• Endoscopic examination and treatment
• Osaka City Pancreatic Cancer Early Detection Project
• Gastrointestinal Mapping

Greetings

The Department of Gastroenterology is responsible for the diagnosis and treatment of various diseases of the digestive tract from the esophagus to the rectum, the biliary tract (gallbladder and bile duct), the pancreas, and the liver. Led by specialists in each field, we aim to provide early diagnosis through detailed examinations every day, as well as highly specialized and safe advanced medical care. As a regional hub hospital, we value cooperation with local doctors. If you have any concerns about digestive diseases, please feel free to contact us.

In addition to focusing on daily medical care, we also focus on training the next generation of medical professionals and conducting clinical research.Department of Gastroenterology, Kyoto UniversityAlthough it is an affiliated facility of the University of Tokyo, we welcome the participation of highly motivated young doctors from all over the country. If you are a medical student or a resident doctor and would like to visit,HerePlease apply from here.

Characteristics and Initiatives

• Endoscopic submucosal dissection (ESD) for early gastrointestinal cancer
• Endoscopic band ligation (EBL) for colonic diverticular bleeding
• Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA) for pancreatic and biliary tract cancer
• Various drainage procedures and stent placement for malignant biliary strictures
• Endoscopic treatment for bile duct stones and chronic pancreatitis
• Antiviral therapy for chronic hepatitis B and chronic hepatitis C
• Radiofrequency ablation (RFA) for hepatocellular carcinoma
• Diagnosis and treatment of ulcerative colitis and Crohn's disease
• Chemotherapy for gastrointestinal malignancies
• Nurturing the next generation of medical professionals and clinical research

About treatment

Gastrointestinal department

Endoscopic treatment for early gastrointestinal cancer

We perform precise endoscopic diagnosis using magnifying endoscopes and other instruments, and perform endoscopic submucosal dissection (ESD) for early-stage cancers of the esophagus, stomach, and large intestine. After endoscopic treatment, we compare endoscopic findings with histopathological images in an effort to improve our endoscopic diagnostic capabilities.

Diagnosis and treatment of gastrointestinal bleeding

We diagnose various types of gastrointestinal bleeding, including small intestinal bleeding, and perform hemostatic procedures primarily using endoscopes. For colonic diverticulum bleeding, we perform endoscopic band ligation (EBL), with favorable results. For gastrointestinal bleeding with an unknown source, we search for the source using double-balloon endoscopy or capsule endoscopy.

Palliative treatment for malignant gastrointestinal obstruction

For malignant gastrointestinal obstruction, we perform gastrointestinal stent placement as part of palliative care.

Biliary and pancreatic department

Diagnosis and treatment of pancreatic and biliary tract cancer

We aim to diagnose pancreatic and biliary tract cancers early through highly accurate imaging and endoscopic diagnosis. We perform histopathological diagnosis using techniques such as endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA), and work in collaboration with the Department of Gastroenterological Surgery to provide multidisciplinary treatment. We also undertake the latest endoscopic treatments, such as endoscopic papillectomy for ampullary tumors and transgastrointestinal biliary drainage for malignant biliary strictures using endoscopic ultrasound (EUS).

Additionally, with the aim of early diagnosis of pancreatic cancer, we are collaborating with six medical associations in the northern Osaka area (Kita Ward, Oyodo Ward, Miyakojima Ward, Higashiyodogawa Ward, Tennoji Ward, and Asahi Ward) and four general hospitals (Saiseikai Nakatsu Hospital, Osaka City General Medical Center, Yodogawa Christian Hospital, and Osaka Red Cross Hospital) to develop the "Early Pancreatic Cancer Project in the Northern Osaka Area."

Medical treatment for bile duct stones and chronic pancreatitis

We perform endoscopic lithotripsy for bile duct stones, stent treatment and pancreatic lithotripsy for chronic pancreatitis, and endoscopic ultrasound drainage for infected pancreatic pseudocysts.

Liver Division

Diagnosis and treatment of viral hepatitis

Controlling chronic hepatitis is important from the perspective of inhibiting progression to liver cirrhosis and preventing liver cancer, but with the rapid advances in antiviral therapy in recent years, we are entering an era of complete control of viral hepatitis. With the aim of inhibiting progression to liver cirrhosis and preventing liver cancer, we are actively implementing nucleic acid analog therapy for chronic hepatitis B and DAA (Direct-acting Antiviral Agent) therapy for chronic hepatitis C.

Treatment for hepatocellular carcinoma

For hepatocellular carcinoma, which is suitable for local treatment, we perform percutaneous puncture treatment (ethanol injection therapy, radiofrequency ablation therapy).In cases where it is difficult to visualize the lesion using only standard B-mode abdominal ultrasound, we use RVS (real-time virtual sonography) to display MPR images (virtual ultrasound images) of CT or MRI of the same cross section as the abdominal ultrasound in real time, in order to accurately visualize the lesion.If necessary, we also use an ultrasound contrast agent (Sonazoid).

For hepatocellular carcinoma that is not amenable to local treatment, transarterial chemoembolization (TACE) has traditionally been the primary treatment. However, in recent years, remarkable progress has been made in systemic chemotherapy, with the development of "molecular targeted drugs" that suppress the growth of cancer and the proliferation of blood vessels that nourish the cancer, and even "immunotherapy (immune checkpoint inhibitors)" that do not eliminate cancer with the drug itself but activate the patient's own immune system and use that immune power to eliminate cancer. At our department, we proactively introduce these new treatments in cases where we believe TACE will not be sufficiently effective or in cases with extrahepatic metastasis.

Department of Inflammatory Bowel Disease (IBD)

For mild to moderately active ulcerative colitis, we aim to induce remission with treatments that have relatively few side effects by actively introducing 5-ASA preparations, steroid preparations, and apheresis therapy. Meanwhile, for severe cases, we use immunosuppressants such as tacrolimus and TNF-α antibody preparations, striving to avoid total colectomy. Treatment for ulcerative colitis is evolving every year. Recently, antibody preparations with new mechanisms of action have been developed that prevent disease-causing lymphocytes from invading the large intestine, and we are working to introduce these new treatments if they are expected to be effective.

For Crohn's disease, rather than the strict nutritional therapy that is unique to Japan, we proactively use steroids, immunosuppressants, and anti-TNF-α antibody preparations, and have established a system in place that allows treatment on an outpatient basis while patients can continue their daily lives as much as possible.

Chemotherapy department

We provide perioperative and palliative chemotherapy for malignant tumors of the digestive system. For advanced cancer, we work with the Department of Gastroenterological Surgery and Radiation Oncology to provide multidisciplinary treatment, including chemotherapy. For patients with metastatic or postoperative recurrent cancer who are eligible for palliative chemotherapy, we also work with the Department of Palliative Care to strive to alleviate pain for the whole person.

Medical Treatment Results