Overview

The gastroenterology department provides prevention, diagnosis and treatment of various gastrointestinal disorders. It includes disorders of oesophagus, stomach, small and large intestines, gall bladder, pancreas and liver, which may be simple like jaundice to complex like IBD or cancer.

Key Diseases

A. Medical Gastroenterology and Hepatology

The department deals with various medical problems in gastroenterology in the outpatient, inpatient, `and emergency services setting. The doctors have expertise in the management of the full spectrum of gastrointestinal, liver and pancreatico-biliary diseases. This includes, but is not restricted to, disorders like inflammatory bowel disease, irritable bowel syndrome, malabsorption syndrome, gastrointestinal bleed, chronic diarrhea, constipation, peptic ulcer, reflux disease, acute liver failure, chronic liver disease (viral, alcoholic and others), portal hypertension, bilio-pancreatic disorders and malignancies, crohn's diseases, pancreatitis, ulcerative colitis, celiac diseases, gastrointestinal bleeding, hepatitis, chronic and acute liver diseases, peptic ulcers etc.

B. Interventional Gastroenterology

We have a well-equipped endoscopy department where diagnostic, therapeutic as well as emergency procedures in gastroenterology are performed. We also perform procedures like percutaneous and transjugular liver biopsy, HVPG monitoring and TIPSS placement.

Key Procedures

UGI Endoscopy: Examination of the upper gastrointestinal tract using a flexible video-endoscope. Diagnostic – for disorders like acid-peptic disease, H. pylori infection, gastro-esophageal reflux disease, cancers of the esophagus and stomach.

Therapeutic – for management of emergencies like variceal bleeding (procedures like sclerotherapy, variceal banding), endoscopic therapy for bleeding peptic ulcer by injection, application of hemoclips or thermal current, placement of percutaneous endoscopic gastrostomy (PEG) tube or jejunostomy as a feeding device for neurologically impaired individuals or those who are unable to swallow. We also perform endotherapy for early cancers and place stents for palliation of obstructive malignant lesions.

Colonoscopy: Examination of the lower gastrointestinal tract using a flexible video-endoscope. Diagnostic – for disorders like polyps, cancers, strictures, bleeding sites, diverticuli.

Therapeutic – This is for the management of colonic obstruction with stenting, endotherapy for lower gastrointestinal bleeding, and polypectomy.

ERCP (Endoscopic retrograde cholangio pancreatography): This procedure involves treating various bilio-pancreatic disorders. These include obstructive jaundice caused by common bile duct stones (extraction of the stones) or relieving obstruction in bilio-pancreatic cancers by placement of plastic or metal stents. ERCP also aids in obtaining tumor tissue cytology / biopsy from the bile duct to confirm the diagnosis in suspected cases of malignancy. We also treat chronic pancreatitis and perform pseudocyst drainage in acute or chronic pancreatitis by placing plastic stents

EUS – Endoscopic ultrasonography: This procedure involves performing ultrasound examination with a probe attached at the tip of an endoscope. It allows detailed visualization of the walls of the esophagus, stomach, duodenum, as well as the pancreas, bile duct, other adjacent organs, lymph nodes and blood vessels. This allows quicker and definitive diagnosis of various diseases, staging of cancers, and thus aids in management. EUS is also helpful in procuring tissue for examination. It aids in difficult biliary and pancreatic therapeutic endoscopic procedures.

GI Radiology

We have a well-equipped department of interventional radiology that performs procedures like;

• Transjugular liver biopsy
• Measurement of hepatic venous pressure in cirrhosis of liver by HVPG
• Liver cancer treatment procedures like
• Chemoembolization: injection of chemotherapeutic agents into blood vessels supplying the liver tumor.
• Radiofrequency ablation: ablating tumor tissue by radiofrequency waves.
• Therasphere: injection of radioactive agent into liver tumors.
• Liver biopsy
• Liver lesion biopsy
• Pancreatic biopsy
• Abdominal lymph node biopsy
• Abscess drainage
• Percutaneous transhepatic biliary drainage for relieving jaundice due to obstruction of bile duct - Bile duct stenting for cancers
• Angiography – Diagnostic and treatment of gastrointestinal bleeding, treatment of aneurysm

GI Surgery:

• Liver resection surgeries for benign and malignant tumours
• Ablative therapy for liver tumours: alcohol injection, chemoembolisation, radiofrequency ablation
• Surgery for gallbladder and bile duct cancer, biliary strictures, gallstone disease
• Surgery for pancreatic cancer, chronic pancreatitis
• Management of acute pancreatitis
• Portal hypertension surgery: Shunt surgery and devascularisation procedures
• Surgery for benign and malignant bowel pathologies
• Laparoscopic surgery including diagnostic and staging laparoscopies, laparoscopic cholecystectomy and advanced procedures such as biliary calculus surgery, laparoscopic liver resection, laparoscopy assisted bowel resection etc
• Liver Transplant Program - The Hinduja Hospital has all facilities required to carry out this major life saving procedure successfully. This includes a fully equipped theatre suite, advanced laboratory support and state of the art intensive care unit. Patients are being listed after a 3-stage assessment. Liver transplant is indicated for irreversible liver pathology, where the life span is expected to be less than 1-2 years. The commonest causes of end stage liver disease in India are cirrhosis due to Hepatitis B, C and excessive alcohol intake. Rarer causes include auto-immune cirrhosis, cryptogenic cirrhosis, primary sclerosing cholangiitis, and the Budd-Chiari syndrome.
• Special equipment: CUSA, Harmonic scalpel, Argon beam coagulator, advanced laparoscopic surgical equipment, availability of RITA for radiofrequency ablation.