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Liver Transplant Surgeon By Dr Apurv Deshpande Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome.[medical citation needed] Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor match.

Liver Transplant Surgeon By Dr Apurv Deshpande Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome.[medical citation needed] Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor match.

Pancreatic surgery is required when someone has problems with their pancreas such as pancreatic cancer or pancreatitis (inflammation and auto-digestion of the pancreas). To contextualize, auto-digestion refers to the process in which the enzyme responsible for helping break down the nutrients of the food consumed destroys its tissue. You must know all the conditions that will justify a pancreatic surgery. The silver lining is that not ALL pancreatic abnormalities will require surgery. Here they are so to keep you in the know: 1. PANCREATIC CYSTS – Some may even turn cancerous, if not treated at the right time. 2. ACUTE PANCREATITIS – A single attack involving bleeding, swelling and damage to the pancreas and its blood vessels after inflammation and auto digestion after which the organ may return to normal. 3. CHRONIC PANCREATITIS – Inflammation and auto digestion of the pancreas which does not subside and becomes worse over time. This disease hits people who are between the ages of 30 to 40. 4. PANCREATIC NEUROENDOCRINE CANCER – A rare type of cancer which rises from the hormone-secreting cells. 2. Who might need pancreas surgery? We will be discussing two diseases here, which may require you to have a pancreas surgery done. Their symptoms will also be mentioned so that you will know what to look out for. i. PANCREATITIS – Symptoms of this disease tend to occur suddenly. They are: ● Abdominal pain ● Difficulty in eating ● Weight loss ● Diarrhea ● New-onset diabetes (occasionally) ii. PANCREATIC CANCER – Symptoms of this disease tend to occur gradually, taking days, weeks or even months. They are: ● Weight loss ● Diarrhea ● New-onset diabetes ● Jaundice (yellowing of the skin and eyes) sans the pain ● Dark urine and gray stools 3. How is pancreas surgery performed? A pancreas surgery will be performed depending on the disease that a person is suffering from. We sympathize with all readers who happen to be either a prospective patient or their family member. While the impending surgery can be daunting, some of it may also be laced by curiosity. Therefore, this segment of the blog will aim to explain how pancreas surgery is conducted. Some of the surgical procedures that have been considered safe and effective are as follows: i. The Whipple Procedure – Also known as pancreaticoduodenectomy, this procedure works best for patients suffering from pancreatic cancer or some other benign complications restricted to the head of the pancreas. The surgeon will remove the head of the pancreas, part of the bile duct and the gall bladder. They will then reconnect the remaining pancreas to the intestine, bile duct and stomach. ii. Distal pancreatectomy – This surgical procedure will often be laparoscopic meaning it will be aided by a small camera and smaller incisions at the surgical site. This procedure intends to remove tumors at the end or tail of the pancreas. iii. Total pancreatectomy – A relatively rare procedure because of the undisputable side-effects attached to it such as diabetes, this surgery constitutes removal of the entire pancreas, the gallbladder, part of the stomach, small intestine and the spleen. It is performed when cancer spreads throughout the pancreas but can still be removed. iv. Endoscopic retrograde cholangiopancreatography – ERCP is performed when the cause of pancreatitis seems to be something such as a gallstone lodged in the bile duct. In this procedure, a tube with a tiny video camera at the end of it will be slid down the throat into the small intestine and stomach after which dye will be injected into the drainage tube of the pancreas to locate the possible obstruction. The purpose of the dye is to produce enhanced images of the pancreas and the bile ducts on the X-ray machine. This helps the doctor view the site of the blockage after which he or she can remove the hindrance. Special instruments such as a balloon catheter or a basket catheter are inserted through the tube to remove this obstruction or stretch a segment of the bile duct. A pancreatic pseduocyst is caused due to chronic pancreatitis. This is a fluid-filled sac that forms in the abdomen and is comprised of pancreatic enzymes, blood, and necrotic (dead) tissue.

OESOPHAGUS Benign disease- Motility disorders, Gastro-oesophageal reflux diseases, Achalasia cardia, Hiatus hernia, Diaphragmatic hernia, oesophageal mass or cyst, corrosive oesophageal injury ( acid, phenyl, etc). Symptoms- Difficulty in swallowing, chest pain, gastric reflux, vomiting, breathlessness, cough, and lung infection. Investigations- Barium swallows, Oesophageal Manometry, OGD scopy, and CECT. Treatment: Laparoscopic Fundoplication, Laparoscopic Diaphragmatic Hernia repair, Laparoscopic oesophageal mass or cyst excision, oesophagectomy with gastric pull up or colonic conduit. Malignant- Oesophageal cancer. Symptoms- Difficulty in swallowing solid foods and liquids, loss of appetite, and weight loss. Investigations- OGD scopy and biopsy of the tumor, histopathology of tumor and CECT, and PET scan SOS. Treatment – Laparoscopic or open oesophagectomy with oesophagogastric anastomosis. Stomach – Benign disease- Neuroendocrine tumors, GIST (Gastro intestinal stromal tumor), Gastric outlet obstruction, perforation. Symptoms – Early satiety and upper abdominal fullness or discomfort, loss of appetite and weight loss, black color stool. Investigations – OGD scopy and biopsy of the tumor, histopathology of tumor and CECT, and PET scan SOS. Treatment – Laparoscopicor open partial Gastrectomy, Total Gastrectomy. Malignant – Stomach cancer Symptoms – Early satiety and upper abdominal fullness or discomfort, loss of appetite and weight loss, black color stool. Investigations- OGD scopy and biopsy of the tumor, histopathology of tumor and CECT, and PET scan SOS. Treatment – Radical Gastrectomy. Intestinal- Benign – Intestinal obstruction, Ileal tuberculosis, intestinal perforation. Symptoms – Abdominal distention, vomiting, obstipation, septicemia. Investigations- X-ray abdomen, CECT. Treatment- Laparotomy and resection anastomosis for the diseased part. Malignant – Malignant GIST (Gastrointestinal stromal tumor), Cancer. Symptoms – Abdominal lump, black color stool, weight loss, and loss of appetite. Investigations- X-ray abdomen, CECT. Treatment- Laparotomy and resection anastomosis for the diseased part. Colonic- Benign – Ulcerative colitis, Crons disease, colonic bleeding, colonic obstructuion, colonic divericulitis, Symptoms – Watery and bloody diarrhea, weght loss. Investigations – Colonoscopy and biopsy, CECT abdomen. Treatment – Total Proctocolectomy with ileal conduit, Stoma surgery. Malignant – Colonic cancer. Symptoms – Altered bowel habit, blood in motion, weight loss and loss of appetite, abdominal discomfort and obstruction. Investigations – Colonoscopy and biopsy, CECT abdomen. Treatment – Hemicolectomy, Total Proctocolectomy with ileal conduit, Stoma surgery. Rectum Benign – Rectal cyst, rectal bleeding, Ulcerative colitis, Crhons disease, chronic constipation. Symptoms – Altered bowel habit, blood in motion, weight loss and loss of appetite, abdominal discomfort and obstruction. Investigations – Colonoscopy and biopsy, CECT abdomen. Treatment – Hemicolectomy, Total Proctocolectomy with ileal conduit, Stoma surgery. Malignant – Rectal cancer. Symptoms – Altered bowel habit, blood in motion, weight loss and loss of appetite, abdominal discomfort and obstruction. Investigations – Colonoscopy and biopsy, CECT abdomen. Treatment – Anterior Resection, Abdominal Perineal Resection with permanent stoma. Ananl canal – Benign- Hemorrhoids, anal fissure, fistula-in- ano. Symptoms- Bleeding per rectum, pain, burning sensation at perianal region, itching, trismus and pus discharge. Investigation – MR Fistulogram. Treatment – Hemorhoidectomy (open or stappler), fissurectomy, Fistulectomy. Malignant- Anal cancer. Symptoms- Bleeding per rectum, pain, burning sensation at perianal region, itching, trismus and pus discharge. Investigations – Proctoscopy and biopsy, Histopathological report and MRI.

Gastrointestinal surgery deals with diseases of Stomach, oesophagus and duodenum. GERD, Ulcer, Bleeding, Cancer, Hiatal hernia, Achalasia, Acid Burns Perforation and Gastric Outlet and obstruction are common diseases.

HPB Surgery HPB (Hepato Pancreato Biliary) Guide Skim through this HPB guide that covers every important aspect of this disease, its causes, symptoms and Treatments. 1. HPB conditions The HPB surgical procedure will work to eliminate medical conditions such as: ● Primary liver cancer ● Liver tumor removal – The most common liver tumor to metasize in this organ is known as colorectal cancer which can be cured only after the complete surgical removal of the disease. Another metasizing tumor in the liver is the neuroendocrine tumor of the gastrointestinal tract. ● Benign and malignant diseasesin the pancreas – Pancreatic tumors are common but the development of neuroendocrine tumors of the pancreas as well as cystic tumors is also common.

Advanced laparoscopic surgeries have become the gold standard in gallbladder surgery, splenectomy, adrenalectomy, anti-reflux operations and weight loss surgery. Compared to traditional surgery, there is substantial improvement in post operative pain and reduced recovery time in laparoscopic surgery. Usually the patient can return to all normal activities within a week

Pancreatic surgery is required when someone has problems with their pancreas such as pancreatic cancer or pancreatitis (inflammation and auto-digestion of the pancreas). To contextualize, auto-digestion refers to the process in which the enzyme responsible for helping break down the nutrients of the food consumed destroys its tissue. You must know all the conditions that will justify a pancreatic surgery. The silver lining is that not ALL pancreatic abnormalities will require surgery. Here they are so to keep you in the know: 1. PANCREATIC CYSTS – Some may even turn cancerous, if not treated at the right time. 2. ACUTE PANCREATITIS – A single attack involving bleeding, swelling and damage to the pancreas and its blood vessels after inflammation and auto digestion after which the organ may return to normal. 3. CHRONIC PANCREATITIS – Inflammation and auto digestion of the pancreas which does not subside and becomes worse over time. This disease hits people who are between the ages of 30 to 40. 4. PANCREATIC NEUROENDOCRINE CANCER – A rare type of cancer which rises from the hormone-secreting cells. 2. Who might need pancreas surgery? We will be discussing two diseases here, which may require you to have a pancreas surgery done. Their symptoms will also be mentioned so that you will know what to look out for. i. PANCREATITIS – Symptoms of this disease tend to occur suddenly. They are: ● Abdominal pain ● Difficulty in eating ● Weight loss ● Diarrhea ● New-onset diabetes (occasionally) ii. PANCREATIC CANCER – Symptoms of this disease tend to occur gradually, taking days, weeks or even months. They are: ● Weight loss ● Diarrhea ● New-onset diabetes ● Jaundice (yellowing of the skin and eyes) sans the pain ● Dark urine and gray stools 3. How is pancreas surgery performed? A pancreas surgery will be performed depending on the disease that a person is suffering from. We sympathize with all readers who happen to be either a prospective patient or their family member. While the impending surgery can be daunting, some of it may also be laced by curiosity. Therefore, this segment of the blog will aim to explain how pancreas surgery is conducted. Some of the surgical procedures that have been considered safe and effective are as follows: i. The Whipple Procedure – Also known as pancreaticoduodenectomy, this procedure works best for patients suffering from pancreatic cancer or some other benign complications restricted to the head of the pancreas. The surgeon will remove the head of the pancreas, part of the bile duct and the gall bladder. They will then reconnect the remaining pancreas to the intestine, bile duct and stomach. ii. Distal pancreatectomy – This surgical procedure will often be laparoscopic meaning it will be aided by a small camera and smaller incisions at the surgical site. This procedure intends to remove tumors at the end or tail of the pancreas. iii. Total pancreatectomy – A relatively rare procedure because of the undisputable side-effects attached to it such as diabetes, this surgery constitutes removal of the entire pancreas, the gallbladder, part of the stomach, small intestine and the spleen. It is performed when cancer spreads throughout the pancreas but can still be removed. iv. Endoscopic retrograde cholangiopancreatography – ERCP is performed when the cause of pancreatitis seems to be something such as a gallstone lodged in the bile duct. In this procedure, a tube with a tiny video camera at the end of it will be slid down the throat into the small intestine and stomach after which dye will be injected into the drainage tube of the pancreas to locate the possible obstruction. The purpose of the dye is to produce enhanced images of the pancreas and the bile ducts on the X-ray machine. This helps the doctor view the site of the blockage after which he or she can remove the hindrance. Special instruments such as a balloon catheter or a basket catheter are inserted through the tube to remove this obstruction or stretch a segment of the bile duct. A pancreatic pseduocyst is caused due to chronic pancreatitis. This is a fluid-filled sac that forms in the abdomen and is comprised of pancreatic enzymes, blood, and necrotic (dead) tissue.