Department of Medical Gastroenterology & Hepatology

Medical Gastroenterology & Hepatology

The Department of Medical Gastroenterology and Hepatology at LIGG is comprised of the following services and areas of speciality.

Liver Diseases

Pancreatic Diseases

Billiary diseases

Diagnostic and Therapeutic Endoscopy and ERCP

Gastrointestinal Haemostasis

Cancer Detection and Palliation Unit

Diagnostic Facilities

State of the art diagnostic modalities include

All forms of upper gastrointestinal video-endoscopy

All forms of lower gastrointestinal video-endoscopy / colonoscopy

Small bowel enteroscopy (Intra-operative)

Motility studies (Colonic transit study)

Fluoroscopic imaging of the liver, gall bladder, bile ducts, pancreas and intestinal tract.

Intraoperative fluoro-radiology (image intensifier- Cholangiogram/ Pancreatogram)

Endoscopic Submucosal Dissection is being formed for a case of Benign tumor of lower one third of Esophagus with Therapeutic Olympus 190 series Endoscope with waterjet.

Clinical areas provided by inpatient services

The Centre offers comprehensive services to patients with acute, chronic, and end-stage liver diseases. The clinical core of the Centre consists of outpatient and inpatient consultations aiming at comprehensive, multidisciplinary approach to a variety of liver diseases. We coordinate and deliver state-of-the-art diagnostic and therapeutic procedures in an evidence based fashion.

Diagnostic Facilities

Management of liver cirrhosis and its sequelae like hepatic encephalopathy, ascites, portal hypertensive bleeding, hepatorenal syndrome, spontaneous bacterial peritonitis.

Management of acute and chronic hepatitis of different etiologies with state-of-the-art medical therapies.

Treatment of Fulminant hepatic failure in a dedicated ICU area

Multidisciplinary approach to the management of liver malignancies (primary or metastatic).

Lab facilities for clinical pathology, biochemical and virological work up.

Liver biopsy (percutaneous).

Percutaneous Aspiration/Drainage of liver abscess/hepatic cyst.

Paracentesis with or without pigtail insertion

Outpatient activities

State-of-the-art facilities for the complete diagnosis and management of whole spectrum of acute and chronic liver diseases, including

Viral hepatitis

Alcoholic hepatitis

Lifestyle liver disorders-Fatty Liver, Non-alcoholic Steatohepatitis (NASH)

Drug-induced hepatitis.

Autoimmune liver disease

Cirrhosis of various etiologies

Genetic abnormalities

Metabolic disorders

Hematochromatosis

Wilson disease

Primary sclerosing cholangitis

Liver tumors, especially Hepatocellular carcinoma and Metastatic liver cancer

Hepato-Biliary tuberculosis

Liver abscess

Pancreatic Diseases

The Pancreas Clinic offers comprehensive services by experienced pancreatologists with long track records for patients with acute and chronic pancreatitis, pancreatobiliary cancers and pancreatic cystic disease. The services comprise comprehensive care including detailed workups, diagnosis, medical or/and surgical treatment, when indicated, on an outpatient as well as inpatient basis. The clinic has been functioning for the past eight years now and it has one of the largest pancreatic registries in Orissa nearly 400 patients.

Diagnostic and Therapeutic Facilities

Endoscopic retrograde cholangiopancreatography (ERCP)

Multi-Slice CT scan

Magnetic resonance cholangiopancreatography (MRCP)

Pancreatic duct stenting

Pseudocyst drainage

Celiac plexus block

Comprehensive management of alcohol related pancreatitis, tropical pancreatitis, autoimmune, metabolic and drug induced pancreatitis etc is also available. Pancreatic function testing and evaluation of idiopathic or unknown causes of pancreatitis is undertaken here.

The highlight of our Pancreatitis Care Programme is the integration of clinical care of pancreatitis, care of pancreatic diabetes and its complications, advice on diet and life style during each visit, explaining the basis of the disease and the rationale for decision making and making the patient a full partner in the treatment of his/her disease. In this clinic the maximum emphasis is laid on the quality of life of the patient – it is totally patient oriented and not disease oriented.

Management of Pancreatobiliary Cancers

Diagnostic facilities available include non-invasive tumor markers, CECT scan, MRCP and MRI. Non-surgical management including biliary drainage and stenting, etc. is available. Evaluation and management of pancreatic cysts and cystic cancers is also undertaken. Excellent support is extended to the Pancreas Clinic by the pancreatobiliary surgeons from GI Surgery who have a vast experience in hepato- pancreato-biliary surgery and routinely undertake all types of surgeries ranging from the simplest to the most complicated whipple’s Pancreatico-duodenectomy and Necrosectomy.

Billiary Diseases

Gall Bladder (State of the art facility available for)

Gall Bladder Stones

Bile Duct Stones/Cholelithiasis/Cholecystitis

Magnetic resonance cholangiopancreatography (MRCP)

Gall Bladder Cancer

Obstructive Jaundice

Biliary Atresia

Paediatric Gastroenterology

The Paediatric Gastroenterology wing has been set up to provide efficient diagnosis and management of paediatric gastroenterological and hepatobiliary problems. Paediatric endoscopy including upper GI endoscopy and colonoscopy are being routinely performed for various indications like dysphagia (for congenital and corrosive injury in children), foreign body ingestion, and acid peptic diseases, bleeding per rectum due to rectal and colonic polyps. Therapeutic colonoscopic polypectomy is routinely performed in children.

Centre for Gastrointestinal Haemostasis

A dedicated team of endoscopists, gastrointestinal surgeons, interventional radiologists, and vascular surgeons are available for treating patients with upper or lower gastrointestinal bleeding. A fully-monitored emergency ICU service, and a 24 hour endoscopic and surgical service ensure immediate control of massive bleeding. Complex diagnostic and therapeutic modalities often avoid the need for high-risk surgery. The availability of all the investigational modalities within the hospital makes LIGG one of the best centres for evaluation of gastrointestinal bleeds. The unit has risen to be a tertiary referral centre in the state of orissa for this pathology. Patients presenting with GI bleeds are resuscitated in the intensive care setting if needed.The investigation required for each patient is decided after consultation between the surgeon, interventional radiologist and the medical gastroenterologist. The availability under a single roof of al advanced imaging techniques like Upper GI Endoscopy, Colonoscopy, On-table Enteroscopy, and Angiography ensures that a patient will not need to be shifted out of the hospital for any evaluation.