Hepato-Pancreato-Biliary Surgery

Our surgeons use sophisticated imaging and screening techniques to root out disease in the early stages and are supported by MIOT International’s world-class, 24-hour laboratory. Endoscopy is used for both diagnosis and treatment at the Centre.

• Cholangioscopy (SPYGLASS system) enables endoscopists to enter and visualise the biliary and pancreatic ducts and obtain target biopsies of suspected cancer lesions. It is also used to target and fragment stones using a laser beam.
• Endoscopic Retrograde Cholangio-pancreatography (ERCP), a specialised procedure, is performed with fluoroscopy and contrast injection, to examine and treat conditions of the bile ducts and pancreas.
• Endoscopic Ultrasound (EUS), a hybrid of both endoscopy and ultrasound, helps to identify stones and early cancer in the bile duct and pancreas and aids in the treatment of liver diseases.

Our interventional radiologists perform trans-jugular liver biopsy and pressure studies in patients with advanced liver disease and portal hypertension.

Trans-jugular intra-hepatic portosystemic shunt (TIPSS), a percutaneously-created connection within the liver between the portal and systemic circulation, is done for patients with advanced liver disease.

Liver fibrosis is usually identified through a liver biopsy, an invasive procedure that can cause bleeding and pain. However, at MIOT International, patients have the option of a new, painless and rapid scan for identifying liver fibrosis at an early stage, called Acoustic Radiation Force Impulse (ARFI) Imaging (also called fibro-scan). The system picks up even the tiniest anomalies and allows for the early detection and treatment of disease. This is especially beneficial to patients with fatty liver, diabetes, obesity, alcohol-abuse and viral hepatitis.

One of the biggest challenges surgeons face in liver surgery is haemorrhage because of the difficulty in suturing or sealing hepatic tissue. In pancreatic surgery, the complexity of the organ’s location, as well as its multiple channels to transport the digestive juices, bile and blood, make surgery difficult.

The MIOT Hepato-Pancreato-Biliary Centre for Surgery and Transplantation performs surgery and transplants of the liver, pancreas and biliary tree, with excellent results.

Sub-super-specialisation, advanced technology and the development of new surgical and anaesthetic techniques have helped to significantly counter the risks of surgery on these organs. Our experienced surgeons – some of the best in the country in this speciality – perform laparoscopic surgeries on the liver, gallbladder or pancreas regularly, using cutting-edge, high-definition laparoscopy equipment, including the harmonic scalpel, which allows them to visualise and approach difficult areas confidently.

Screening to root out disease in the early stages is one of the Centre’s most vital services. Liver diseases are diagnosed through liver-function tests and an ultrasound scan as part of a Master Health Check for pancreatic maladies through imaging and detailed blood studies at our sophisticated laboratory. We use tumour-markers to pick up cancer of the liver and pancreas. Advanced diseases can be picked up with a computerised tomography (CT) scan, magnetic resonance imaging (MRI) or magnetic resonance cholangiopancreatography (MRCP).

Disease and Diagnostic Tests

Gallstones – Ultrasonogram

Bile Duct Obstruction – Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangio Pancreatography (ERCP), Endoscopic Ultrasound (EUS), Ultrasonography

Cancer Of The Bile Duct – Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangio Pancreatography (ERCP), Endoscopic Ultrasound (EUS), CT scan

Liver Disease, such as Viral Hepatitis – Liver-function tests, Ultrasound

Advanced Liver Disease – Fibroscan (ARFI), Liver-function tests, Ultrasound

Liver Cancer – CT scan, MRI, Liver-function tests, Ultrasound scan, Tumour markers

Acute Pancreatitis – CT scan, S. Amylose, Endoscopic Retrograde Cholangio Pancreatography (ERCP)

Chronic Pancreatic Disease – CT scan, Endoscopic Retrograde Cholangio Pancreatography (ERCP)

Pancreatic Cancer – CT scan, Endoscopic Retrograde Cholangiopancreatography (ERCP), Tumour markers, Endoscopic Ultrasound (EUS)

Lifestyle, habits and illness may have damaged your liver over the years. You may not have had any warning signals as your liver can work in complete silence until it is 90% damaged. At this point, your entire system shuts down and a liver transplant becomes your only option.

Steep increase in incidence

What you may not know is that liver disease is growing at an alarming rate in India today, with one in every five people affected. Another cause for concern – the affected age group is getting younger. And its effects are obvious both at the workplace and at home.

The solution within

The solution, surprisingly, lies in the liver itself. Most people don’t know that Liver is the only organ that can regenerate – even if is severely damaged, with conscious lifestyle changes and medical support, if need be.

Herein lays our chance to reverse the damage we’re doing to ourselves –The MIOT LIVER GYM.