How to flush out the blockage if there is too little water and no flushing force? If it weren't for Song Xuelin's reputation as a talented scholar in Beidu, Zhu Huicang would have suspected that no teacher had taught this student well, and he didn't even know this basic common sense.
Xie Wanying was even more puzzled. She didn't hold anything with her hands. She was just pressing the patient's abdomen, lifting the patient's waist, and changing the patient's position.
Sometimes changing the patient's position can help with drainage. The problem is that such an operation is of little significance for a pipe that is really blocked. If the obstruction is so severe that it is stuck, the gravity effect of changing the position alone is smaller than the impact of water flow, and it is highly unlikely that the stuck obstruction will fall off by itself. Therefore, it can only be flushed with greater force. If flushing fails, it needs to be dug out. Surgery or the use of other instruments, such as the choledochoscope used when operating on Zhao, is a good way to observe and deal with postoperative drainage tube obstruction.
Why not use a choledochoscopy?
The use of a choledochoscope in the drainage tube after surgery requires certain conditions. For example, the drainage tube used in the original operation must be short, thick and straight enough, and the drainage tube must be as vertical as possible to the extrahepatic bile duct when it comes out of the body to avoid angles, otherwise the choledochoscope cannot enter.
Therefore, the patient's current situation is that the doctor did not perform choledochoscopy during the operation, nor was he prepared for the use of choledochoscopy after the operation, which made the drainage tube obviously unsuitable for the use of choledochoscopy. As for the reason, it may be that the patient's own special situation is not suitable for the use of choledochoscopy during the operation, or it may be that the doctor performing the operation did not even think of using choledochoscopy.
In addition, choledochoscope equipment is expensive. This patient is HIV-infected. For safety reasons, a separate set of equipment should be used for such HIV-infected patients. The National Association of Hepatobiliary Surgery definitely does not have separate equipment for HIV-infected patients, because there are too few such patients, and if they are prepared, they will be idle and will not be used for a long time and will be scrapped. Infectious disease hospitals may or may not have them, because the equipment is expensive.
The only option is to have another surgery. Now Cao Yong and his colleagues are standing here, and their opinion is consistent with the previous doctor's. This patient is not qualified to undergo another emergency surgery.
We should try our best. Zhu Huicang thought that this might be the reason why Tao Zhijie and others who were present did not stop the two young doctors from trying. He had always been a little skeptical about Xie Wanying's operation. What she was thinking was too mysterious, and he couldn't imagine it. He always felt that this person was just hitting the jackpot, and had extremely good luck all the way.
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Will her "luck" continue to be good tonight? Will she be "lucky" with this kid Beidu?
Zhu Huicang put his hand on the frame of his glasses again, and his lenses were full of emotion: he was just thinking that these two guys were lucky, they were really "lucky".
Something like mud and sand flowed out of the drainage tube. It seems that what blocked the drainage tube was not a stubborn "big rock", but some accumulated "mud and sand". If it is flushed with a large flow, the patient's physical condition is not very good, and it may cause heavy bleeding. It is better to find an angle that can pry the "mud and sand block" and use a small flow of water, such as a 2 ml syringe, which is easier to control the flow rate and suction negative pressure to penetrate. After all, mud and sand are easier to loosen than big rocks, as long as the angle is found.
This is roughly what the two young doctors were thinking, but it is not easy to find the angle to solve this problem. The doctor who does the water injection has a very important feel, and he must feel where the resistance comes from at any time. It is even more difficult for the doctor who does the adjustment of the patient's position, and he must be able to see the position of the organs and pipes inside the patient from outside the patient's body, which is equivalent to having a pair of X-ray eyes.
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