Liver cancers:
We offer full range of treatment options for liver cancers including primary liver resections, staged operations after portal vein embolization, loco-regional therapies such as trans-arterial chemo embolization and trans arterial radio-embolization and ablative therapies such as radio-frequency ablation and microwave ablation. We also have ICG testing to assess and predict the function of the remnant liver in cirrhotic patients undergoing liver resections.
We also offer resections for tumors of the colon, breast and kidney which metastasize to the liver. We perform them either as a combined operation or after chemotherapy. For smaller tumors are resected laparoscopically.
Pancreatic cancers:
We offer upfront resection in primarily operable tumors, as well as resections after neo-adjuvant chemotherapy and radiotherapy to downstage locally advanced pancreatic cancers. Our expertise in transplantation allows us to safely resect pancreatic cancers involving the major blood vessels with acceptable morbidity and mortality.
We also offer pancreatic resections for benign conditions of the pancreas, cystic tumors of the pancreas and pancreatic trauma. A significant number of resections for these are done laparoscopically.
Gall bladder and bile duct cancers:
We specialize in resections of the gall bladder and bile duct cancers. For gall bladder cancers we offer resections upfront in operable disease and after downstaging them with neo adjuvant chemotherapy in locally advanced gall bladder cancers. In gall bladder cancers involving bile ducts or primary bile duct cancers, we reduce the jaundice by stenting the bile duct endoscopically or by puncturing the liver and placing a tube in the bile duct.
Our expertise with liver transplantation allows us to offer complex liver resection with or without resection of major blood vessels to eradicate the tumor.
The spectrum of disease also involves benign or non cancerous conditions.
Notable amongst those are
- Stricture of bile ducts which are either iatrogenic (post cholecystectomy) or inflammatory. We specialize in offering complex reconstructions to restore biliary enteric continuity and are backed up by a very efficient team of gastroenterologists and intervention radiologists who are able to manage them non surgically if restructuring occurs at a later date.
- Choledochal cysts
- Pancreatitis / severe acute & chronic pancreatitis: We offer minimally invasive (key hole) pancreatic necrosectomy in acute pancreatitis complicated by infective necrosis. We also offer various surgical procedures for chronic pancreatitis including resection and drainage procedures.
- Portal hypertension (shunt / non shunt) operation: We offer shunt operations in patients with portal hypertension with recurrent gastrointestinal bleeding and in patients with biliary obstruction caused by dilated veins around the bile duct (portal cholangiopathy)
- Hepatolithiasis: These are stones within the liver and we offer a multidisciplinary approach to them wherein along with the Urologists, we use a combination of laser lithotripsy, ultrasonic lithotripter and mechanical lithotripter to remove the stones within the liver. We are one of the very few centers in India who offer this treatment for eradication of hepatolithiasis.
- Gall bladder: We offer laparoscopic operations for gallstones whether uncomplicated or even when they are complicated by infection, perforation or severe infection. When remnant gall bladder after cholecystectomy contains stones and is symptomatic, we offer laparoscopic completion cholecystectomy
Liver transplantation:
We offer orthotopic liver transplantation for end stage liver disease, liver cancers and metabolic disorders of the liver. Though the bulk of our transplant was through deceased donors earlier, we now offer living donor liver transplantation where a person donates part of his/her liver to be transplanted to a near relative suffering from end stage liver disease/liver cancer.
We also have expertise and offer pediatric liver transplantation for various disorders requiring liver transplantation for the child. Even though the best option is for a parent/grand parent/elder sibling (>18 years) to donate a small part of the liver for the kid, we also offer reduced sized grafts/split livers from deceased donors for the child when no suitable donor is found.
The transplant work is carried out as a multidisciplinary team endeavor with representation from relevant departments such as the Surgical Intensive Care Unit, Hepatology, Anaesthesia, Paediatric Surgery, Pathology, Psychiatry and Transplant Coordinator/Nurse.
When on a deceased donor list, the patient has to stay in Vellore till he gets an organ. We like our patients to stay in Vellore for 100 days following liver transplantation. This is the time period when more intense monitoring is required as an outpatient and when most of the changes in medications are carried out.
Our cost for liver transplant is one of the cheapest in the country with quality care at par with that available at the best centers world over. For further information regarding liver transplantation at CMC, please email us at livertransplant@cmcvellore.ac.in or hpb@cmcvellore.ac.in
