Facilities

The department of Hepatology PBS & LT runs an eight-bedded dedicated, state-of-the-art Hepato-Pancreatico-Biliary (HPB) ICU for managing critically ill patients with ALF, ACLF, ESLD and its complications.

Overview

It is staffed by well-traines ICU nurses and technicians as well as duty doctors who are present round the clock. Patients with severe pancreato-biliary diseases with organ failure are also managed here. Apart from ventilatory support, the ICU provides advanced hemodynamic monitoring, various modes of hemodialysis including continuous renal replacement therapy (CRRT), plasma exchange therapy (PLEX) and extracorporeal membrane oxygenator (ECMO) therapy.

Point-of-care procedures including ultrasonography (POCUS), bed-side GI endoscopy, bronchoscopy and interventional radiologic procedures are performed regularly. The department also helps in managing a 12-bedded Liver Transplant ICU in collaboration with the department of HPB Surgery and LT.

Other Services
In Patient Ward

Hepatology has a 22-bedded in-patient ward for HPB patients, with single or double-occupancy beds, staffed round the clock with doctors and nurses. Both, the ward and the ICUs have an average occupancy of >80%.

Outpatient Services

A well-appointed and well-attended OPD with specialty clinics for NAFLD, AUD, Liver transplant recipients is run by the department.

Point-of-care ultrasound (POCUS)

Point-of-care ultrasound (POCUS) assessment is available for top-to-toe monitoring of ICU patients includes assessment of hemodynamics, echocardiography, ONSD, tapping of ascites, pleural effusion, etc.

Liver stiffness measurement (LSM)

Liver stiffness measurement (LSM) with a state-of-the art Fibroscan system from Echosens is available in the Hepatology OPD.

Endoscopy Services

Round-the-clock GI endoscopy services are available for routine and emergency procedures. Therapeutic ERCP services for all types of biliary and pancreatic procedures including ‘rendezvous’ procedures for complex biliary drainage are performed routinely. A major area of interest is endoscopic management for benign biliary strictures after cholecystectomy, after liver transplantation, for chronic pancreatitis, and due to stricture due to portal cavernoma cholangiopathy (PCC).

Interventional Radiology (IR) Services

Integrated in-house interventional radiology support is available for scheduled procedures and round the clock for elective and emergency interventions for variceal bleeding (TIPSS, BRTO, BATO, PATO), arterial bleeding (angiography and selective embolization), HCC (TACE, SIRT/TARE, RFA, MWA, SBRT, etc.), occlusion of spontaneous shunts in refractory HE, biliary drainage for all types of biliary obstruction and for bile leaks (PTBD, ‘rendezvous’ procedure), for monitoring HVPG, transjugular liver biopsy (TJLB), abscess drainage and a variety of other IR procedures. Ultrasound-guided percutaneous liver biopsies are performed routinely.

Academic Facilities

A structured teaching program is in place, with regular presentations and evaluation of trainees and active teaching by mentors. A seminar room with LED projector for PowerPoint presentations and a well-equipped Departmental Library is available. Hard copies of two different international journals (American Journal of Gastroenterology, Journal of Hepatology) and three Indian Journals (Indian Journal of Gastroenterology, Journal of Clinical and Experimental Hepatology, Journal of Digestive Endoscopy) are delivered regularly.

The central library, the KD Gupta library, has up-to-date text books and several journals for Hepatology, Gastroenterology, Medicine and other specialties and also provides access to digital learning resources. Combined Clinical Rounds, for all specialties in the Medical University and separate rounds for Postgraduate and Undergraduate students are conducted regularly, offering great learning and exposure to multidisciplinary management being carried out in this university.

Mahatma Gandhi University

Trainees also have opportunities to participate in local, regional and national meetings and conferences to which the departmental faculty is invited regularly.