Medical Gastroenterology

Overview
The Sakra Institute of Digestive and HPB (Hepato-pancreato-biliary) sciences has two departments i.e Medical and Surgical.  At Sakra World Hospital, we strive to offer the patients with comprehensive multidisciplinary approach for all Gastrointestinal / Liver / Pancreatic / Gall bladder related problems.

The Medical Gastroenterology team has dedicated,  qualified, experienced team which provides the clinical evaluation; state of art endoscopy suites with focus on high end technology; emphasis on patient safety; disinfection protocols; with high ethical values. We have excellent supporting team which includes experienced GI surgeons, Interventional radiologist, GI pathologist, ICU specialist and Anaesthesiologists.
The Department focus is on:

1. Minimally Invasive Advanced Interventional Endoscopy services which deals with:
Removing bile duct stones:
Other than the conventional methods of removing bile duct stones (ERCP), our  centre has expertise and facilities to remove largest of stones in bile duct by technology called spyglass and holmium laser. In the absence of these high end technology, most of them would require surgery.

Providing Relief of Jaundice by Endoscopy routes for patient with obstruction of bile duct due to Gall bladder/ Pancreatic/ and Bile duct cancers.

Endoscopic treatment for Pancreatitis like stone removal, stenting, drainage of fluid collection (Pseodocyst and walled of pancreatic necrosis).

Endoscopic removal of early tumours of stomach/colon by endoscopic mucosal resection; which requires high end technology and skills which are not readily available in most of the centres in our country.

Our centre also provides endoscopic palliation for Gastrointestinal Advanced Cancers (Oesophageal/Stomach/Colon) by Oesophageal/ Antral / Colonic Stenting.

Ours is one of the rare centre which has expertise to visualize the small intestine by Single Balloon Enteroscope for patients with gastrointestinal bleeding where source is not detectable by conventional upper endoscopy and colonoscopy.
We have latest Endoscopic Ultrasound which helps us to diagnose bile duct and pancreatic stones/tumours, also to find the cause of pancreatitis where conventional imaging would have not delineated the cause.  Focused tissue samples from the diseased areas can be taken which is otherwise difficult by conventional methods.

2. Gastrointestinal Physiology Lab
We have dedicated Gastrointestinal Physiology Lab which performs PH metry, Esophageal and Anorectalmanometry for patients with refractory or difficult to treat Gastroesophageal Reflux Disease (GERD)/Constipation/ and Fecal incontinence. We also offer biofeed back therapy for constipation and anal incontinence.

3. Liver Unit
We have a focused Liver Unit which mainly focuses on diagnosing the cause of liver problems; optimising the treatment; and for advanced liver disease patients we offer technically demanding procedures like
TIPSS for patients with difficult to treat ascites (Fluid in abdomen)
Hepatic Vein Stenting/IVC Stenting for blockade of blood vessels in liver.
TACE/RFA for liver cancers
Transjugular Liver Biopsy
We have a dedicated team of doctors who have vast experience in managing various liver diseases and also have performed liver transplants earlier.   Our centre is awaiting for the permission to start the liver transplant programme shortly.

4. Endoscopic Treatment of Obesity
Our centre has expertise for Endoscopic Treatment of Obesity by placing balloon into the stomach endoscopically for achieving weight loss for select group of patients.

5. Luminal Clinical
We also have a focused team which deals with Gastrointestinal Luminal problem like inflammatory bowel disease (Ulcerative Colitis and Chrohn’s Disease). These patients often require regular follow-up, endoscopic procedure and in certain difficult to treat patients initiating specialised treatment with biologicals.

Services

ESOPHAGEAL DISEASES

Diagnostic services

Upper GI endoscopy for
        Retrosternal burning sensation and reflux disease
        Difficulty in swallowing

Endoscopy with NBI for
        Early detection of esophageal cancers

Manometry for difficulty in swallowing

Ph Metry for reflux disease

Endoscopic Ultrasound for
        Evaluation of submucous lesions/ growth
        Assessment of resectability of tumors

Therapeutic services
        Control of GI bleeding – EVL/EST
        Foreign body removal
        Esophageal stricture dilatation
        Esophageal stent placement
        Ballon dilatation for Achalasia
        EMR/ ESD for early esophageal cancer

STOMACH DISEASES

Diagnostic services

Upper GI endoscopy for evaluation of
        Ulcer disease
        Bleeding
        Cancers/ polyps
        Anemia
        Vomiting

Endoscopic Ultrasound for
        Evaluation of submucosal lesions

Therapeutic services for
        Bleeding ulcer – Injection therapy, Clipping of vessel and thermal abalation
        Glue injection for gastric varix bleed
        Stent placement for gastric outlet obstruction
        Feeding tube/ PEG tube placement
        Foreign body removal
        APC for GAVE
        EMR/ESD for early gastric cancer
        Balloon placement for treatment of obesity

PANCREATICO BILIARY DISEASES

Diagnostic services

Endoscopic Ultrasound for
        Detection of small bile duct stones and tumors
        Diagnosis of early Chronic Pancreatitis
        Evaluation of Pancreatic Cancers
        Tissue acquisition from lymphnodes, and pancreatic lesions

Choledochoscope/Spyglass
        For evaluation of bile duct stricture
        To rule out bile duct cancers

Therapeutic services
ERCP for
        Metal and plastic stent placement for biliary obstruction/ portal biliopathy
        Bile duct stone removal
        Endoscopic management of bile duct inuries
        Pancreatic duct stone removal
        Accessory pancreatic duct sphinchterotomy and stenting for Pancreas divisum
        Drainage of pancreatic pseudocyst  
        Pancreatic duct stenting for  -
                Pancreatic duct stricture
                Pancreatico pleural fistula
                Traumatic pancreatic duct disruption

Endoscopic necrosectomy

Endoscopic Ultrasound for
        Drainage of pancreatic pseudocyst  
        Celiac gangion block/neuronolysis

SMALL INTESTINAL DISEASES

Enteroscopy for diagnosis and management of small intestinal
        Bleeding
        Tumors

COLONIC DISEASES

Diagnostic services

Colonoscopy for
        Blood in stool
        Long standing diarrhea
        Colonic obstruction
        Detecting cancers

Endoscopy with NBI for
        Early detection of colonic cancers

Manometry for
        Severe constipation (due to pelvic floor dysfunction)
        Fecal incontinence

Endoscopic Ultrasound for
        Evaluation of anal sphincter defects

Therapeutic services for
        Polypectomy for  colonic polyps
        Endoscopic mucosal/ submucosal dissection for precancerous lesions and early cancers
        Colonic decompression
                Tumor related obstruction (endoscopic metal stent placement)
                Non tumor related ( Volvulus and pseudo obstruction)
        Colonic/ piles bleeding ( Banding/ injection therapy/ Clip placement)
         Biofeedback for severe constipation and fecal incontinence

SPECIAL OPD SERVICES

HEPATO PANCREATO BILIARY CLINIC for liver, gall bladder, bile duct and pancreatic diseases

LUMINAL CLINIC for Chronic diarrhea, Ulcerative colitis, Crohns disease, Swallowing disorders, Dyspepsia and Reflux disease