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Faculty

• 

  Dr. (Prof.) Naimish N. Mehta 
  MBBS, MS, FACRSI, FAIS, FEBS, FALS (HPB)

   
  Chairman, Centre for Digestive Sciences (cfds)
  (GI Surgery, HPB Surgery, Hepatology and Liver Transplantation)
  Professor & Head Department of HPB & Liver Transplantation Surgery I
   
• 

  Dr. R P Choubey – MBBS, MS, FRCS I

• 

  Dr Ajay Sharma – MBBS, MS, MCh 

• 

  Dr Anand Nagar- MBBS , MS, DNB SGE 

• 

  Dr. Karan Kumar MD, DM
  Hepatology & Liver Transplantation

• 

  Dr Shashwat Sarin – MBBS, MS , MCh, Fellowship Liver transplant and HPB

• 

  Dr Aryan Mathur – MHA, MSW, Transplant Coodinator(NOTTO)

Overview

The department was founded in 2013 with the following objectives:

• Patient care - High quality, state-of-the-art, evidence based
• Affordable - Treat all patients however sick or poor
• Quality training of GI Residents
• Research - Finding Indian solutions for Indian problems

Our aims were to take care of the patients on the basis of ethical practice and scientific principles, to maintain higher standard of training, carry out interesting and meaningful research, publish research outcomes regularly in peer-reviewed journals and to establish a state-of-art liver transplant programme.

State of the art techniques

In our department we perform both open and laparoscopic GI surgery for benign and malignant conditions of the esophagus, stomach, small and large bowel/intestine. Gastrointestinal bleeding both overt and occult is dealt with-in our department. We have a state of the art imaging and interventional radiology services which form an important part of our patient management both in the emergency and elective situation. Liver resections are performed using CUSA, drip monopolar cautery, kellyclysis and harmonic. Laparoscopic upper GI surgery is a new art in our armamentarium which is being utilized in appropriate situations. The future is that we still strive to remain and counted among the best Surgical Gastroenterology and Liver Transplantation departments in the world.

Services

GI Surgery

Liver, bile duct surgery

Stones, tumours and cysts are commonly seen in the liver, gall bladder and bile duct. Many of these require surgery for cure. Our team has been performing surgery on these organs for more than a decade.
Because we regularly perform complicated surgery on these organs, especially during liver transplantation, we have a thorough understanding of the anatomy. As a result we have been ranked as the best liver transplant centres in Delhi, India. Trust us to deliver the best outcomes of the surgery for our patients.

Pancreatic cancer and spleen surgery

Cancer of the pancreas is an aggressive disease and often has invaded adjacent organs at the time of diagnosis. Our panel of cancer specialists including oncologist and surgeons will help you understand and make decisions regarding treatment- like should chemotherapy be given before surgery? Or will surgery help?
Our surgeons are experienced in minimally invasive (laparoscopic) surgery, Whipple operation for removal of the cancer bearing portion of the pancreas, even in the difficult situation where arteries and veins have to be divided and rejoined.

Cancer surgery

Our 'tumour board' group of experts from surgery and chemotherapy discuss every case to decide on the best course for your disease.
When surgery is required, expertise at laparoscopic surgery makes the process of recovery faster and less painful.

Commonly performed surgeries

Laparoscopic cholecystectomy for stones and cancer of gallbladder, Laparoscopic and thoraccoscopic surgery for oesophageal cancer, achalasia, Laparoscopic surgery for stomach, small intestine, colon and rectal cancer, Hydatid cyst and cancer of liver, Surgery on the spleen and adrenal

Liver cirrhosis & Treatment

Cirrhosis is scarring or damage to the liver, usually permanent. Whatever the reason for the damage, (eg hepatitis B or C, long term alcohol intake, fatty liver, sometimes the reason cannot be identified) the resultant damage results in similar problems to the patient.

Common problems: getting tired easily, swelling of feet, water accumulation in the stomach, jaundice, confusion, coma, vomiting of blood Your doctor can make a diagnosis based on a few tests

Cirrhosis is largely progressive disease and we do not have medicines to cure cirrhosis. All treatment is directed towards prevention of complications of cirrhosis and managing problems faced by patient. These problems are directly related to the liver being scarred.

Treatment

In early stages medicines are effective in controlling symptoms. With time, as disease progresses more and more medicines are required for control of symptoms. This is a stage where patients are not able to do daily activities which they previously could.

Patients require hospital admissions, usually repeated admissions for treatment of complications, like removal of fluid or treatment of various stages of drowsiness or coma. In this stage joining an 'ascites club' or support group of patients with similar disease can help understand and deal with the problem better. Such groups can be found at MGH, the best liver transplant hospital in India. One can reach them via the liver transplant coordinator at MGH.

At this stage, a liver transplant surgery should be considered. MGH offers both cost effective and curative surgeries in India. For more details regarding liver transplant surgery cost, procedure, etc. you can call us at our helpline number.

Talk to our transplant coordinator for better assistance.

Liver resections:

State of art equipment is available for preoperative evaluation such as MDCT, MRI and PET-CT and safe liver resections eg: CUSA, Argon beam coagulator, and intraoperative ultrasound facility. Radiofrequency ablation (RFA), Transarterial chemoembolisation (TACE) is also available.

Liver surgeries for

 Hepatocellular carcinoma -

• Hepatoblastoma
• Hemangioma
• Metastatic tumors
• Benign liver tumors
• Hydatid cysts
• Amebic liver abscess
• Liver injury
• Hepatolithiasis
• Hemobilia

Surgeries for gallbladder and bile duct

Gall bladder cancer: Fifth most common GI malignancy and more common in North India compared to South, presents with either pain, jaundice or abdominal lump. Triphasic CT is helpful not only in the diagnosis but also in assessing the resectability.

Benign disease – gall stones – laparoscopic & open procedure -

Bile duct: Over 100 patients with cancer of bile ducts or bile duct injury following surgery for gall bladder stones have been successfully managed

Surgeries for Biliary system

• Cancer (Hepatectomy/ Whipple’s procedure)
• Choledochal cyst
• Mirrizzi syndrome
• Hemobilia
• Bile duct injury (Biliary fistula)
• Benign biliary stricture (Primary hepaticojejunostomy/ re dohepaticojejunostomy)- 150
• Biliary atresia – Kasai porto- enterostomy
• Choledocholithiasis

Pancreatic surgery: We are a high volume center for pancreatic surgery. We perform a complete range of procedures for the pancreas including resection and surgery for acute and chronic pancreatitis. 

Pancreatic cancer (Whipple’s procedure/ median pancreatectomy/ bypass     procedure) –

• Chronic pancreatitis - 
• Severe acute pancreatitis (necrotizing pancreatitis) – necrosectomy - 
• Pancreatic cystic lesions - 
• Trauma

Upper GI Surgeries

Major esophageal surgeries for both benign and malignant conditions of esophagus. 

Esophageal cancer - Esophagectomy (Transhiatal / Transthoracic) - 

• Corrosive stricture (acid/alkali ingestion) – Gastric/ colonic pull up - 
• Hiatus hernia repair - 
• Esophageal perforations
• Tracheoesophageal fistula
• Achalasia

Gastro-duodenal surgeries .

• Gastric (stomach) cancer - gastrectomy (Total/ Subtotal/ partial/ distal) - 
• Duodenal cancer
• Peptic ulcers (Gastric/ duodenal)
• Gastro- duodenal bleeding
• Gastric obstruction
• Duodenal fistula
• Gastro- duodenal perforations

Colorectal Surgeries

Colonic surgeries 

• Cancer – 
• Ulcerative colitis (Subtotal colectomy/ proctocolectomy/ hand sewn & stapled pouch procedures) 
• Obstruction
• Polyposis coli
• Bleeding
• Obscure G.I. bleed
• Perforation
• Fistula
• Pouch related complications
• Diverticulitis

Appendix

• Surgeries for Laparoscopic and open appendectomy

Cancer Mesorectal excisions (LAR/ APR/ Sphincter saving operations for rectal cancer) - 

• Rectoveginal fistula -
• Rectal prolapse
• Hemorrhoidectomy – stapled and open procedures
• Complex fistula in ano

Portal Hypertension

Shunt procedures for portal hypertension has come down over the period of time and this is because of the excellent in house Gastroenterology support. 

Portosystemic shunt procedures (splenorenal/ portocaval/ mesocaval)

• EHPVO - 
• NCPF - 
• Budd Chiari syndrome
• Cirrhosis with bleed
• TIPPS procedure
• Non-liver surgeries in patients with portal hypertension
• Obstructed umbilical hernia
• Inguinal hernia
• Gall stones
• Mucormycosis of stomach with bleed.

Miscellaneous

• Cancer
• Obstruction - 
• Bleeding - 
• Perforation - 
• Fistula - 
• Gangrene- 
• Crohn’s disease
• Mesenchymal tumors

Obscure GI bleed: Management of patients with obscure GI bleed can be very challenging. After exhausting all the available modalities of investigation, in these patients we have come to a conclusion (after managing such cases for more than a decade) that the commonest site for bleed is from terminal ileum or cecum and that blind right hemicolectomy is the treatment of choice in majority of the patients in India. Patients with portal hypertension and chronic renal failure, there is a need for on table enteroscopy and colonoscopy to rule out ectopic varices, portal hypertensive colopathy and uraemic colopathy. In them there is a small chance of re-bleed, hence one needs to be careful before performing a blind hemicolectomy.

Enterocutaneous fistula: We have a vast experience in management of enterocutaneous fistulae and we have a policy of introducing early enteral feeding and exteriorization of the fistulated segment to build up the patient’s nutrition. We also believe in distal mucus fistula feeding for very high and proximal fistulae, and this is possible due to the excellent in-house stoma care facility. This distal bowel feeding helps in utilizing the whole segment of bowel for nutrition. We also believe that apart from building up the innate immunity, enteral feeding also reduces the bacterial translocation and avoids all the complications associated with expensive parenteral nutrition.

Other surgeries including

• Pseudomyxoma peritonei (Hyperthermic intra-peritoneal chemotherapy/ peritonectomy/ debulking) -
• Gastro-intestinal stromal tumor
• Contact us 
• Liver Helpline 24X7