Chapter 743: [(743)] A tough problem has emerged Chapter 743: [(743)] A tough problem has emerged The reasoning was based on the observation that the discovered gallstones in the bile duct were all quite small, and this was consistent across both cholangioscopy and ultrasound CT scans. Small stones shouldn’t cause such severe bile stasis that would lead to systemic jaundice.
The cholangioscopy continued deeper into the liver duct to further verify if the conclusion made by He Guangyou and his team was correct.
The light source rotated in multiple directions, illuminating the patient’s right hepatic duct; a multitude of gallstones, a shocking sight, densely packed within the duct, rendering it as impermeable as if it had been clogged up tightly, there was no way bile could continue to flow smoothly through such a pathway.
What a shock! Everyone was taken aback by such a scene.
“It does seem likely that the gallstones caused it,” admitted He Guangyou and He Jiuliang with a note of emotion in their voices. All one could say was that the human body is so mysterious; it often presents exceptions that overturn the doctor’s original understanding. Now, the usual definition that large stones cause jaundice had to be challenged by this special case of Zhao Zhaowei. Even small stones could potentially become a deadly threat to a patient’s life.
“Why are the stones all small and not large?”
“If it were due to abnormal bile composition or a problem with dietary intake, it would be strange to have all small stones and not a single large one.”
“Are there any roundworm eggs? Doesn’t seem like any were found?”
“The strangest thing is, large stones might block the bile duct and therefore remain stationary, but small stones shouldn’t; since the opening of the hepatic duct is downward, small stones should fall due to gravity instead of getting stuck together.”
“Didn’t Xiao Song mention something about the angle problem?”
A group recalled what Song Xueling had said before, and it seemed to make sense.
The angles between the right and left hepatic ducts were incorrect, leading to bile reflux. Thus, even small stones could force the bile to flow backward, accumulating more stones over time, preventing bile drainage and eventually causing systemic jaundice.
“How can we assess the angle?”
When someone raised this question, everyone suddenly realized it was the most challenging problem to solve.
The human body is three-dimensional, all its organs and tissues are three-dimensional, and their interconnections are all in three dimensions. A doctor can only consider the 3D structure; it’s not possible to think in just two dimensions. So, the angle problem Song Xueling talked about had to be an angle in a three-dimensional world.
It was like being tasked with the most complex geometric math problem.
Surgeons staring at the screen found themselves dumbstruck. Some began rubbing their foreheads, wishing they could make their brains work faster.
The anesthesiologist and nurses glanced over at the surgeons and quickly turned their heads back: There was no way they were going to join in on this tough problem, it was far too challenging to consider.
The expressions on everyone’s faces indicated that most doctors could only throw up their hands in surrender. It’s not the doctors’ fault; such problems could only be imagined by a mathematical genius in a short time. And so, various tools to aid doctors are often invented out of necessity.
Medical devices like the cholangioscope and Laparoscopic are akin to extensions of the doctor’s hands. The 3D modeling software that Cao Yong had taught her could be considered another brain to assist the doctors’ thinking, playing a crucial role in planning surgical pathways for patients.
But, tools merely assist; the final reliance is on the doctors themselves. The equipment might not be used, and the 3D modeling might be incorrect.
The biggest issue now was not an inability to clear the stones, but to figure out why the patient had so many small stones in the first place; otherwise, after clearing the stones, if the patient continued to relapse, the surgery would have been pointless.
While everyone was deep in thought, the cholangioscope that had entered the intrahepatic bile ducts for investigation suddenly ceased moving.