Chapter 744: [(744)] The leader came to inspect. Chapter 744: [(744)] The leader came to inspect. Chief Surgeon seemed to have fallen into a mental deadlock, which was troublesome.
After regaining composure, the cholangioscope was withdrawn slightly, pulled back to the confluence of the left and right hepatic ducts at the common hepatic duct, apparently to attempt re-observing the angulation issue.
As everyone had anticipated, it was very difficult to determine if there was any problem with the angle from an internal observation alone. The light source moved back and forth, but it seemed to reveal no issues with angles.
Unable to find any breakthrough, the group of doctors felt like they were going insane.
“Could it be that the right hepatic duct appears a bit smaller than the left one?” He Jiuliang strained to find some discrepancy.
The others quickly agreed, “If that’s the case, it indicates that his right hepatic duct is congenitally narrow.”
“No, if the problem is only with the right hepatic duct, why are there abscesses and stones in his left liver as well?”
“Did Xiao Song ever mention his right hepatic duct being narrow?”
Confronted with the questions from his seniors, Song Xueling’s brown eyes seemed even more puzzled, “The difference in the diameter of the ducts on both sides falls within a reasonable physiological deviation that doesn’t need to be accounted for.” Essentially, he never mentioned nor considered it to be the issue.
After digesting his academic words, the others were heavily struck. Having ruled out the reason of congenital narrowing of the right hepatic duct, they had to return to the angle problem. Currently, it seemed impossible to determine the angle using cholangioscopy from the inside; they had to think of another method.
“Can we observe the flow of bile?” Gong Xiangbin considered the hypothesis.
If they could see where the bile reflux was occurring, they would definitely be able to identify the angulation issue.
However, Decisive Moment, the Chief Surgeon, immediately withdrew the cholangioscope.
The patient had developed jaundice, which indicated that a bile duct obstruction led to the secretion pressure of bile reaching its limit. Hepatocytes would no longer secrete bile into the ducts; instead, in a situation where the production of bile wouldn’t stop, bilirubin would reflux into the blood. Waiting for the bile to show signs of reflux during surgery was likely an impossibility.
The Chief Surgeon was indeed calm and collected. Withdrawing the cholangioscope meant observing the angle from the outside. The others were concerned that it might be necessary to open up the liver to clearly understand the relationship; both hepatic ducts were inside the organ.
Opening the liver would be a significant injury to the patient, and it wasn’t necessary for merely an examination. What if they cut and it turned out not to be the issue?
The exploratory surgery had been going on for a full hour and a half.
A dense feeling of anxiety spread among everyone. Where was the breakthrough point?
At that moment, footsteps of two people were heard returning to the operating room.
“Old Zhao, there’s no need for excessive worry over a surgery performed by your own department’s doctors,” said Director Tang with the air of a high-ranking officer.
The young doctors in the operating room straightened their backs: the leader had come for an inspection.
Director Tang and Zhao Huaming stood side by side at the entrance of the operating room.
“The situation seems alright,” Director Tang remarked on the progress of the surgery.
“Alright?” Zhao Huaming asked weakly, not very hopeful.
“If it’s gallstones, removing them could resolve the jaundice. It’s certainly better than any kind of bizarre intrinsic liver cell disease,” Director Tang said. This revealed that he had discussed the case with Tao Zhijie.
Zhao Huaming exclaimed in surprise, “You’ve discussed it?”
“How could we not care about your grandson or not do our utmost to treat him? We’ve considered the same concerns that you have,” Director Tang said, subtly criticizing him for his lack of calm.
Zhao Huaming could not help feeling anxious as all the renowned doctors in the department had reviewed his grandson’s condition, and even his own research had not yielded any clear answers, “It can only mean that his condition is unusual.”