Hepatogastroenterology Department

To focus on screening and early treatment of hepato-gastrointestinal diseases as well as gastro-intestinal cancers

To provide a high standard medical service and conduct innovative research based on evidence medicine and ethical standards in the management, prevention and treatment of hepato-gastrointestinal diseases affecting Egyptian patients.

Prof. Ayman Abdel-Aziz

Email: aymantbri@hotmail.com

 

 

Former heads :

• • Prof. Wael Safwat
    
  • Prof. Ahmed El Ray
  • Late Prof. Amna El Kaliouby
  • Prof. Nadia El Behairy
  • Prof. Moataz Hassan
  • Prof. Ibrahim Mostafa
  • Prof. Ahmed Sadek
  • Prof. Hesham El Khayat
  • Prof. Maged El Ghannam
  • Late Prof. Aly Zein El Abdeen
  • Late Prof. Nawal El Badrawy
  • Late Prof. Alaa Ismaeil

Staff members :

• • Prof. Nadia El Behairy
  • Prof. Moataz Hassan
  • Prof. Ibrahim Mostafa
  • Prof. Magdy Youssef
  • Prof. Ahmed Sadek
  • Prof. Naglaa Hashem
  • Prof. Hesham El Khayat
  • Prof. Maged El Ghannam
  • Prof. Gamal El Attar
  • Prof. Youssry Abdelrahman
  • Prof. Alaa Awad
  • Prof. Shendy Mohamed Shendy
  • Prof. Moataz Serry Syam
  • Prof. Mahmoud El Ansary
  • Prof. Wael Safwat
  • Prof. Raafat Atta
  • Associate Prof. Abdelaziz Aly Abdelaziz
  • Associate Prof. Mohamed Darwish
  • Associate Prof. Mohamed Abo el Ezz
  • Associate Prof. Ayman Abdelaziz
  • Researcher Ahmed Gamal
  • Researcher Sherif Morsy
  • Researcher Ayman Atef Namera
  • Researcher Ahmed Abdelazeem
  • Researcher Haitham Abdallah
  • Researcher Ahmed Rashad
  • Researcher Ali Abdel Rahim
  • Researcher Mohamed El Kady
  • Researcher Mostafa Ibrahim
  • Researcher Khali Ragab
  • Researcher Mohammad Abdel Hamid

1- The strategic research plan of the department is concerned with the management and treatment of:

• • Chronic liver diseases that are mostly caused by hepatitis viruses, fatty liver, non-alcoholic steatohepatitis (NASH) in addition to other infectious agents, which affect the liver and biliary system as schistosomaisis, fascioliasis, hydatid disease, amebiasis etc…). This runs in parallel with the management of their complications that include portal hypertension, ascites, fibrosis, encephalopathy and hepatocellular carcinoma.
  • Gastro-intestinal diseases that include organic and functional diseases of the gastro-intestinal tract. The main brunt of research is related to ultrasonography, endoscopy, ERCP, endo-sonography as well as motility studies. Inflammatory bowel disease.

2- The field of research include:

• • Epidemiological research involving field studies to know incidence and prevalence of different illnesses and their impact on the community together with the different control and preventive measures.
  • Clinical research that concerned with studying different aspects of diseases including morbidity, diagnosis and different lines of management as followed:
    • • Early detection and screening for GIT malignancy.
      • New advances in GIT endoscopy.
      • Gastro-intestinal motility disorders.
      • Gastric and esophageal diseases.
      • Pancreatic and biliary diseases.

A. A signed agreement between TBRI and Beaujon hospital, France in 2007, whichwas renewed twice in 2012 and 2017. The agreement has opened a new scope for the cooperation between The Hepatogastroenterology department of TBRI and the departments of Hepatology and Gastroenterology in Beaujon Hospital:

• •  TheHepatogastroenterology department organized 10 scientific meetings with Beaujon hospital on annual basis since 2007- 2018. This was done in cooperation with different TBRI departments. The meetings were animated by professors from Beaujon hospital in addition to professors from Hepatogastrenterology, Pathology, Anesthesia and Microbiology TBRI departments.
  •  The 10th meeting was animated by a workshop on Endosonography
  •  The agreement resulted in a collaborative research project with the Hepatology department (Beaujon Hospital) through the Egyptian French program Imhotep in 2007. The project was successfully accomplished and presented as an abstract in the European Congress ( European Association for the study of the Liver – EASL) and published in the European Journal of Gastroenterology and Hepatology EJGH
  •  The agreement also offered young TBRI researchers training in Beaujon Hospital

B. The department succeeded to be a “Reference Centre for Training” at the level of local and international institutions especially from the Arab and African Countries (Sudan, Libya, Ethiopia, Nigeria, Kenya, Palestine, Morocco, Cameron).

C. The department was the seat of an annual international workshop for therapeutic endoscopy from the period 1999- 2010. This was in collaboration with the “American Society of Endoscopy” and the “European Society of Endoscopy”

D. The department organized training courses in endoscopic management of portal hypertension, ultrasonoraphy in liver and GIT diseases and in colonscopy. This was in collaboration with the Cairo Training Center (CTC) that gathers the Egyptian experts in all branches of hepatogastroenterology and trainees from other Arabian and African countries.

E. Received awards :

• •  Prof. Ibrahim Mostafa received the State appreciation Award for his work in the field of Hepatogastroenterology.
  •  Prof. Alaa Awad received an award for his submitted article at APASL single topic conference on Hepatitis C Virus, December 2010, Chiba, Japan.

• Diagnostic and therapeutic upper endoscopy: the performed techniques include biopsy, injection sclerotherapy, band ligation of oesophageal varices, injection of gastric varices, oesophageal dilatation, oesophageal stent application and extraction of foreign body.
•  Endoscopic Retrograde Cholangiopancreatography (ERCP)
•  Diagnostic and therapeutic Colonoscopy: the performed techniques include biopsies, dilation, stenting, polypectomy and haemostasis.
•  Diagnostic and therapeutic endosonography
•  Enteroscopy
•  Diagnostic and intervention sonography including radiofrequency and Ethanol injection of HCC, percutaenous drainage of liver or abdominal abscesses, cysts, PAIR and liver biopsy
•  GIT motility study.

Inpatient unit: which includes 40 beds as well as 3 ICU rooms with 12 beds capacity

Outpatient unit : with an outpatient clinic that is linked to the Endoscopy and the Ultrasonography units

The Endoscopy unit which consists of four procedure rooms, a recovery area, and administrative office. The unit is self-contained offering pre, intra, and post-procedure care for patients undergoing endoscopy procedures. The unit is a fast-paced episodic unit caring for both outpatients and inpatients.

1. 1.  The unit provides a high level of teamwork environment that comprises :
       – Highly regarded team can diagnose and treat a wide variety of gastrointestinal disorders from esophageal, pancreatic, and early colon cancers, to gallstones and gastroesophageal reflux disease.
       – Trained nurses and technicians who assist physicians in diagnostic and therapeutic procedures. The nurses also offer one-on-one patient contact that provides patients with support and guidance about procedures as well as disease progression.
   2.  Scheduling is flexible, with on-call evening, weekend and holiday coverage requirement especially in cases of emergencies e.g. hematemesis.
   3.  The interventional endoscopists are sparing patients from unnecessary, major surgical procedures by diagnosing and treating conditions with minimally invasive endoscopic techniques. In a gastrointestinal interventional endoscopy procedure, physicians use thin, flexible tubes equipped with miniaturized cameras and devices to diagnose and treat conditions such as complex pancreatic and biliary problems and gastrointestinal cancers.

Ultrasound unit which is equipped with two advanced US machines, with Doppler facilities. The unit provides routine diagnosis and performs different techniques guided by ultrasound including liver biopsy- drainage of abscesses, Radiofrequency, ethanol injection, etc…

Hepatocellular Carcinoma unit “established in 1999”, the unit is mainly concerned with:

• •  Surveillance of patients with liver cirrhosis and chronic hepatitis for early detection of HCC
  •  Diagnosis and management of patients using percutaneous ablative techniques including radiofrequency ablation and intratumorethanol injection as well as performance of intraoperative radiofrequency ablation.
  •  The research work of the unit is extended to other areas such as epidemiology, risk factors and factors associated with poor survival.

Training workshops on :

1.  Upper and lower endoscopy
2.  Therapeutic endoscopy and treatment for portal hypertension
3.  ERCP
4.  Ultrasonography and interventional ultrasonograpghy
5.  Motility and pH-metry
6.  Endosonography
7. Hepatology

Scope of Services :

1.  Clinical assessment, diagnosis and management of hepato-gastrointestinal and infectious diseases.
2.  Diagnostic and therapeutic upper and lower gastrointestinal endoscopies.
3.  Pancreaticobiliary and intervention sonography and endosonography.
4.  Diagnostic and intervention sonography and endosonography.
5.  Intensive care for critical liver diseases (hematemesis and hepatic coma).

Routine out and in patient services :

•  The Hepatogastroenterology department has an outpatient clinic, which is daily supervised by a professor
•  the clinic is linked to the endoscopy unit and to the ultrasound unit to facilitate management of the patients.
•  The admission of cases occurs in the inpatient section which is equipped by three intensive care units (ICU), two of these ICU’s are concerned with cases of Hematemesis
  

Omar M, El-Din SS, Fam N, Diab M, Shemis M, Raafat M, Seyam M, Hssan M, Badawy A, Akl M, Saber M. SEN virus infection in Egyptian patients with chronic hepatitis C and patients undergoing hemodialysis. Medscape J Med. 2008; 10(12):290.

Taha AA, Seyam M, El-Ray A. Efficacy of percutaneous radiofrequency ablation in the management of hepatocellular carcinoma with schistosomisis.J Egypt SocParasitol. 2009; 39(1):205-12.

El-Zayadi AR, Badran HM, Saied A, Shawky S, Attia Mel-D, Zalata K. Evaluation of Liver Biopsy in Egyptian HBeAg-Negative Chronic Hepatitis B Patients at Initial Presentation: Implications for Therapy. Am J Gastroenterol 2009; 104: 906 -11.

Martinot-Peignoux M, Stern C, Maylin S, Ripault MP, Boyer N, Leclere L, Castelnau C, Giuily N, El Ray A, Cardoso AC, Moucari R, Asselah T, Marcellin P. Twelve weeks posttreatment follow-up is as relevant as 24 weeks to determine the sustained virologic response in patients with hepatitis C virus receiving pegylated interferon and ribavirin. Hepatology 2010; 51(4):1122-6.

Demerdash ZA, Diab TM, Aly IR, Mohamed SH, Mahmoud FS, Zoheiry MK, Mansour WA, Attia ME, El-Bassiouny AE. Diagnostic efficacy of monoclonal antibody-based sandwich enzyme linked immunosorbent assay (ELISA) for detection of Fasciola gigantica excretory/secretory antigens in both serum and stool. Parasit Vectors.2011; 4:176.

Giguere A, Anas A, Nasser T, Hassan MH, Ahmed U, Beejay N, Nouh M, Khalowf M, Saleh A, Khan A, Attia M, El-Azab G. Treatment of hepatitis C virus infection in patients on maintenance hemodialysis: a single United Arab Emirates center experience. Eur J Intern Med. 2011; 22(6):582-6.

Asselah T, De Muynck S, Broët P, Masliah-Planchon J, Blanluet M, Bièche I, Lapalus M, Martinot-Peignoux M, Lada O, Estrabaud E, Zhang Q, El Ray A, Vidaud D, Ripault MP, Boyer N, Bedossa P, Valla D, Vidaud M, Marcellin P.IL28B polymorphism is associated with treatment response in patients with genotype 4 chronic hepatitis C.J Hepatol. 2012; 56(3):527-32.

Abdel Haleem H, Zayed N, Abdel Hafez H, Fouad A, Akl M, Hassan M, Hammam O, Morsy A, Saleh A, Seyam M, Zakaria Z, Zakaria S. Evaluation of the diagnostic value of serum and tissue apoptotic cytokeratin-18 in patients with chronic hepatitis C. Arab J Gastroenterol. 2013; 14(2):68-72.

El Ray A, Asselah T, Moucari R, El Ghannam M, Taha AA, Saber MA, Akl M, Atta R, Shemis M, Radwan AS, Ghali A, Paradis V, Marcellin P. Insulin resistance: a major factor associated with significant liver fibrosis in Egyptian patients with genotype 4 chronic hepatitis C.Eur J GastroenterolHepatol 2013; 25(4):421-7.

Dabbous HM, Elmeteini MS, Sakr MA, Montasser IF, Bahaa M, Abdelaal A, Fathy M, Refaie R, Seyam M, Abdelmonem A, Mukhtar A, Hegazy N, Almoneiri M. Optimizing outcome of recurrent hepatitis C virus genotype 4 after living donor liver transplantation: moving forward by looking back. Transplant Proc. 2014;46(3):822-7.

Hassanien M, El-Talkawy MD, El-Ghannam M, El Ray A, Ali AA, Taleb HA. Predictors of in-hospital mortality in patients with hepatocellular carcinoma and acute variceal bleeding.Electron Physician. 2015;7(6):1336-43

Zoheiry MM, Hasan SA, El-Ahwany E, Nagy FM, Taleb HA, Nosseir M, MagdyM, Meshaal S, El-Talkawy MD, Raafat I. Serum Markers of Epithelial Mesenchymal Transition as Predictors of HCV-induced Liver Fibrosis, Cirrhosis and Hepatocellular Carcinoma. Electron Physician. 2015;7(8):1626-37.

El Ray A, Azab MM, El-Aziz IM, El-Aleem AA, El-Talkawy MD, El-Badea MA,El Ansary M, Safeem AA, Diab TM.Non-invasive predictors for thepresence, grade and risk of bleeding from esophageal varices in patients with post-hepaticcirrhosis.J Egypt SocParasitol. 2015;45(2):421-8.

Barakat AA, Metwaly AA, Nasr FM, El-Ghannam M, El-Talkawy MD, Taleb HA.Impact of hyponatremia on frequency of complications in patients withdecompensated liver cirrhosis.Electron Physician. 2015;7(6):1349-58.

Fam NS , Defasque S  , Bert F, Leflon-Guibout V, El-Ray A, El-Ghannam M, Attia ME, Omar M, Desouki DG, Valla D, Nicolas-Chanoine MH. Faecal carriage of extended-spectrum β-lactamase (ESBL)-producing enterobacteria in liver disease patients from two hospitals in Egypt and France: a comparative epidemiological study. Epidemiol Infect. 2015; 143(6):1247-55.

Seyam MS, Gabr HA, Salama ZA, Mokhles MA, Marzaban RN, Soliman AF. Evaluation of fluvastatin in combination with the standard of care therapy (PEG-IFN/Ribavirin) in Egyptian patients with hepatitis C virus.Turk J Gastroenterol. 2015; 26(6):511-6.

Badawy AA, Hammam O, Moussa M, Atta R, Aboshousha T, Said N, El-Assaly N, El-Badrawy N. Hepatic Expression of Nitric Oxide Isoforms and Serum Nitrites/Nitrates in Chronic Hepatitis C With or Without Schistosomiasis. Annals Pathol Lab Med 2016; 3 (4): A250-58.

Eman El-Ahwany, Faten Nagy, Mona Zoheiry, Mohamed Shemis, Mona Nosseir, Hoda Abu Taleb, MagedElGhannam, Rafaat Atta, SuherZada. Circulating miRNAs as Predictor Markers for Activation of Hepatic Stellate Cells and Progression of HCV-Induced Liver Fibrosis. Electronic Physician 2016; 8 (1): 1804-10.

Akl M, Hindawi AE, Mosaad M, Montasser A, Ray AE, Khalil H, Anas A, Atta R, Paradis V, Hadi AA, Hammam O. Fibrosis in Chronic Hepatitis C: Correlation between Immunohistochemically-Assessed Virus Load with Steatosis and Cellular Iron Content .  Open Access Maced J Med Sci 2016; 4(4):578-84.

El-Lakkany NM, Hendawy AS, Seif El-Din SH, Ashour AA, Atta R, Abdel-Aziz AA, Mansour AM, Botros SS. Bioavailability of paracetamol with/without caffeine in Egyptian patients with hepatitis C virus. Eur J ClinPharmacol. 2016;72(5):573-82.

Hadi AA, Hindawi AE, Hareedy A, Khalil H, Ashiry RA, Elia S, Sadek A, Magdy M, Atta R, Anas A, Bakr H, Hammam O. Her2/neu Protein Expression and Oncogene Amplification in Gastric Carcinoma with Clinico-Pathological Correlation in Egyptian Patients. Open Access Maced J Med Sci. 2016;4(4):535-42.

Akl M, Hindawi AE, Mosaad M, Montasser A, Ray AE, Khalil H, Anas A, Atta R(3), Paradis V, Hadi AA, Hammam O. Fibrosis in Chronic Hepatitis C: Correlation between Immunohistochemically-Assessed Virus Load with Steatosis and Cellular Iron Content. Open Access Maced J Med Sci. 2016; 4(4):578-84

Dabbous HM, Montasser IF, Sakr MA, Refai R, Sayam M, Abdelmonem A, Sayed H, F Abdelghafar M, Bahaa M, S Elmeteini M. Safety, Efficacy, and Tolerability of Sofosbuvir and Ribavirin in Management of Recurrent Hepatitis C Virus Genotype 4 After Living Donor Liver Transplant in Egypt: What Have We Learned so far? Hepat Mon. 2016; 16(5):e35339.

El-Ghannam MT, Hassanien MH, El-Talkawy MD, Saleem AAA, Sabry AI, Abu Taleb HM. Performance of Disease-Specific Scoring Models in Intensive Care Patients with Severe Liver Diseases. J ClinDiagn Res 2017; 11(6):OC12-OC16.

Hassan RM, Khorshed SE, Ibrahim RA, Sabry O, Abdel Rahim A, Mashaal AR, 2Amgad Anas, Abdel Aziz A, Abdel Moneam M. Lens Culinarisagglutinin reactive 3 alpha fetoprotein as a diagnostic serum marker for hepatocellular carcinomawith normal alpha fetoprotein level. AdvBiol Res. 2017; 11 (4): 212-20

Hammam O, Magdy M, Anas A, Rahim AA, Heedaya M, Helmy A. Expression of hnRNP Kand Claudin-4 in HCV-InducedEarly HCC and Adjacent Liver Tissue. Open Access Maced J Med Sci. 2017;5(5):595-602.

Rozeik MS, Hammam OA, Ali AI, Magdy M, Khalil H, Anas A, Abo El Hassan AA, Rahim AA, El-Shabasy AI. Evaluation of CD44 and CD133 as markers of liver cancer stem cells in Egyptian patients with HCV-inducedchronicliverdiseases versus hepatocellularcarcinoma. Electron Physician 2017;9(7):4708-17.

Mourad L, El-Ahwany E, Zoheiry M, Abu-Taleb H, Hassan M, Ouf A, Rahim AA, Hassanien M, Zada S. Expression analysis of liver-specificcirculatingmicroRNAs in HCV-inducedhepatocellularcarcinoma in Egyptian patients.Cancer BiolTher 2018; 15:1-7.

AbdElRahim AY, Fouad R, Khairy M, Elsharkawy A, Fathalah W, Khatamish H, Khorshid O, Moussa M, Seyam M. Efficacy of carvedilol versus propranolol versus variceal band ligation forprimaryprevention of varicealbleeding.Hepatol Int. 2018; 12(1):75-82.