The reason is that the bile duct stones found are all very small, and the results of choledochoscopy, B-ultrasound and CT are consistent. Small stones will not cause severe cholestasis and lead to systemic jaundice.
The choledochoscopic examination continued to go deeper into the hepatic duct to further confirm whether He Guangyou and his team's conclusion was correct.
The light source rotates in multiple directions to illuminate the right hepatic duct in the patient's body. The sight of the gallstones is shocking. They are densely distributed in the hepatic duct, blocking the gallbladder cavity tightly. How can the bile continue to flow smoothly in such a duct?
Scary! Everyone must be shocked to see such a real scene.
"It seems that it is really caused by gallstones." When He Guangyou and He Jiuliang admitted this, their tone was full of emotion. It can only be said that the human body is too mysterious, and exceptions often appear to overturn the original cognition of doctors. Now, the usual definition that only large stones can cause jaundice is about to be broken by Zhao Zhaowei's special case. Small stones can also become a big killer that threatens the patient's life.
“Why are kidney stones usually small and not big?”
"If it is an abnormality in bile composition or a problem with dietary intake, it is unlikely that there are only small stones and no large stones. It is too strange."
"Are there any ascarid eggs? I don't think I found any?"
"The strangest thing is that the large stones block the bile duct horizontally so they may not move, but the small stones are not like that. The opening of the bile duct opens downwards, so the small stones should fall downwards due to gravity. How could they get stuck together?"
...
...
"Didn't Xiao Song mention something about the angle problem?"
A group of people remembered what Song Xuelin had said before, and it seemed to make sense.
The angle between the right and left hepatic ducts is incorrect, which causes bile reflux. Therefore, even if the stones are small, the bile reflux can only go back. As more and more stones are produced, the bile cannot be discharged, and eventually systemic jaundice appears.
“How do you tell the angle?”
When someone raised this question, everyone suddenly realized that this was the most difficult problem to solve.
The human body is three-dimensional, and all organs and tissues inside it are three-dimensional, and the connections between them are all three-dimensional. Doctors can only think of three-dimensional structures, and cannot think of two-dimensional ones. Therefore, the angle problem that Song Xuelin mentioned must be the angle in the three-dimensional world.
It is equivalent to doing the most complicated geometry math problem.
The surgeons stared at the images on the monitor in a daze. Some of them touched their foreheads, wishing their brains could work faster.
The anesthesiologist and the nurse looked in the direction of the surgery department and turned their heads away: We absolutely will not join in on this fun, it's too hard to imagine.
The expressions of everyone at the scene showed that most doctors could only throw up their hands and surrender. Don't blame the doctors, only a mathematical genius can think of such a problem in a short time. Therefore, various things that assist doctors in their work are often invented because of practical needs.
Medical devices such as choledochoscopes and laparoscopes are equivalent to the hands of doctors. The 3D modeling software that Cao Yong taught her before can be considered as another brain to assist doctors in their thinking, and plays a vital role in the surgical path planning for patients.
Auxiliary tools are just auxiliary tools, and ultimately the doctor has to rely on himself. The equipment may not be used, and the 3D modeling may be wrong.
The biggest problem now is not to clear the stones, but to figure out why the patient has so many small stones. Otherwise, if the patient continues to relapse after the stones are cleared, the operation will be meaningless.
While everyone was racking their brains, they saw that the choledochoscopic instrument had entered the intrahepatic bile duct for exploration and then stopped moving.
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