Cholangiojejunostomy is an important part of gastrointestinal function reconstruction. Although it can not be said that it is very difficult, it is absolutely very important.


    In the reconstruction of digestive tract, the most difficult operation is pancreatogastrostomy, and pancreaticoduodenectomy is one of the most difficult operations.


    The difficulty of digestive tract reconstruction is actually around the small intestine!


    The difficulty is naturally in the treatment of the small intestine.


    Small bowel anastomosis seems to be the simplest, but as a central link, it is the most difficult.


    Because he connects the stomach, bile duct, pancreas


    These three important digestive organs, together with the small intestine, constitute 90% of the digestive tract.


    It seems that we have not paid much attention to colorectal anastomosis.


    At first, Chen Cang thought that the difficulty of digestive tract reconstruction was not high, but with in-depth understanding, he increasingly realized that this difficulty seems to be much higher than he imagined!


    Otherwise, it will not bother digestive surgery for hundreds of years, and there is no better solution so far.


    At this time, when Chen Cang looked back, he suddenly found that the original pancreatic surgery skill expansion package really occupied the stool.


    The most difficult problem seems to be solved by him first.


    After the operation, Chen Cang held the mirror meticulously.


    Endoscopic gallbladder surgery is actually very challenging.


    For example, in this patient at this time, the reason for bile duct stricture is that when cholecystectomy was performed, the bile duct was inadvertently damaged, resulting in bile duct stricture, cholestasis and jaundice.


    Under endoscopic surgery, bile duct injury seems to have become a very serious problem.


    This is no longer a person''s business, and has even become an industry problem.


    Thinking of this, Chen Cang is no longer anxious to think about stealing teachers or what to do. He hopes to use his mirror holding skills to observe the gallbladder and see if it can reduce the probability of bile duct injury!


    Chen Cang simply sank down and began to watch Auster''s operation.


    After laparoscopic exposure of the bile duct, careful separation is required.


    Due to the dense blood vessels around the bile duct, care should be taken during the passage of multiple blood vessels.


    When Oster operated, he didn''t relax his vigilance because he was good at it, but took it very seriously.


    At this time, Chen Cang suddenly said, "Professor Auster, what do you think is the main reason for damaging the bile duct during biliary surgery and gallbladder surgery?"


    This question suddenly silenced Auster!


    About 80% ~ 90% of extrahepatic bile duct stricture was injured during operation.


    Only 10% ~ 20% of them were secondary to peribiliary inflammation, infection and ischemia.


    So why damage?


    This is a very important question!


    Since the damage rate is so high, why not conquer it?


    Auster thought of this and couldn''t help saying, "this is a problem!"


    In a word, Ma Yuehui couldn''t help rolling his eyes!


    I thought I could say something good?


    At this time, he Zhiqian, who acted as an assistant, also thought.


    The operations to deal with traumatic biliary stricture are re biliary operations, some even more than 10 times, which is very difficult.


    It is definitely not a successful operation, including the patients at this time, which was completed once three years ago!


    Four people think at the same time.


    After a while, Auster said, "maybe it''s still because of the problem of the art field?"


    He Zhiqian also nodded: "well, even open surgery, when dealing with the gallbladder, it is easy to damage the bile duct when dealing with the gallbladder triangle because of the dense liver and blood vessels."


    While Oster was dealing with the common bile duct, Chen Cang suddenly said, "wait a minute, I''ll change your angle, and you''ll deal with it again!"


    Chen Cang took the lead in following the endoscope when he separated and entered the lesser omental foramen. At this time, Chen Cang turned the optical fiber. Soon, the wire knots left by previous operations and the scar nodules at the bile duct stenosis appeared in the TV picture.


    Seeing the original narrow, Chen Cang fell into meditation.


    Why did it hurt here?


    Thinking of this, he hurriedly said, "let me see where the last punching operation was."


    Suddenly, Auster''s eyes brightened.


    Marks left by several operations on the abdomen appeared.


    Chen Cang looked at several marks, and Oster quickly separated which was the operation hole and which was the auxiliary.


    Chen Cang stared at the four-dimensional map and kept thinking


    At this time, he found the power of his four-dimensional map!


    This is clearly a simulation structure diagram.


    Through the three cavities, it even began to simulate the operation at that time.


    After a few minutes, Chen Cang had thought of dozens of possible injuries.


    This... Is no different from what I didn''t expect.


    Dozens of operations are obviously not representative. He needs to find a commonness of injury!


    Thinking of this, Chen Cang understood that this is no longer a problem that can be solved by one operation, and more operations may be needed to verify it.


    Chen Cang simply said, "Professor Auster, you handle it and I''ll give you a vision!"


    Auster nodded. The question raised by Chen Cang also plunged him into meditation.


    The operation went by minute.


    Chen Cang constantly brings the endoscopic technique into play, taking into account all structures and organizations as much as possible.


    Auster''s cholangiojejunostomy went well!


    This is the first time that Oster has been held by Chen Cang personally. It is also a real sense of how powerful Chen Cang''s mirror holding technology is!


    Every step, Chen Cang can even think of it in advance.


    Blood vessels, ligaments, liver, bile ducts... Any tissue that may be damaged, Chen Cang will use endoscopic techniques to illuminate the field of vision in advance, and then do a good job of warning!


    The endoscope is like the doctor''s eyes, and Chen Cang, as a mirror holder, forcibly turns the doctor''s eyes into a 360 degree camera without dead angle!


    So that Oster''s next operation was very smooth!


    Oster also feels that his operation today is unprecedented smooth, and every detail can be grasped in place.


    All this is naturally due to Dr. Chen.


    For a time, Auster had a hunch that Chen Cang might be more powerful than himself?


    Thinking of this, Auster looked up at Chen Cang and saw that his eyebrows were tight and he didn''t know what he was thinking!


    Suddenly, Auster suddenly felt a thump in his heart, and his eyes were a little more worried.


    Is it... Is Dr. Chen dissatisfied with his performance in this operation?


    Thinking of this, Auster suddenly felt nervous, and the operation became more and more rigorous and serious!


    The operation will be over soon!


    However, Chen Cang still didn''t say a word, which made Auster more nervous!