The DHC Endoscopic Unit
is an outstanding facility. The trainee will develop expertise in the many procedures available in our specialty. These experiences include upper GI endoscopy, enteroscopy, and colonoscopy, injection and cautery treatment of GI bleeding, esophageal dilation techniques, laser use, endoscopic ultrasound, and liver biopsy. Our unit performs over 12,000 procedures per year. In addition, the biliary Endoscopy Service offers advanced biliary and pancreatic imaging, stenting, and stone removal, as well as biliary manometry and papillotomy. Training in the latter service is provided for selected Fellows in the third year who wish to gain this expertise.
This laboratory provides an opportunity for innovative investigation in gastrointestinal motility studies (esophagus, stomach, small bowel, colon, and rectosigmoid) with emphasis on intubation techniques, electrophysiology, and radionuclide studies. Other diagnostic procedures include breath tests for malabsorption as well as for diagnosis of bacterial overgrowth and Helicobacter pylori infection, secretin-stimulated gastrin, gastric acid secretory measurements, and esophageal pH and provocative stimulation tests for chest pain.
Experience in outpatient consultation is offered by benefiting from our 15,000 patient interactions each year. This is achieved both under faculty supervision, which allows the Fellow to see patients from each faculty member's clinic and which emphasizes different gastrointestinal disorders, as well as in long-term, fellows' continuity clinics conducted by the individual Fellows.
Hepatology experience is gained through rotation on the Digestive Health Hepatology Service with inpatient and consultative care on Medical and Surgical services as well as in outpatient clinics. There is close collaboration with an active Liver Transplant program, which performs over 75 transplants per year. A wide variety of acute and chronic liver diseases are encountered, and there is ample opportunity for involvement in patient management, including anti-viral therapy, endoscopic management, invasive radiologic intervention (such as TIPS) and close interaction with the Biliary Endoscopy Service. In addition, liver biopsy and large volume paracentesis are routinely performed. Excellent pathology expertise is available for review of liver and intestinal specimens. Fourth year training is also available in Transplant Hepatology.
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