The most feared accident during surgery is not the gallbladder-heart reflex. Why? Because the surgeon and anesthesiologist have experience with this and know that the patient is at risk, so they can prevent it in advance. Even if an accident is discovered, they still know how to deal with it quickly.
For common surgical accidents such as the gallbladder-cardiac reflex, as long as the doctor makes a good plan, the success rate of rescue is very high.
"Senior Brother Tao has made a plan. If necessary, they will use a sealing method during the operation to freeze the vagus nerve here and avoid the gallbladder-heart reflex." Xie Wanying told the surgeon about the arrangement so that Dr. Zhang, who was performing the anesthesia, could rest assured.
For an associate professor like Tao Zhijie, avoiding this predictable surgical risk is a small matter and is too easy to solve.
Zhang Tinghai knew the contingency plan made by Tao Zhijie. Besides, as an experienced anesthesiologist, he could handle such surgical issues with ease.
Before surgery, patients will be routinely injected with atropine in the ward to calm the vagus nerve. When they arrive in the operating room, they will be given oxygen through a mask and given general anesthesia to further calm the patient's vagus nerve.
If something happens during the operation, he will prepare rescue medicines in advance before the surgeon works on the special area, and he also knows what medicines will be needed at that time, so there is no need to be afraid.
Zhang Tinghai was well aware of all the contingency plans. What he was worried about was not this, but "Teacher Lu's heart is not very good. Could it be related to gallbladder-heart syndrome?"
There is a big difference between cholecardiac syndrome and cholecardiac reflex. Although both affect the patient's heart, the causes are different. As mentioned earlier, the latter is a vagus nerve reflex triggered by the surgeon's operation. Cholecardiac syndrome is an inherent disease of the patient, a heart problem caused by chronic cholecystitis and other diseases in the human body.
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Here we need to further discuss the anatomical relationship between the human heart and gallbladder. The human heart is innervated by the T2-8 spinal nerves, where T is the abbreviation for the thoracic vertebrae. The gallbladder and common bile duct are innervated by the T4-9 spinal nerves. In this way, the nerves innervated by the two cross at T4-5.
Where there is intersection, if there is a problem on one side, it is bound to affect the other side.
When the gallbladder is inflamed, the pressure in the bile duct increases, which is transmitted to the heart through crossed nerve reflexes, causing the coronary arteries to contract and blood flow to decrease. Undoubtedly, typical heart disease symptoms will appear, such as myocardial infarction.
The department has discussed Mr. Lu's condition many times. Xie Wanying said, "Yes, we have thought about this possibility. Therefore, the gallbladder will probably be removed during the operation, even if there is no cancer cell infiltration. This is because Mr. Lu's gallstones are very serious."
At this point in the discussion, removing the patient's gallbladder is the only cure for cholecardiac syndrome, so it seems to have nothing to do with his nightmare.
Zhang Tinghai sighed, not knowing what his nightmare was about.
"Doctor Zhang." Xie Wanying could sense his inner anxiety. All the teachers and seniors were anxious before the operation, and it was understandable because the patient was Teacher Lu. She comforted Doctor Zhang like she gave candy to Senior Brother Cao last time, saying, "Drink something sweet, you will feel better."
Zhang Tinghai wanted to roll his eyes at her. If she were a medical student, who wouldn't be worried about the teacher and be extremely nervous? But she was so calm that she could drink sweet and eat spicy food.
Squinting his eyes, Zhang Tinghai remembered what many senior doctors had said to younger doctors: an excellent doctor must have an extremely strong heart.
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