Chapter 123
He truly listened humbly to Dr. Lu’s surgical recommendations.
“The condition of the stones is severe, and acute inflammation has occurred; surgical removal is the only definitive treatment,” Dr. Lu provided his diagnostic opinion.
“Hmm, that makes some sense.”
Dr. Xu merely nodded slightly, with no great fluctuation in facial expression.
“Xiao Zhou, you have always had excellent diagnostic skills, help us contribute some ideas!”
“Alright!”
After carefully reviewing all the data, Zhou Can also examined the patient’s actual condition.
“I don’t think we should perform surgery right now!”
Zhou Can had been following Dr. Xu these days, learning various surgical knowledges, and had made significant progress.
His breadth of vision, predictive ability, and control of risks all saw great improvement.
The patient became anxious upon hearing this.
“Doctors, please, perform the surgery on me quickly! The pain is unbearable. If there is no surgery, I… oh, wow…”
Splashing!
The patient vomited, but fortunately, Nurse Liu Xia, with her extensive experience, was quick and caught it for the patient.
The 12-hour fasting before surgery was actually to prevent anesthesia-induced vomiting, which could lead to asphyxiation death.
In a situation like just now, if it had occurred under anesthesia, it would have been very dangerous for the patient.
“Do you think the patient shouldn’t have surgery right now because he hasn’t fasted preoperatively?”
Dr. Xu asked.
The content of the patient’s vomit was not insignificant, and it was quite concerning.
“That’s actually something for the anesthesiologist to consider. My opinion against immediate surgery is twofold. First, based on the examination reports, I believe the patient’s intra-cholecystic stones injured the mucosa, leading to bile stagnation in the gallbladder and eventually causing a bacterial infection. The acute pain, nausea, and vomiting he is experiencing are likely due to the inability to expel bile, resulting in excessive internal pressure.”
Zhou Can presented his diagnostic points calmly and unhurriedly.
His explanation was much more detailed than Dr. Lu’s hastily made remarks.
Diagnosing a patient has a lot to do with personal work style. Lazy people tend to take shortcuts in diagnostics too; even the surgical plans they provide are more geared towards quick and simple treatments, reluctant to think too much about post-surgical outcomes and the various potential risks during surgery.
It’s not that they aren’t professional; it’s just their reluctance to delve deep into thought.
Such doctors exist and make up at least about ten percent of the medical workforce.
Many are just coasting through the days.
However, they hardly ever cause problems because their superiors keep a watchful eye on them, vetting their decisions.
Also, because their superiors and department leaders are aware of their work style, these doctors are never in charge of making decisions for crucial diagnostic and treatment activities.
They are basically assigned tasks with lower risks.
“Secondly, the patient’s physical weakness and advanced age inherently increase the surgical risk. Moreover, upon analysis of the examination reports, I suspect there is purulence around the gallbladder. It’s necessary to first drain the pus, control the inflammation, and then schedule a surgery at a later date.”
These surgical opinions were things Zhou Can would never have been able to express before.
So, it goes to show that the fastest growth for a doctor comes through practice.
He’s been immersed in the operating suite for half a month, receiving plenty of surgical training opportunities each day, along with careful guidance from Dr. Xu. His insights and practical surgical knowledge have improved too greatly compared to before.
Just like the time he mocked Du Leng for being all theory and no practice.
Books can only teach theory; the flexible application of knowledge in practice, combined with various practical experiences, is something that can’t be learned by just reading books or watching videos.
It’s only by being on the spot, in the operating room, that one can learn the real surgical knowledge.
“You’ve seen the patient’s condition; the mortality risk of acute cholecystitis is not low, let’s hear your treatment plan. We must ensure the patient’s safety.”
The mortality rate of acute cholecystitis exceeds 10%, which really isn’t low.
And this disease often arises as a postoperative complication or from someone weak with multiple underlying conditions.
After onset, the patient’s physical condition is simply not resilient enough to withstand gallbladder removal surgery.
Under such circumstances, symptomatic treatment is basically the only option.
First stabilize the patient’s condition, waiting until they meet the surgical indications, then proceed with the operation.
“My therapeutic opinion is to perform an ultrasound-guided puncture first, to drain part of the bile to the outside and reduce the internal pressure in the gallbladder. Meanwhile, carry out an interventional radiography to position the puncture and drain the pus around the gallbladder. Surgery will be performed when the patient meets the surgical indications.”
Zhou Can gave two treatment suggestions.
“Just operate on me quickly, if I don’t get the operation today, I won’t leave; I’d rather die here…” The patient was in such pain that his face was contorted.
As a general rule, when patients suffer from severe pain and physical discomfort, their temper can turn particularly foul.
Patients don’t understand medicine; hearing the doctors discussing and not proceeding with surgery, he would disagree with whatever they said.
“Please get the Gallbladder Surgery and Internal Medicine doctors to come for a joint consultation!”
Dr. Xu felt quite helpless in the face of the patient’s threats.
Bringing in doctors from two authoritative departments for a consultation can lessen the pressure they need to bear, distribute the risks. It also convices the patient and their family.