45 adult worms were removed from the lower digestive tract. After completion, Zheng Ren said: "Director Luo, I am doing ercp with Su Yun. Are you here to guide me?"

"Boss Zheng is so polite." Director Luo said very realistically: "I can't get such a deep bug."

After saying that, he paused and smiled, "If the insects in this position were only used to use deworming medicine, and they would be discharged bit by bit after they died. Many of them could not be discharged, and they would directly turn into stones."

"If the bile duct is blocked, it depends on the situation."

"Try it, I may not be able to take it out." Zheng Ren said while preparing the ercp stuff, "I can't do it alone, so I have to pull Su Yun together."

The patient was lying on the left side, and the nurse and anesthesiologist were all wearing lead clothes in the operating room, while the others left the operating room.

"Director Luo, don't you help me?" Professor Yang asked in a low voice.

"Boss Zheng is polite to me," said Director Luo. "If you really want to be an ERCP, my level is almost impossible to match even the people under my command."

"You see what you said."

"To be honest, I'm older, and some microscopic operations are not done properly. Boss Zheng is so old that he can do it for at least 20 years!" Director Luo said enviously.

Professor Yang sighed slightly in his heart.

Generally, Boss Zheng is a graduate student or a doctoral student. It is not a bit exaggerating to say anything, but he is definitely still studying surgery and has no way to go on stage to solve difficult and complicated diseases.

It would be great if ordinary surgery can be successfully completed without any mistakes.

But when looking at Boss Zheng through the leaded glass, Professor Yang sighed again. Whether it is interventional or surgical, the same is true. How about liver cancer removal? People first intervene in the surgery and then undergo resection. Gradually, people with liver and gallbladder became accustomed to this operation.

The director is preparing to arrange someone to go and learn interventional surgery with Boss Zheng these days.

There is no need to be particularly meticulous, just use medicine and embolism. After all, surgery is required, so there is no need to be too exquisite.

He had changed a lot without realizing it, and he didn't feel too clear about being in it. Professor Yang recalled the scenes he had come into contact with Boss Zheng, and when he looked back, he felt a little confused.

On the screen, the ercp surgery has begun. The duodenoscopy passes through the esophagus, stomach, and enters the descending section of the duodenum to find the duodenum.

Professor Yang has seen many ERCP surgeries, and the next selective intubation is a very difficult step. However, when he looked at Boss Zheng’s operation, he felt nothing in his heart.

It is appropriate for Boss Zheng to do it, but it would be strange if it could not be done. It is worth discussing why the whole hospital is together.

Sure enough, the catheter was inserted through the biopsy hole, and Boss Zheng adjusted the angle button and lifted the pliers to make the catheter perpendicular to the rt opening, and then the catheter was naturally inserted into the rt of the duodenum.

Then Zheng Ren started angiography.

Retrograde cholangiogram shows an abnormal image of about 15 cm near the right liver segment of the intrahepatic bile duct. Compared with the CT film, it can be confirmed that this is the root cause of severe pain in the patient.

The roundworms are stimulated and crawl into the trough of the duodenum and into the gallbladder in the liver. Whenever the roundworms move, the patient will feel heart-wrenching pain.

Why did this come from? I really believe that it is better to eat less and move more than to eat more with this perseverance.

Professor Yang looked at the image silently and evaluated the patient's condition in his heart. This kind of ERCP operation is quite difficult, but Director Luo can't do it anyway.

Is there any precedent for using ercp to capture insects in China? There are those with proximal ends, but I have never had such a deep experience, so it is quite difficult.

"Xiao Yang, take the insects intact. What would you do if it were replaced by you?" Director Luo asked.

Although Professor Yang has never done ercp, he still understands the basic theories and operations. This is equivalent to sitting and providing a certain idea.

"Uh..." Professor Yang thought about it carefully, but then smiled bitterly: "Director Luo, you are making things difficult for me."

"What do you want?" Director Luo stared at Boss Zheng's operation tightly and said casually.

"It is not difficult to catch the roundworm with the pliers. At least it is not difficult for Boss Zheng." Professor Yang said.

It's not difficult, it's really different.

The intrahepatic bile tract is quite thin, and it is very difficult to operate the ercp to retrieve stones in the intrahepatic bile tract, let alone take a living thing.

"The difficulty lies in the fact that the roundworm does not have an obvious mouthpart and climbs tightly on the bile duct, its outer layer... seems to have a protective layer, right?"

When it comes to the details, Professor Yang hesitated a little.

He couldn't explain it clearly because he was too meticulous, so he just chatted with Director Luo based on his memory.

"Well, the outer layer of the roundworm has a stratum corneum, which has physical strength and corrosion resistance, but is comparable to antelope horns and rhino horns. It has a very strong resistance to mechanical damage, chemical damage and biological damage. Therefore, although the roundworm does not survive in the stomach, it is not digested by gastric juice." Director Luo said.

"It's very elastic. If you grab the end of the roundworm and pull it out, I'm afraid the insects will break from the middle."

"It's good when the space is large. Although the roundworms do not have suction cups, the outer wall has the ability to adsorption." Director Luo said, "The roundworms in the gastrointestinal tract are easy to remove, but the bile ducts in the liver are too difficult."

"I don't understand."

"I can't understand either." Director Luo said: "At first I just wanted to ask if there is a good idea for Boss Zheng, but since he has come, it proves that he already has an idea. I'm really curious about how Boss Zheng takes out the bugs."

"Surgery? If Boss Zheng opens his abdomen and cuts the liver and worms, it is possible at his level."

"No, if you have surgery, or if you have a surgery of this level, Boss Zheng's girlfriend will follow you on stage." Director Luo said with certainty.

Yes, Professor Yang nodded.

The angiography has long been over, but in the ercp room, Boss Zheng and Su Yun stopped after only doing a simple operation.

Director Luo was a little surprised and pressed the intercom.

Su Yun's voice immediately came out of the intercom.

"…Metformin, you dare to eat anything. This thing can also be used to lose weight. I really admire human imagination."

"Metformin improves insulin resistance, reduces insulin levels, thereby reducing fat synthesis and weight. But will the average person eat metformin, not have any problems?"

"It must be. A classmate who went abroad to study two days ago said that there was a man who was on the other side who was consuming metformin and was in a coma. There was no one at home, and when he found out, he almost became vegetative."
Chapter completed!