The Department of Hepatology at PGIMER, Chandigarh is proud to announce the introduction of a groundbreaking procedure aimed at revolutionizing the management of complications associated with cirrhosis - gastric varices and hepatic encephalopathy. Developed by Dr. Sahaj Rathi and his team, this innovative technique called Endoscopic Ultrasound-Guided Transgastric Shunt Obliteration (ETSO) offers a promising therapeutic option.

Cirrhosis patients often have shunts which can lead to brain fog and blood vomiting from dilated veins in the stomach. Until now, these shunts were typically treated through interventional radiology procedures known as BTRO. However, due to financial or technical constraints, this method may not be suitable for all patients.

Building upon their extensive experience in using endoscopic ultrasound (EUS) to manage bleeding stomach veins (gastric varices), Dr. Rathi and his team have pioneered a new EUS guided technique that effectively obliterates these shunts. The procedure involves identifying the vessel supplying the shunt and occluding it using cyanoacrylate glue and platinum coils.

To showcase the potential of this technique, it was first introduced at the prestigious Digestive Disease Week congress in San Diego, USA in 2022. Subsequently, the team published their experience with seven cases in a recent scientific paper in the American Journal of Gastroenterology. To date, the team has successfully performed shunt obliterations in over 12 cases of hepatic encephalopathy and over 20 cases of gastric varices.

One of the notable advantages of this technique is its significantly reduced cost and shorter procedure time. Additionally, this procedure can be performed in stages, which is particularly advantageous for patients with compromised liver function.

While ETSO represents a potentially significant advancement in shunt obliteration, it is still a novel technique that requires further data before it can be widely adopted. As the Department of Hepatology continues to explore the potential of ETSO, larger studies are planned to examine its role in managing gastric varices and hepatic encephalopathy compared to standard techniques.

This groundbreaking procedure exemplifies the Department of Hepatology's commitment to advancing patient care and pioneering innovative solutions for complex liver conditions.

For further information please contact Dr Sahaj Rathi 7087429911.