Doctor: I Can Synthesize Infinite Entries

Chapter 100: Chapter 99: Invitation to the Hepatobiliary Surgery Grand Rounds

Wu Ting had performed an abdominal paracentesis in an ambulance, diagnosing a rare case of spontaneous common bile duct perforation.

This greatly impressed Cai Qi, the director of Hepatobiliary Surgery. After returning to his department, he held a small meeting and shared Wu Ting’s case.

As a result, the entire Hepatobiliary Surgery department grew curious about Wu Ting. Some were impressed, some thought he just got lucky, and of course, some were eager to see how they measured up.

Wu Ting was all set to go home after his shift ended.

But then, Director Cai called, inviting Wu Ting to visit the Hepatobiliary Surgery department.

Wu Ting wasn’t about to pass up such a great opportunity. He turned right around and headed for Hepatobiliary Surgery.

As it happened, it was the day for Director Cai’s grand rounds. He had invited Wu Ting over to tour the Hepatobiliary Surgery ward and review some cases, giving Wu Ting a comprehensive understanding of the pre-operative, intra-operative, and post-operative stages of patient care.

At the same time, grand rounds were a perfect occasion for Director Cai to introduce Wu Ting to his department’s doctors, laying the groundwork for future collaboration.

Of course, Director Cai also intended to demonstrate the capabilities of the Hepatobiliary Surgery department, ensuring Wu Ting wouldn’t underestimate them.

In clinical practice, Hepatobiliary Surgery is also known as Hepato-Pancreato-Biliary (HPB) Surgery.

The diseases treated include those of the liver and biliary tract, such as gallstones, cholecystitis, biliary tumors, and common bile duct stones.

Cai Qi made a point of introducing Wu Ting to his department’s doctors.

Everyone was quite curious about Wu Ting, who had recently become quite renowned at City First Hospital. Seeing how young, dapper, and handsome he was, the doctors’ first impression of him was excellent.

After the introductions, Director Cai began the grand rounds with Wu Ting in tow.

Wu Ting observed carefully, paying special attention to the patients who had undergone a cholecystectomy.

Lu Xuejun, a senior attending physician in the Hepatobiliary Surgery department, was in charge of several patients.

Accompanied by a resident and two interns, Lu Xuejun began his report to Cai Qi.

”...The patient in bed two underwent a laparoscopic cholecystectomy yesterday morning. We’re monitoring post-operative abdominal distention... the return of bowel sounds... first flatus... and first bowel movement...”

After finishing his report, Lu Xuejun sounded somewhat resigned. These were, after all, unavoidable post-cholecystectomy complications.

After listening, Cai Qi agreed that the patient’s recovery was slower than expected.

One of the junior doctors on Lu Xuejun’s team asked with a puzzled expression:

”Director Cai, why do nearly all patients experience these symptoms to some degree after a laparoscopic cholecystectomy? Post-operative abdominal distention, nausea, vomiting... some patients suffer immensely, which severely affects their psychological well-being and delays their discharge.”

Cai Qi offered a professional and detailed explanation for the junior doctor:

”The reason patients experience post-operative abdominal distention, nausea, and vomiting is primarily due to gastrointestinal dysfunction.”

”During a laparoscopic cholecystectomy, noxious stimuli such as changes in body position, anesthetic intubation, pain, and visceral traction can all trigger an autonomic nervous response.”

”The autonomic nervous system, which is composed of the sympathetic and parasympathetic nervous systems, is widely distributed throughout the gastrointestinal tract. A laparoscopic cholecystectomy inevitably affects the autonomic nervous system, therefore causing gastrointestinal dysfunction.”

The junior doctor looked disappointed upon hearing Director Cai’s explanation.

”So, Director Cai, is there no good solution?”

Hearing the junior doctor’s probing question, Cai Qi gave a wry smile, his expression full of regret.

”This is a universal problem in our field. To date, there is no solution.”

”We can only say that due to individual patient differences and the skill level of the Technician, the severity varies. There is no method to completely resolve it yet.”

The junior doctors looked dejected upon hearing this. But that was the nature of medicine; many procedures had inherent side effects. All they could do was wait for medical advancements and improvements in Surgical Techniques.

But that was easier said than done!

Lu Xuejun moved on to the next patient, who had also undergone a laparoscopic cholecystectomy.

This patient was also suffering from gastrointestinal dysfunction, experiencing post-operative vomiting, nausea, and repeated dry heaving.

”Director Cai, we’ve started the patient in bed three on medication to control the symptoms.”

Cai Qi nodded. Due to these unavoidable side effects, patients who underwent laparoscopic cholecystectomies generally had to be kept for observation.

A small number were discharged on the same day, but most required a three to five-day stay.

After all, compared to other procedures, a cholecystectomy was relatively minor. However, these minor surgeries were also the most common, with the largest patient base and the most widespread clinical application. Their treatment plans were already streamlined and standardized.

Improving such a fundamental Surgical Technique was, paradoxically, extremely difficult. Any breakthrough would be a milestone with massive potential for widespread adoption.

Listening to the exchange between Director Cai and his team, Wu Ting realized just how incredible the new Surgical Technique he’d mastered truly was.

’The Qi-Flow Regulation Combined Laparoscopic Cholecystectomy (Purple)... once I introduce it, it’ll send a seismic shock through the entire field.’

’Next, I should visit the National Medical Department and find Deputy Director Huang Hong. We can start implementing this new Surgical Technique together.’

Cai Qi moved on to the next patient. Wu Ting hadn’t yet begun to master the conditions of the remaining patients, so he didn’t follow as closely.

After rounds were completed, Cai Qi addressed his department with an important announcement.

”Everyone, for the next six months, we all need to work hard toward our application to become Fan City’s first provincial-level ERAS Hepatobiliary Surgery ward.”

Wu Ting didn’t quite understand what Director Cai meant.

Lu Xuejun explained to Wu Ting with a hint of pride:

”Dr. Wu, ERAS stands for the Enhanced Recovery After Surgery concept. It’s the most cutting-edge trend in surgical ward development in the country.”

”The simplest explanation is that we use a multi-level, multi-disciplinary approach with various methods to accelerate a patient’s recovery and discharge.”

Lu Xuejun offered an example:

”Take the laparoscopic cholecystectomy you’re studying, Dr. Wu. If we could resolve its post-operative complications and significantly shorten the patient’s recovery and discharge time, that would add a lot of points to our ERAS ward application.”

Cai Qi added:

”ERAS has been our department’s primary goal for the last two years.”

”We’re mainly focusing on improving surgical procedures, altering bowel preparation protocols, speeding up post-operative recovery, and preventing complications. I believe that if we can achieve a breakthrough in any one of these areas, our department can claim the title of Fan City’s first provincial-level ERAS Hepatobiliary Surgery ward.”

As he spoke, Cai Qi was both under immense pressure and brimming with motivation.

”Dr. Wu, I’m well aware that you’ve pioneered two brand-new Surgical Techniques in Emergency Surgery. You’re always welcome to come and exchange ideas with us in Hepatobiliary Surgery. If you have any thoughts, please feel free to share them with me. If you can develop some new approaches or directions in the hepatobiliary field, it could provide a significant boost to our provincial ERAS ward project.”

Cai Qi had high hopes for Wu Ting, though of course, he didn’t expect him to contribute anything immediately.

He simply hoped that over time, Wu Ting would make some valuable contributions during his exchanges with the Hepatobiliary Surgery department.

The other doctors from the Hepatobiliary Surgery department didn’t take Director Cai’s polite words to heart.

”Director Cai, thank you for the opportunity.”

”I’ve actually been studying laparoscopic cholecystectomy recently, and naturally, the surgery requires a large number of patients to practice. I have a bold request... would it be possible for the Emergency Surgery department to receive some suitable patients from the Hepatobiliary Surgery outpatient clinic?”

”To be honest, I’ve recently been reading some domestic and international journals on post-operative complications for this procedure, and I’ve had some insights... some preliminary ideas. I’m planning to go to Director Huang Hong of the National Medical Department to try out a new Surgical Technique.”

”If this Surgical Technique can be successfully implemented, it might be of some help to your department’s provincial ERAS ward application.”

Wu Ting didn’t beat around the bush; he got straight to the point and asked Cai Qi for patients.

After all, it was much easier to screen for patients needing only a cholecystectomy in a specialized outpatient clinic. The patients admitted to the emergency department were too numerous and varied; gathering enough cases to practice his new Surgical Technique would take goodness knows when.

Cai Qi and the other Hepatobiliary Surgery doctors were taken aback by Wu Ting’s request.

Lu Xuejun was dumbfounded. ’I was just giving a hypothetical example!’

’And he just ran with it!’

’Is this him making grand promises to the boss to get what he wants?’

’Does he really think improving a Surgical Technique is as easy as breathing? And solving the post-op complications of a cholecystectomy, on top of that? The nerve of this guy.’