Comprehensive Liver Treatment for All Hepatology Conditions

Complete Range of Liver Treatments and Procedures

At PACE Hospitals, we offer comprehensive treatment for a wide range of liver diseases, including hepatitis, cirrhosis, fatty liver, and liver cancer. With a focus on patient-centered treatment plans, we ensure optimal outcomes through medical and interventional approaches tailored to each individual's needs.

Non-pharmacological management

These treatments do not involve medications but focus on lifestyle changes, dietary adjustments, and other supportive measures.

Lifestyle Modifications

• Abstinence from Alcohol: Critical in conditions like alcoholic liver disease and alcoholic hepatitis.
• Dietary Changes: Ensuring a healthy diet, weight loss (for non-alcoholic fatty liver disease /non-alcoholic steatohepatitis conditions), and a low-salt diet for managing ascites.
• Exercise: Regular physical activity is recommended for conditions like NAFLD and cirrhosis.
• Nutritional Support: Correction of deficiencies is important. Doctors may recommend supplements such as thiamine (Vitamin B1), vitamin D, and folate in liver disease.

Patient Education

Educating patients on managing comorbidities, such as type 2 diabetes, hypertension, and obesity. Doctors also recommend smoking cessation and alcohol avoidance to prevent disease progression.

Monitoring and Follow-up

Regular medical check-ups are necessary to assess liver function, monitor disease progression, and detect complications.

Pharmaceutical Management

These involve medications used to manage symptoms, treat underlying causes, and prevent disease progression.

Medications for Specific Liver Diseases

• Corticosteroids: Used in autoimmune hepatitis, alcoholic hepatitis.
• Immunosuppressants: Used in autoimmune liver diseases (autoimmune hepatitis, primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC).

Antiviral Medications

• Nucleos(t)ide analogs: These antiviral medications block the replication of the hepatitis B virus (HBV). By inhibiting viral DNA polymerase, they prevent the virus replication, reducing liver damage and the risk of cirrhosis or liver cancer.
  
• Direct-acting antivirals: These drugs specifically target proteins essential for the hepatitis C virus (HCV) to replicate. 

Gallstone dissolution agent 

This agent is used to treat Primary Biliary Cirrhosis and cholestatic liver diseases. This is a bile acid that helps reduce the accumulation of toxic bile acids in the liver. 

Vitamin E

Used in the treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). It helps improve liver function by decreasing inflammation and preventing further liver injury.

Chelating Agents (Iron Chelators)

These agents are used in conditions like hemochromatosis and other iron overload disorders. This bind excess iron in the body and help remove it through the urine or feces. 

Lactulose

It works by trapping ammonia in the gut and promoting its excretion through the feces. This helps prevent or treat hepatic encephalopathy, leading to confusion, altered mental status, and other neurological symptoms.

Antibiotic

This is used in hepatic encephalopathy and as a gut sterilizing agent. It is a broad-spectrum antibiotic that reduces the growth of bacteria in the gut, which produce toxins like ammonia that the liver normally detoxifies.

Interventional/ minimally invasive procedures

These include minimally invasive and surgical techniques used to treat or manage liver diseases.

Endoscopic Procedures:

• Double Balloon Enteroscopy: Double balloon enteroscopy is an advanced endoscopic procedure used to examine and treat bleeding or abnormalities in the small intestine, which are common in patients with chronic liver disease and portal hypertension. 
• Cholangioscopy / Pancreatoscopy: Cholangioscopy and pancreatoscopy allow doctors to directly view the bile ducts and pancreatic ducts using a small camera. In liver conditions, cholangioscopy helps diagnose and treat bile duct strictures, stones, infections, and tumors that can worsen liver function. Direct visualisation improves accuracy compared to imaging alone and allows targeted treatments such as stone removal or tissue sampling, helping prevent bile blockage and further liver damage.

Vascular / Radiological Procedures:

• Balloon-occluded Retrograde Transvenous Obliteration (BRTO): It is used to treat enlarged stomach veins (gastric varices) that develop due to severe liver disease and high pressure in liver blood vessels. The procedure helps to block abnormal veins that may bleed heavily. By sealing these veins, BRTO reduces the risk of life-threatening bleeding and improves blood flow through the liver.
• Inferior Vena Cava (IVC) Filter Placement: IVC filter placement helps protect patients with liver disease who are at high risk of blood clots. Liver disorders can affect blood clotting, which increases the chance of clots travelling to the lungs. The filter is placed in a large vein to trap clots before they cause serious complications.
• Transjugular Intrahepatic Portosystemic Shunt (TIPS): TIPS is used to lower high blood pressure in the liver’s blood vessels caused by cirrhosis. The procedure creates a new pathway for blood flow within the liver, which reduces pressure in swollen veins. This helps control severe bleeding, reduces fluid buildup in the abdomen, and improves symptoms in patients with advanced liver disease.

Biliary Interventions:

• Percutaneous Transhepatic Biliary Drainage (PTBD): The PTBD procedure is used when bile cannot flow normally from the liver due to blockage in the bile ducts. A thin tube is placed through the skin into the liver to drain bile outside or into the intestine. This reduces bile buildup, relieves jaundice, prevents infection, and protects the liver from further damage caused by prolonged bile blockage.
• Percutaneous Cholecystostomy (PC): Percutaneous cholecystostomy is performed to drain an infected or inflamed gallbladder, especially in very ill patients who cannot undergo surgery. By removing infected bile, the procedure reduces pain, controls infection, and prevents the spread of inflammation to the liver, helping stabilize the patient until further treatment is possible.
• Biliary Drainage & Stenting: Biliary drainage and stenting restore normal bile flow by placing a small tube inside a narrowed or blocked bile duct. This relieves pressure in the liver, improves digestion, reduces jaundice, and lowers the risk of infection.

Tumour-targeted & Ablation Procedures:

• Chemoembolization (Transarterial Chemoembolization – TACE): It is a minimally invasive procedure used mainly to treat liver tumors, including hepatocellular carcinoma. In this procedure, chemotherapy drugs are delivered directly into the blood vessels supplying the tumor, followed by blocking these vessels to cut off the tumor’s blood supply.
• Tumor Ablation Procedures: Tumor ablation procedures are image-guided, minimally invasive treatments that destroy liver tumors directly while preserving surrounding healthy liver tissue. These techniques are most effective for small or localised tumours and are commonly used in patients who cannot undergo surgery.
• Radiofrequency Ablation (RFA): Radiofrequency ablation uses high-frequency electrical energy to generate heat and destroy cancer cells through a thin needle placed directly into the tumor. It is highly effective for small liver tumors and offers good local tumor control with minimal recovery time.
• Microwave Ablation (MWA): Microwave ablation destroys liver tumors by generating high-temperature heat using microwave energy. It allows faster treatment and can treat slightly larger tumors compared to RFA, with reduced heat-sink effect near blood vessels.
• Cryoablation: Cryoablation treats liver tumors by freezing abnormal tissue using a thin probe placed directly into the tumor. The extreme cold destroys cancer cells while minimising damage to nearby healthy liver tissue. This approach is useful for patients who are not suitable for surgery and helps control tumor growth.
• Irreversible Electroporation (IRE): Irreversible electroporation treats liver tumors using short electrical pulses that destroy cancer cells without using heat or cold. This technique is especially helpful when tumors are located close to important blood vessels or bile ducts.