Department of

GI-HPB Surgery

Department of GI-HPB (Gastro-intestinal and hepato-pancreatico-biliary) Surgery

About the Department:

The Department of GI-HPB surgery is one of the six units of the larger Division of Surgical Oncology in this tertiary care oncology hospital of Eastern India. As it steps in to its second decade, the unit boasts of a cohesive team of five full time Consultant Surgeons and six Fellows delivering high quality surgical service. In order to offer specialised surgical care, the unit is functionally divided in to three sub-specialities:

(1) Upper gastrointestinal, thoracic and peritoneal surface oncology

(2) Hepato-pancreatico-biliary surgery

(3) Colorectal surgery

The unit performs the entire gamut of operations for cancer of the GI tract and HPB organs: oesophagectomy, gastrectomy, pancreaticoduodenectomy, hepatectomy, radical cholecystectomy, colectomies and rectal resections etc. These cancers often spread to the peritoneum, the lining of the abdominal cavity, thereby precluding the possibility of being cured. But in selected patients cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) may be performed with curative intent: the surgical unit has considerable expertise in this area. While a large number of surgeries for colon and rectal cancer are performed by laparoscopic (key-hole) technique, the Da Vinci robot will be increasingly used in the future.  It also boasts of using the CUSA routinely for liver operations. In addition surgery for lung and mediastinal cancers are also performed. The unit is also preparing to start liver transplantation programme for primary cancers of the liver.

Our instituition has pioneered the multi-disciplinary management of GI cancers in this part of the country with disease management groups (DMGs) and multi-disciplinary teams (MDTs). The use of neoadjuvant treatments, where appropriate, as determined by our multi-discplinary teams, continue to improve patient outcomes.

Based on the data of 2019, the approximate number of operations performed in a calendar year is: oesophagectomy (30), lung resections (35), gastrectomy (70), Whipple operations (35), hepatectomy (30), colectomy (100), rectal resections (80) and HIPEC (15).

Teaching Programmes

The unit offers a 2-years Fellowship programme wherein the trainee has to undertake all routine clinical work, including assisting the Consultant in the operation. In addition they take turns to present cases in multidisciplinary meetings, present weekly audits and discuss recent publications. The Fellows actively participate in entering clinical data prospectively in a bespoke RedCap® based online database. They are also mandated to maintain a log book. The unit is on the verge of starting periodic internal assessment of Fellows using the online Moodle® platform.

Research projects and collaborations

  1. PANGEN study looking in to the genetic profiling of periampullary and pancreatic head cancers (in collaboration with Indian Statistical Institute, Kolkata)
  2. Developing ex-vivo models of gallbladder cancers to understand pathogenesis and newer modalities of treatment
  3. The department is also part of the Global Surgery International Collaborative and is running the following research projects
    • Cheetah Trial: Cluster randomised trial of sterile glove and instrument change at the time of wound closure to reduce surgical site infection
    • Crocodile Study: A study on catastrophic expenditure and referral pathways influence on presentation and treatment
    • Crane Trial: A Cluster Randomised Feasibility Study of a sustainable nutritional Intervention for Patients undergoing Cancer Surgery in low- and middle-Income Countries. (Formal approval awaited)
    • Penguin Trial: Perioperative respiratory care and outcomes for patients undergoing hIgh risk abdominal surgery
    • Covid Surg cancer: A study to assess the impact of COVID 19 on cancer patients requiring surgery
    • Covid Surg week: a study to assess optimal timing for surgery following SARS-CoV-2 infection
  4. Molecular predictors of responsiveness of rectal cancer to neoadjuvant radiotherapy (being conceived in association with the Radiation Oncology unit)

Covid-19 and Cancer in the Indian ethnic group (CCIG): The interplay between ethnicity and the environment. A National Cancer Grid Sudy

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