Gallbladder Cancer Specialist team include Gallbladder Oncologist & Gallbladder Cancer surgeon. This team act as a unit to deal with Gallbladder Cancer. Gallbladder Cancer if resectable then surgery is done by Oncosurgeon. If it is not resectable then chemotherapy is given by Medical Oncologist.Incidence has increased in young population also
More common in North India. High incidence is seen in female sex. Most common complain is pain in right upper abdomen. Anorexia and weight loss which are symptoms of any cancer are present. Most cases are diagnosed in advanced stage when the tumor is unresectable. Early diagnosis and treatment is key for the good survival rate as in any cancer
USG abdomen can show mass or focal thickening in the gallbladder. CECT abdomenis done to stage the tumor. FNACis not done as it may risk the seedling of cancer cells in the needle tract. PET scan is done selectively
Treatment of Gallbladder Cancer
Gallbladder is situated on the inferior aspect of right lobe of liver adhered to it. Gallbladder is removed along with this part of liver to which it is adhered. Standard lyphadenectomy along with resection this whole procedure is called as radical cholecystectomy. Cystic duct margin is sent for frozen section intra-operatively and if it comes to be positive then common bile duct is also excised and thenRoux-en-Y Hepatico-jejunostomyis performed. Extended right hepatectomy is done if tumor is located at the neck and involve right sided portal structures.
Role of staging laparoscopy
Staging Laparoscopy is the first step. It is done to look for metastatic deposits missed on CT scan. If metastatic deposits are seen on staging laparoscopy then biopsy is taken from the deposits and sent for frozen section and if these comes to be positive then surgical procedure is abandoned
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Consult Dr Amit Jain Best Gallbladder Cancer SurgeonOncosurgeon at Max HospitalPatparganj Delhi, Ghaziabad, Noida India
Esophagus is food pipe that connects from mouth to stomach or in other words it carries food from the mouth to the stomach. Esophagus cancer incidence is increasing. The length of esophagus is divided into three parts upper third, middle third and lower third
Esophagus Cancer Causes
Cause of lower third cancer is obesity and GERD. Histologically lower third cancer is adenocarcinoma. Cause of middle and upper third cancer is smoking and alcohol. Histologically it is squamous cell carcinoma
Cancer causes obstruction to the passage of food bolus. The most common symptom these patients complain is dysphagia that is difficulty in swallowing food. These patients adapt there food intake, when they have dysphagia to solid food they start eating soft diet and when narrowing does not allow soft diet they start taking liquid diet the most common presentation. Anorexia and weight loss are common symptom. In advanced cancer patient can have pain over the bone, hoarseness in the voice
Upper GI endoscopy is the main diagnostic tool. when patient present with complain of dysphagia the first investigation to be done is upper GI endoscopy. Biopsy taken at this time proves the diagnosis. CECT chest and abdomen is done for the staging.PET Scan is done in the selected cases only
The main stay of treatment of esophagus cancer is surgery. For this tumor should be resectable and patient should be fit. In locally advanced tumor before surgery chemo-radiotherapyis given. In metastatic disease palliation is required. As the main symptom is dysphagia esophagus stenting is done. This is done by upper GI endoscopy. If this is not possible feeding jejunostomyis done
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The most common cause of acute pancreatits are alcohol intake and the gallbladder stone. When acute pancreatitis is caused by biliary stones it is called as biliary pancreatitis. Biliary pancreatitis management involve team work of critical care doctor,Gastrophysician, Gastrointestinal surgeon & intervention Radiologist
Clinical Features of Pancreatitis
Patients present with features of acute pancreatitis like severe acute abdomen pain radiating to back; Investigations show increased serum amylase and Lipase level with deranged Liver function tests (LFT)
Biliary pancreatitis management is supportive. To know the status of Common bile duct MRI/MRCPabdomen is done. Mostly stone has passed through the Common bile duct into the duodenum. If the MRI/MRCP show stone in the common bile duct then patient require ERCP and CBD stone clearance. If the patient condition is not stable and is in cholangitis/septic shock ERCP is done on urgent basis otherwise ERCP is done on elective basis once pancreatitis settle.
The Gallbladder is removed during same hospitalization in mild biliary pancreatitis management with no associated fluid collection as gallstone is the cause and is the source and if not removed patient may again develop pancreatitis. Cholecystectomy is advised after 4 weeks in moderate and in severe biliary pancreatitis management as if some comlications of pancreatitis requiring intervention, that can also be done at same time. Indications for surgery for pancreatitis remains the same such as infected pancreatic necrosis. Pancreatic necrosectomy should be delayed and ideally should be done after 4 weeks of episode.
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Pancreatitis disease is common with very high morbidity and mortality rate. Alcohol is the most common culprit and should be avoided. Dr Amit Jain with his advance laparoscopic approach is specialize to do pancreatic necrosectomy with minimally invasive approach which has got low morbidity and mortality. To have regular update about this topic plz visit and like our face book page
The term incidental gallbladder cancer means when gallbladder cancer is detected on histopathology following eitherLaparoscopic cholecystectomy oropen cholecystectomy. It carries a good prognosis as gallbladder cancer detected like this are of early stage. Completion radical cholecystectomy is performed in these patients as early as possible
Missed Gallbladder Cancer
When there is doubt of Gallbladder cancer pre-operatively and these patients are not further investigated for same and on histopathology gallbladder canceris detected it is termed as missed gallbladder cancer. The term missed gallbladder cancer also applies when gallbladder specimen after removal is not cut intra-op and its mucosa is not examined and histopathology comes out to be Gallbladder Cancer
Incidental Gallbladder Cancer Treatment
Once diagnosed to have gallbladder cancer on biopsy report, further treatment depends on stage of cancer. Beyond T1a stage completion radical cholecystectomyis done
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How to prevent acid reflux naturally is most common question by patients who suffer from acid reflux.The best doctor to answer the question how to prevent acid reflux naturally is gastroenterlogist. Incidence of reflux disease has increased.The main cause is change in lifestyle.Physical inactivity and obesity are the main cause of increased incidence. In long term reflux disease is risk factor for esophagus cancer.Best way of reflux disease is prevention. Here are some of ways we can prevent reflux disease
Increased incidence of obesity is the main cause of GERD. Obesity causes GERD in many ways. Pressure on the stomach by excess belly fat, increase in estrogen and development of hiatus hernia
Dietary Modifications to prevent acid reflux naturally
Avoid fatty food, spicy foods, chocolate,coffee, acidic foods like citrus. Eat frequent small meal. Large meals fill the stomach and put pressure on the LES, making reflux and GERD more likely.
Don’t lie down immediately after eating: Gravity normally helps keep acid reflux from developing. With full stomach on lying down acid more easily presses against the LES and flows into the esophagus.
Elevate your bed at Head End Side: This works on the principle of gravity, raising the head end of the bed allow gastric acid down in the stomach because of gravity; just extra pillows does not help much
A number of medications increase risk of GERD. Medications cause reflux by relaxing the LES or further irritating an already inflamed esophagus . Examples include Non-steroidal anti-inflammatory drugs, or NSAIDs, Calcium channel blockers (often used to treat high blood pressure), Certain asthma medications, including beta-agonists like albuterol, Potassium, Iron tablets
Quit smoking and Alcohol
Nicotine and Alcohol relax the muscles of lower esophageal sphincter
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Fatty liver is accumulation of fat in the liver; Fatty liver is the most common USG finding done for abdomen complain. In long term it can cause liver damage. The main causes are obesity, diabetes, alcohol intake and hyperlipidemia. It will be the main cause of liver disease in next decade
Symptoms of Fatty Liver
Liver is vital organ of our body with so many functions. Small amount of fat is normal in the liver but excessive amount can damage the liver and hamper its function. Simple Fatty liver does not cause any symptom but if it progress to second stage liver damage that is liver inflammation medically called as steatohepatitis patients may develop symptoms such as loss of appetite, weight loss, pain abdomen and fatigue and if not taken care at this stage it may progress to liver cancer and chronic liver damage and have symptoms of liver failure such as jaudice, bleeding from GI tract, ascites, confusion and so on.
Liver function tests may be deranged but these does not confirm. Ultrasound abdomen and CT scan can detect fat but the severity of injury is determined by Liver biopsy
The first line recommended treatment is to reduce risk factors such as avoiding alchol intake, reduce weight, control diabetes. Regular exercise and healthy food is enough for further progress of this disease. there is no proven role of any medication .If liver damage reach to last stage of chronic liver disease with cirrhosis then only option remains isliver transplantation
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It is the most common finding in ultrasound abdomen done for any reason. Earlier it was thought to be a benign condition but now it has been proven that if not treated at early stage it can lead to chronic liver disease and finally liver failure. plz like and visit our face book page to know more about it
Dr Amit Jain is currently working as Senior Consultant at the Department of GI Surgery,GI Oncology, Minimally Invasive and Bariatric Surgery at Max Hospital Patparganj & Vaishali. He is advance laparoscopic Gastrointestinal Surgeon. He specialize in Hepato-pancreato-biliary surgery and has special interest in Bariatric surgery. He has performed various complex Gastrointestinal Surgery in last 15 years. His special interest in LaparoscopicGastrointestinal Cancer Surgery and Bariatric Surgery. He performed the first bariatric surgery in Greater noida Uttar Pradesh at Yatharth Hospital. Also first weight loss surgery in entire kumaon region of uttarakhand at Medicity Hospital Rudrapur
Qualifications of Dr Amit Jain
He passed his MBBS from Kasturba Medical College in Mangalore. He completed his MS in General Surgery from Gandhi Medical College Bhopal. Done MCh in GI Surgery from GB Pant Hospital Delhi one of the best institute in India. There are very few institutes in India where GI Surgery programme is run
He has worked as Senior Resident at ILBS Hospital Vasant Kunj New Delhi. After his MCh he joined as Assistant Professor in the department of GI Surgery at Dayanand Medical College Ludhiana. He worked as Senior Consultant in the Dept of GI Surgery at Nayati Hospital Mathura.
He got fellowship in advance laparoscopic colorectaland upper GI surgery. Fellow in Minimally Invasive or Laparoscopic surgery. Fellow in Indian Association of Gastrointestinal Endoscopic Surgery
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Dr Amit Jain is best Laparoscopic ColoRectal Surgeon in East Delhi, Noida. Consult today Dr Amit jain for any query regarding GI Surgery
He is renowed GI Cancer Surgeon. Prevention is always better then cure. He run various screening programmes for early detection of GI cancer. These are done in high risk patients for Gastrointestinal Cancer like patients of chronic liver disease