Chapter 862: Porcelain Gallbladder
Like a master painter, a simple picture quickly appeared on a sheet of A4 paper.
Looking at this picture, Mu Tao’s eyes lit up.
Mu Tao seemed to have understood several important points without needing to explain. When he went back and compared it with the radiographic films, he thought that there would be a new breakthrough. That was what Mu Tao thought.
“Old Mu, I’m not going to tell you. Go back and see for yourself.” After Zheng Ren finished drawing, he said, “If there’s anything you don’t understand, or if you have any doubts, leave me a message. Or come early tomorrow and we can discuss it together.”
Mu Tao nodded. He understood Zheng Ren’s meaning.
Chang Yue went to call the next patient’s family member. Mu Tao saw that Zheng Ren was still in deep thought, and a thousand emotions surged in his heart.
This was a selfless teaching, and he was afraid that he would not understand, so he tried all means to explain it to him.
Using the thoughts of a normal person, he was a f*cking idiot!
This thought flashed through Mu Tao’s mind.
The rapid progress of human society precisely because of such a person, right? Edison obtained venture capital investment and summarized the experience of his predecessors. Before all the money was spent, he created a light bulb and wanted to monopolize DC power.
He continued to suppress Tesla, but AC still came into being and shattered Edison’s beautiful dream.
Tesla did not use the AC patent to obtain the patent fee that now seemed to be more than ten billion dollars. Everything was used for free.
This move greatly promoted the application of AC.
What Zheng Ren did was exactly this kind of thing.
A great kindness!
He recalled the first time he met Zheng Ren in the Imperial Capital before Pengxi Village. Up until now, Zheng Ren’s image became three-dimensional and vivid in Mu Tao’s mind.
In the following explanations, Zheng Ren drew a simple picture for Mu Tao each time.
Mu Tao took radiographic films, marked them, and placed the pictures carefully, waiting for him to study them properly later.
Unfortunately, there were too many surgeries, and the time was too short. Mu Tao was afraid that he would not be able to study them thoroughly before the surgery.
It was much better to do research with Boss Zheng than at the Mayo Clinic. Mu Tao sighed emphatically from the bottom of his heart.
After the three patients from the Digestive Department finished their communication, Zheng Ren greeted the chief resident and brought Chang Yue and Mu Tao to the Department of Hepatobiliary and Pancreatic Surgery.
It was lunchtime, so Zheng Ren did not want to disturb Professor Yang’s rest.
However, when he arrived at the Hepatobiliary and Pancreatic Surgery Department’s doctor’s office, Zheng Ren saw that Yang Lei was reading the radiographic films. It was a CT scan of the upper abdomen.
“Brother Yang, I’m here.” Zheng Ren did not stand on ceremony and greeted him with a smile.
“Boss Zheng, come here.” Yang Lei did not even look at the radiographic films. He only called Zheng Ren over.
“Huh? What radiographic films?” Zheng Ren asked.
Professor Yang must have asked him to look at the radiographic films with him to make a diagnosis.
“62-year-old female patient. During the physical examination, there was a change in the gallbladder area, so we did a CT scan of the upper abdomen,” Professor Yang said. “Below the fourth stage of the liver, there is no gallbladder in the gallbladder area. There is only a cystic package.
“There are calcification deposits. It looked a little strange, like a porcelain gallbladder, but it was different from porcelain gallbladders I have seen before.”
“Oh? No gallbladder?” Zheng Ren walked over and asked first. Then, he rested his chin on his hand and began to read the CT scan.
On the CT scan, the gallbladder area was like a big bubble. The gallbladder in the original position of the gallbladder had disappeared, and a huge cystic space was there. The texture was uneven, and it looked very strange.
Was it a tumor?
Zheng Ren did not think so. Generally speaking, tumors were solid, and cystic ones were rarely seen.
What was that?
Mu Tao took a look at the radiographic films and was also interested.
The people involved in the intervention, other than freaks like Zheng Ren, were basically doctors who came from radiographic backgrounds.
Regardless of whether it was X-ray radiographic films, CT, or nuclear MRI, there was a certain amount of research.
This radiographic film was interesting. Mu Tao temporarily forgot about the patients with advanced cirrhosis who were undergoing the TIPS surgery. Just like Zheng Ren, he started to look at the radiographic films.
Chang Yue was very helpless. Coming out with Chief Zheng to look at the patients was really a waste of time.
They said that they would look at the patients, but when they saw an abdominal CT, they stopped. When would they be able to finish their work?
However, very quickly, within a few minutes, Zheng Ren said, “Brother Yang, I think that what you said about the porcelain gallbladder is right. Moreover, there is malignant tissue in the gallbladder.”
“I think so too,” Yang Lei said. “Boss Zheng, are you interested?”
“Hmm?” Zheng Ren turned his head to look at Professor Yang. “The patient has already been hospitalized?”
“Yes,” Professor Yang said. “I can do the surgery, but the possibility of completely removing the porcelain gallbladder is not high. When are you free?”
“I have to do the TIPS surgery tomorrow. The day after tomorrow?” Zheng Ren’s hand was a little itchy. He chuckled.
Porcelain gallbladder was a reference to the gallbladder with a hard and fragile form due to calcification of the gallbladder wall.
Porcelain gallbladders had its particularity in clinicopathological features.
Since Cornell first reported and proposed the concept of ‘Porcelain gallbladder’ in 1959, there have been sporadic instances of related literature published abroad.
In particular, the correlation between porcelain gallbladder and gallbladder cancer was raised. Porcelain gallbladders easily accompanied gallbladder cancer, and porcelain gallbladder cancer occurred in the body of the gallbladder, occasionally at the bottom and neck.
In this patient, the whole gallbladder had a tendency to calcify.
With these calcified lesions, it was best to remove the whole. Once broken, it may lead to tumor implantation and metastasis.
However, as the name implied, the entire gallbladder was as fragile as ceramic. It was easier said than done to cut it off completely.
Therefore, when Zheng Ren arrived, Professor Yang did not hesitate to invite Zheng Ren to participate in the surgery.
Zheng Ren was the one who performed the liver autotransplantation for liver hydatidosis. In front of Zheng Ren, Yang Lei no longer had to worry about losing face.
He was not completely confident. If Boss Zheng could do it, he would do it.
However, the porcelain gallbladder was only the initial diagnosis. Zheng Ren asked the patient about the liver function, antibody to echinococcosis, CEA, and CA19-9.
The test results were normal. There was no special history of the patient or her family history.
“Considering the possibility of a simple porcelain gallbladder, I don’t see any cancerous areas,” Zheng Ren said with certainty. “However, you still have to be careful during the surgery. Go on stage the day after tomorrow. Brother Yang, give me a call. I’ll go and help.”
“Okay.” Yang Lei chuckled and took off the radiographic films.
“Two patients with advanced cirrhosis. Let’s go. I’ll bring you to see them.” Yang Lei did not rest. He brought Zheng Ren to see the patients first, then called them one by one to the doctor’s office. Zheng Ren explained the condition to the patients’ families.
Yang Lei was not very interested in Zheng Ren’s drawing. After all, he was a surgeon. The bloody liver area was disgusting to look at, so how could he be interested in a sketch?
Probably only a doctor like Zheng Ren, who was involved in general surgery, could draw such a sketch.
After communicating with the patient’s family, Zheng Ren wished Professor Yang goodbye and returned to the Department of Interventional Medicine.
Chang Yue did not go with Zheng Ren. She stayed behind and explained the live broadcast of the surgery to the patient’s family.
Mu Tao, on the other hand, could not wait to take a leave of absence from Zheng Ren. With the footage and the sketch, he looked for a place to study it.