Gastroentrology

In the specialty of Gastroenterology, we primarily work with the Karolinska University Hospital. Karolinska University Hospital treats patients with advanced and highly specialized surgical and medical diagnoses of the gastrointestinal tract, liver, biliary tract and pancreas, as well as patients with trauma injuries.

Upper abdominal surgery

The Department of upper gastrointestinal diseases and surgical oncology has a more than decade-long history of structured multidisciplinary work procedure. Since 2005, weekly video-linked regional multidisciplinary team (MDT) conferences link Karolinska University Hospital to all hospitals in Stockholm and many other regions in Sweden. Physicians from other centers, domestic or international, are always welcome for consultation or second opinion.

Regarding upper abdominal surgery, the primary focus is on highly specialized surgery involving the pancreas, liver, esophagus and stomach. A majority of these procedures are performed for malignant diseases, but a significant proportion involves advanced benign reconstructive surgery of the esophagus and biliary tract.

The Hepatobiliary & Pancreatic HPB Unit at Karolinska University Hospital is the largest center for hepatobiliary and pancreatic surgery in Sweden with around 550 oncological surgical procedures being performed annually. Karolinska University Hospital is a tertiary referral center for the region and also receive referrals from other counties in Sweden. In addition, Karolinska University Hospital has been selected as one of two Swedish centers for further national centralization of the treatment of locally advanced pancreatic cancer and perhilar cholangiocarcinoma. There is a ongoing focus on further development of minimally invasive surgery and a constant evaluation of our results in academic publications.

The Oesophagogastric (OG) Surgery Unit at Karolinska University Hospital is a highly specialized unit focusing on OG cancer surgery and advanced reconstructive surgery including research and development. The Unit is by far the largest unit in Sweden, a tertiary center for all OG curative surgery in the region and has been selected as one of two National centers for highly complicated surgical cases (free jejunal transplants, multivisceral resections, colon interpositions, and other complicated reconstructions). We perform approximately 130 OG cancer resections and 10 highly complex cases annually. Minimally invasive OG cancer surgery was started in 2012 and today a vast majority of cases are performed with this technique and we are aiming at starting with Robot-Assisted OG cancer surgery in early 2020. The Unit is very active nationally and internationally within the clinical and research field holding several important positions as for example President for European Society of Diseases of the Esophagus (ESDE). Scientific activity is very high with more than 50 publications annually within the field in peer-reviewed highly ranked international medical journals.

The Endoscopy Unit is one of the largest units in Sweden performing over 11,000 procedures per year. This unit performs a wide range of endoscopic procedures that allow both diagnosis and treatment of gastrointestinal and hepatobiliary disorders and it is a tertiary referral center for advanced endoscopic procedures include ERCP, EUS, ESD and EMR. The endoscopy unit drives training and innovation with several endoscopy courses each year and an active academic portfolio of high impact international and national clinical studies.

Conditions treated within the unit of upper abdominal surgery:

Esophageal and Gastric Surgery

The treatment for esophageal cancer may vary depending on the type of cells involved, the stage of the cancer and the overall health of the patient. To remove the cancer, surgery can be used alone or together with oncological treatment. Esophageal resection can be made as an open procedure or with minimally invasive technique.

Gastric cancer

The unit performs both total gastrectomy and distal gastrectomy (open and laparoscopic) for treatment of ventricular cancer. The scope of the surgery depends on the size and location of the tumor, and includes reconstruction of the stomach and other areas.

Pancreatic tumors

For some patients with pancreatic tumors, radical surgery is offered, so called Whipple Procedure. It is a very comprehensive procedure and includes reconstruction of the biliary tract.

Liver tumors

Liver resection (primary and secondary). A liver resection is the surgical removal of all or a portion of the liver.

Cystic tumors

Enucleation, the procedure is performed with robot-assisted surgery.

Lower abdominal surgery

In the area of lower abdominal surgery all types of colorectal diseases are handled with a special focus on locally advanced tumors and recurring cases of colorectal cancer. Robot assisted colorectal cancer surgery is well established within the unit.

Various other types of cancers in the pelvic region can also be treated, such as peritoneal carcinomatosis. Treatment includes extensive cytoreductive surgery combined with intraperitoneal chemotherapy (HIPEC).

Multidisciplinary treatment is conducted in close collaboration with the departments of oncology, radiology, gynecology, reconstructive plastic surgery and vascular surgery.

Conditions treated within the unit of lower abdominal surgery:

Colorectal Cancer (All types)

The unit performs advanced treatment of all types of colorectal cancer, locally advanced tumors of the abdomen/pelvis, local recurrence of colorectal cancer and liver/lung metastatic colorectal cancer.

Peritoneal Carcinomatosis

Treatment of peritoneal carcinomatosis includes extensive cytoreductive surgery combined with intraperitoneal chemotherapy (HIPEC).

Crohn’s Disease and Ulcerative Colitis

Patients with Crohn’s Disease and Ulcerative Colitis can be operated on with open surgery as well as laparoscopic technology. The treatment is conducted in close cooperation with gastroenterologists in a multidisciplinary team.

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