I took a day off and went to work the next day as usual.

The first thing I do when I come to the hospital is of course a round.

During the rounds, Jiang Yurong and Ruan Bin checked together.

The first person to investigate was Wang Deming, an 80-year-old man. Because he had a hepatogastric puncture and catheter drainage surgery the night before yesterday, he had to observe how the situation was. If it was stable, he could start to perform percutaneous pus and drainage. Even the final cholecystectomy.

"The situation has stabilized. It seems that the abdominal drainage can be performed in the afternoon!" After a check-up, Jiang Yurong found that the old man was in a good condition. It proved that the liver and gallbladder puncture and catheter drainage surgery the night before yesterday was very appropriate, which greatly alleviated the other party's condition.

Just as the room was checked, Nurse Xiaoli hurried over.

"Deputy Director Jiang, just now, a pregnant woman in the gynecology department sent me an emergency room. The director of the gynecology department was waiting for you to come over and discuss how to treat this pregnant woman!" Nurse Xiaoli said hurriedly. Since it was Sunday, Director Qian was resting, and Deputy Director Liu was currently undergoing surgery. So he could only call Deputy Director Jiang to go there.

"What's the situation?" Jiang Yurong asked as she walked, "By the way, Ruan Bin, you come with me too."

"Yes." Ruan Bin nodded.

"A pregnant woman who is 9 months old has acute cholecystitis and I heard that the condition is quite serious." Nurse Xiaoli said.

"9 months?" Hearing this, Jiang Yurong frowned.

Ruan Bin frowned when he heard this. Generally speaking, there are relatively high risks for pregnant women to undergo surgery, no matter what kind of surgery it is.

Especially this pregnant woman was 9 months pregnant and was about to give birth to that kind. At this time, she had acute cholecystitis and to be honest, the situation was not optimistic.

When the two came to the consultation room, they saw Director Du Xiujuan from the gynecology department waiting for a long time again.

After both parties politely discussed the pregnant woman's condition.

Jiang Yurong looked at a series of examination reports, and Daimei frowned slightly, "A 9-month-old pregnant woman has acute cholecystitis, accompanied by stones, gallbladder concentration and water accumulation."

Fortunately, there is no gallbladder perforation!

It's also a blessing in disguise.

"This pregnant woman was transferred from a next-level hospital. When she was in a lower-level hospital, she tried conservative drug treatment, but the effect was not good. So she had to transfer to the hospital for surgery!" Director Du explained.

"So, this surgery must be done?" Ruan Bin couldn't help but say. To be honest, the risk is very high!

"Well, her condition is very unstable at the moment. I am worried that if the surgery is not done, the consequences will be very serious. Since the cholecystectomy is from your general surgery department, I immediately sent it to us as soon as this pregnant woman arrived at our hospital. I just want to know now, how confident are you?" Director Du said.

"If you are an ordinary person, there is naturally no problem with the operation in this situation. But she is a 9-month-old pregnant woman, and the anesthesia of the surgery and the length of the operation time will probably cause contractions, processes, and even deaths to the pregnant woman. I dare not say how confident she can be." Jiang Yurong told the truth. After all, she is not a god, and there is an unknown existence of this kind of surgery, and she really cannot guarantee it.

She had also performed cholecystectomy on pregnant women in the hospital in the United States, but she had only performed cholecystectomy on pregnant women of 6 or 7 months and four or 5 months. She really had never performed 9-month-old pregnant women. If she had performed this surgery on pregnant women of 6 or 7 months, she had a 90% success rate!

Ruan Bin also has a director-level cholecystitis removal surgery, so he also knows that if this surgery is performed on a 9-month-old pregnant woman, it is indeed very risky.

Even the surgeons in many hospitals are unwilling to take this risk!

"Director Du, can you talk about the detailed risks of surgery such as 9-month-old pregnant women? I think we have to fully understand and then make plans." Ruan Bin said.

"OK."

"The miscarriage rate for cholecystitis surgery in the early stage of pregnancy is 12%, the miscarriage rate for this surgery in the middle and late stages of pregnancy is 5% and 0%, and the probability of uterine contractions in the middle stages of pregnancy is 0%! The probability of uterine contractions in the middle stages of pregnancy will rise to 40%! Therefore, the best period for cholecystectomy is the second stage of pregnancy! The probability of miscarriage and contractions in the middle stages of pregnancy is the lowest." Director Du explained. She is the director of gynecology, and of course, she knows more about the miscarriage and contractions in pregnant women than Ruan Bin and others.

"That is to say, if a pregnant woman who is 9 months pregnant now has a cholecystectomy, the chance of contractions is more than 40%?" Ruan Bin said solemnly. After all, when she is 9 months pregnant, there will be no miscarriage again, and some of them will have premature birth.

But a 40% chance of contraction is really a life-threatening one.

Once the surgery occurs at that time, it will lead to premature birth of pregnant women, fetal death or even death of pregnant women.

So this risk is not very big.

"40%? The risk is relatively high." Jiang Yurong also said with a serious expression.

"But there is no way at the moment. Conservative drug treatment does not work, so you can only have surgery." Director Du sighed.

"It seems that only surgery is possible. I suggest a laparoscopic cholecystectomy, which has little trauma and is quick to use." Jiang Yurong said.

"Yes, but we are still considering how to reduce uterine contractions during the operation. I wonder what Deputy Director Jiang has?" Director Du said incisively.

This is the most important thing.

"Continuous epidural anesthesia, according to statistics, laparoscopic removal of the gallbladder during pregnancy is a safe and effective treatment, but requires higher surgical skills. It is best to have a shorter surgical time, the lower the chance of uterine contractions!" Jiang Yurong said confidently.

"I have had 28 cases of junior and middle-aged cholecystitis removal at Hopkins Hospital, all of which use laparoscopy. I can usually complete the surgery in 30 minutes. The chance of uterine contractions can be reduced to about 20%. However, the patient is in the late pregnancy, 9 months, and it is also the most dangerous period to choose to undergo surgery. I don't know if it can be reduced. Unless, unless the surgery can be completed in 20 minutes! If it can be completed in 20 minutes, I think it should be a big problem." Jiang Yurong said.

However, she felt that it was a bit too difficult to complete a cholecystectomy in 20 minutes. Generally, the operation time of laparoscopic cholecystectomy can be completed in half an hour to one and a half hours.

It depends on the patient's serious condition, and of course the level of the surgeon.
Chapter completed!