance quietly.

Slow down. Slow down.

After starting, Mao Qi also raised his eyebrows, and he had doubts about the patient's condition. Can't you slow down and take a look at the situation?
Shouldn't the idea of ​​insurance be to free the liver, bile duct, etc. first, then cut a small part to see the situation before making a decision?
In case of dissociation, you can see the condition of the liver portal and confirm whether it has been invaded, which will be even more reassuring.

But Wu Xiaofu had no such idea at all. He just did it according to the invasion of the liver porta, and it flew up quickly. He was really 100% confident!
After changing the surgical plan, this time it was necessary to remove the right half of the liver and the left lower liver, remove the spleen, bile duct and gallbladder, and reconstruct the biliary tract. This operation was much more difficult than before.

By the way, this operation should actually be done by surgery. Mao Qi was confused by Wu Xiaofu. He didn't even think of it just now. Now he thought of it when he saw Wu Xiaofu's operation. However, it was too late. He was already dissociated. about there.

Looking at Wu Xiaofu's operation, Mao Qi also nodded secretly. Regardless of anything else, observing Wu Xiaofu's operation at close range was really top-notch, almost better than him. It was actually possible to achieve this level under laparoscopy.

This is faster and more efficient than disembowelment. Well, isn't this kid trying to install his fork?

Looking at Wu Xiaofu's serious face, he had good reason to suspect that after all, he was originally used to educate Wu Xiaofu about this operation. But now, it seems that the roles have been reversed, and he seems to be educated by Wu Xiaofu.

This kid!
At this point, I really feel a bit of a love-hate relationship.

"Xiao Fu, why don't we look at the portal blood vessels first?"

Seeing that Wu Xiaofu was about to go under the knife, Mao Qi was a little helpless. He was a little unwilling. It would be better to look at the blood vessels in the porta hepatis first. Wu Xiaofu wouldn't let him see the blood vessels exposed outside the liver. , so far there is no problem. If we don’t make a partial incision of the intrahepatic bile duct first, we won’t be able to see the hilar blood vessels inside.

There was a thorn in his heart. He didn't want to speak at first, but Wu Xiaofu was really good at torturing people.

There was no other way, and Mao Qi couldn't hold himself any longer, so he finally took the initiative to speak.

Wu Xiaofu didn't even raise his head, "Director Mao, wait a minute. After cutting it off, let He Yuanhao cut it open and take a look."

Director Mao suddenly felt the urge to hit someone. You have already cut it off. Does it matter whether you cut it or not? Didn't he want to leave a way out for himself? The name of the man named Wu was "Mao Qi" on the surgical drape.

But what else did he want to say? Wu Xiaofu had already used the electric knife to sizzle, and the smell of meat was permeating the air. You could smell it along the holes.

"Director Mao, I heard that experienced doctors can tell whether there are any problems with the organs and tissues under the knife just by smelling them, right?"

Mao Qi didn't even remember that this was the first time he rolled his eyes. He finally understood why he didn't like Wu Xiaofu. This kid was the one who defeated him. In just one day, he had become angry for the first time.

Smell it? Do you think it's a dog?
Those are just boring people who use them to show off. Who can be so awesome? They all smell like burnt. There is no good one. You still want to know the good and bad by smelling it. You are dreaming. No, this is nothing. What are you talking about? Who smells that smell?
I'm afraid there are some perverts out there.

and many more.

Just when Mao Qi couldn't help but want to complain, watching Wu Xiaofu's operation, his heart started to lift again. He swore that he really regretted letting Wu Xiaofu perform the operation. How could this guy think of doing the operation? Once it comes out, what kind of cutting method is this?

(End of this chapter)