Liver Services ( Hepatology)

Hepatology is part of the gastroenterology department at the County Durham and Darlington NHS Foundation Trust. Our specialist team assesses patients with abnormal liver function tests and cares for patients with acute and chronic liver disorders. We provide inpatient care on our specialist Gastroenterology and Liver Unit in ward 5 at University Hospital of North Durham and ward 51 at Darlington Memorial Hospital. We also provide outpatient specialist liver services from

• Shotley Bridge Community Hospital
• Chester-le-Street Community Hospital
• University Hospital of North Durham
• Bishop Auckland Hospital
• Darlington Memorial Hospital

We work closely with the drug and alcohol services to help patients withdraw from alcohol safely and efficiently. We also work closely with the Transplant unit at Freeman Hospital in Newcastle upon Tyne.

We are dedicated to providing first-class hepatology care and continually improving the service we provide our patients. As part of this we have committed to an ongoing programme of service and quality improvement for accreditation with the national Improving Quality in Liver Services (IQILS) programme.

Our Services:

We provide patients with the following services:

• 24/7 gastrointestinal bleed service
• endoscopic diagnosis and treatment of oesophageal and gastric varices
• endoscopic retrograde cholangiopancreatography (ERCP) - gallstone removal from the bile duct
• laparoscopic cholecystectomy/open cholecystectomy - gallbladder removal
• biliary and pancreatic endoscopic ultrasound (EUS)
• fibroscan - a non-invasive method of assessing liver fibrosis
• liver biopsy
• venesection for haemachromatosis

Inpatients

We have a dedicated 32-bed Gastroenterology and Liver unit on ward 5 at University Hospital of North Durham and a 26-bedded unit on ward 51 at Darlington Memorial Hospital where we look after patients with liver, bile duct and pancreatic diseases. We usually admit patients through the Acute Medical Unit.

Day case paracentesis (drainage of abdominal fluid)

If you have an accumulation of fluid in your abdomen, it may need to be drained using a procedure called paracentesis (or abdominal tap).

We do paracentesis as day surgery, so unless you're already staying in hospital, you won't need to stay overnight.

During a paracentesis a small drainage tube is placed through the skin into the fluid. You'll be given a local anaesthetic before the drain is put in. The nurse will then use ultrasound to guide the tube into place. The drain stays in place for around six hours.

We offer day case paracentesis on our medical day unit at Durham and Darlington.

Alcohol Liaison services

Our alcohol liaison service helps alcohol-dependent patients with a variety of health conditions. Our support includes:

• assessing patients for alcohol misuse and harmful or hazardous drinking behaviours
• working closely with patients who are frequently admitted with alcohol-related harm
• helping patients manage their withdrawal from alcohol
• advice and support on alcohol detoxification
• access to local alcohol support services

Fibroscan clinics

We also provide Fibroscan clinics from Durham and Bishop Auckland hospital.

A fibroscan is a type of ultrasound that can measure the degree of scarring in your liver, which allows us to plan your treatment.

It is a simple, painless test that uses high frequency sound waves. A fibroscan gives immediate results. It does not have any potential complications or risks and is non-invasive, which means that it does not break the skin or enter your body.

Endoscopy clinics

We run a number of endoscopy clinics to assess and treat conditions such as gastrointestinal bleeding, jaundice due to malignancy or gallstone disease or bile duct and pancreatic disease.

Clinical Research

We take part in a number of local, national and international liver-related disorder studies in conjunction with the Research, Development and Innovation department. We specifically focus on fatty liver disease and cirrhosis of liver.

We're also taking part in an ongoing national study (CALIBRE Study) about the prevention of bleeding from enlarged veins in the oesophagus (varices). It is unded by the National Institute for Health Research.