肝脏，胆囊和胆管疾病
We perform advanced endoscopic procedures like diagnostic and therapeutic Endoscopic-ultrasound (EUS) and Endoscopic retrograde cholangiopancreatography (ERCP) for the diseases pertaining to the liver, gallbladder, and bile ducts. EUS is a thin flexible tube attached with a camera and ultrasound probe at its tip which uses sound waves to produce images of an area of interest in gastrointestinal tract. It is passed through the mouth and advanced into esophagus (food pipe), stomach and small intestine. Endoscopic retrograde cholangiopancreatography (ERCP) is also a flexible tube attached with a camera at its tip. It is passed through mouth and advanced up to the opening of the bile duct and pancreatic duct. ERCP is performed in conjunction with X-rays.
Procedures performed:
- EUS guided Liver biopsy
- EUS guided Variceal embolization.
- ERCP用于胆管狭窄，胆管结石
- ERCP/Radiofrequency ablation for Malignant bile duct strictures
- ERCP/Ampullectomy
- ERCP/Spyglass Cholangioscopy
Liver Diseases:
Liver is the largest organ in our body. Its main function is to purify blood from toxins and provide other metabolic functions. There are many acute and chronic liver diseases including but not limited to Viral infections like Hepatitis B, Hepatitis C, Alcoholic liver disease, Fatty liver disease, primary biliary cirrhosis, Inherited conditions etc. While most of the liver diseases are adequately managed by our dedicated Transplant hepatology team, some of these liver problems can cause blockage of the drainage tubes of the liver which might need advanced procedure like ERCP (Endoscopic retrograde cholangiopancreatography) to relieve the blockage and place a temporary stent (drainage tube).
Advanced liver disease can sometimes form varices (enlarged veins) in and around the esophagus (food pipe) or stomach. These varices can potentially rupture and cause life threating bleeding. There are various options to prevent these varices from rupturing like placing rubber bands, injecting a sclerosant etc. In addition, we can use Endoscopic ultrasound guidance and place coils and glue into these varices and prevent from rupturing (also called EUS guided variceal embolization).
Some of the liver diseases require a liver biopsy (taking a sample of liver tissue to examine under microscope) and we can perform Liver biopsy under endoscopic Ultrasound guidance.
We work very closely with our dedicated team of Liver transplant surgeons, Hepatologists and manage some of the pre-transplant or post-transplant issues that require our advanced procedural expertise.
Gallbladder Diseases:
胆囊是梨形的器官，位于肝脏下方的腹部右侧。它被称为肝脏生产的胆汁汁储层。它与饭菜结合并将胆汁倒入小肠中，并有助于消化摄入的食物。由于胆汁停滞，荷尔蒙变化，脂肪食物的摄入，肥胖等，从谷物大小到高尔夫球的石头可能在胆囊中形成，石头有时会阻塞胆囊的开口，并可能导致急性胆囊炎（感染/炎症（炎症）胆囊）可能是外科紧急情况。理想情况下，这样的患者需要胆囊手术（胆囊切除术）才能将胆囊拔出。有时由于手术候选药不良而无法进行手术，并且在这种情况下，我们的团队可以使用EUS指导来排干胆囊，通过将胆囊连接到小肠，使用支架/排水管。
Bile Duct Diseases:
Bile ducts are drainage tubes of the liver in connection with the gall bladder. Bile produced by liver flows through the smaller bile ducts into the gall bladder and from the gall bladder into the small intestine through larger bile ducts also called common bile duct/common hepatic duct.
在较小和大的胆管中可能会出现各种问题。胆囊中的石头可以迁移到胆管导致腹痛，黄疸，感染（胆道炎）。由肝脏，胆囊，胆管，胰腺引起的癌症会阻塞胆管的胆管（狭窄），导致胆管导致胆汁排水不足。由于汽车事故/手术的创伤/并发症会导致胆管泄漏（胆汁导管泄漏到胆管外部泄漏到腹腔并导致感染）。影响胆管的其他疾病是囊肿（胆道囊肿），解剖变异，先天异常等。
上述大多数问题是用微创手术（例如ERCP）处理的，在此期间可以去除障碍物，并通过在胆管狭窄的情况下放置临时支架/排水管来完成胆汁排水。我们用于管理胆管问题的工具和技术已经有了巨大的发展。其中一种革命性的设备是一种间谍胆管镜（末端与摄像头连接的薄柔性管），它可以在胆管内部深入，不仅可以准确地诊断问题，而且可以适当地治疗问题。
We work closely with our Surgical Oncology and Medical Oncology colleagues and help them in providing timely diagnosis of bile duct cancer. In some selected cases, we can perform Ablation (technique using controlled current) of bile duct stricture to destroy cancerous tissue and limiting progression of cancer.
Bile duct joins pancreatic duct and opens into an area in the small intestine called ampulla of vater. Ampullary cancer can arise from this area which needs a major surgery in most cases. However, in some selected cases, we perform Ampullectomy (removing the cancerous ampullary tissue by endoscopy).