Hepatology

We provide patients with the following investigative services:

• endoscopic diagnosis and treatment of oesophageal and gastric varices
• endoscopic retrograde cholangiopancreatography (ERCP) – gallstone removal from the bile duct
• percutaneous biliary drainage (PTC) – for blocked bile ducts
• laparoscopic cholecystectomy/open cholecystectomy – gallbladder removal
• biliary and pancreatic endoscopic ultrasound (EUS)
• transcatheter arterial chemoembolisation (TACE) for liver tumours
• hepatic venous wedge pressure (HVWP) measurements
• fibroscan – a non-invasive method of assessing liver fibrosis

We have a dedicated 29-bed Gastroenterology and Liver Unit at the Royal Cornwall Hospital where we look after patients with liver, bile duct and pancreatic diseases.

We usually admit patients through the Acute Medical Unit and we look after patients who are coming in for procedures such as percutaneous biliary intervention (for a blocked bile duct) or TACE (for liver tumours).

Our alcohol liaison service helps alcohol-dependent patients with a variety of health conditions. The service is led by three alcohol liaison nurses. Our support includes:

• assessing patients for alcohol misuse and harmful or hazardous drinking behaviours
• interventions for patients who are admitted to other departments
• 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
• helping patients manage alcohol-related brain injury
• access to local alcohol support services
• rapid transfer to detoxification facilities

Contact the alcohol liaison nurses

07557 215449
Every day from 8am to 4pm

We work with Addaction to treat patients with hepatitis C. This includes services in the community from a specialist nurse and fibroscan for HCV assessment. In some cases, we may treat you at home.

Our service includes input from doctors, rehabilitation units, detoxification services, probation services and housing providers.

The hepatobiliary and pancreatic (HBP) cancer team looks after patients who have, or who are suspected of having, cancer of the bile duct, gallbladder, liver or pancreas.

You may have been referred to us through your GP, our jaundice hotline clinic or acute hospital admissions.

Our team includes hepatology staff, endoscopists, HBP cancer nurses and oncologists. We work closely with the HBP team at Derriford Hospital, and meet weekly to discuss patients who could benefit from curative therapy.

Contact the HBP cancer nurses

01872 252177
07920 786435
Monday to Friday from 9am to 4pm.

We see a range of patients at our general clinics, including those with:

• alcohol- and non-alcohol-related liver disease
• liver cirrhosis and its complications
• inherited and metabolic liver disease including Wilson’s disease, alpha-1-antitrypsin deficiency (AATD), haemochromatosis and glycogen storage diseases.)
• autoimmune-related liver disease including primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), autoimmune hepatitis and immunoglobulin G4-related disease (IgG4)
• gallbladder disease

Clinic times and locations

Bodmin Community Hospital	Monday	2pm
Royal Cornwall Hospital, Truro	Tuesday	2pm
St Austell Community Hospital	Wednesday	9am
Royal Cornwall Hospital, Truro	Wednesday	9am
Royal Cornwall Hospital, Truro	Alternate Thursdays	9am
St Austell Community Hospital	Thursday	9am
West Cornwall Hospital, Penzance	Thursday	2pm
Camborne and Redruth Community Hospital	Friday	1.30pm

You may be invited to attend one of our hot hepatobiliary clinics if:

• You have recently been diagnosed with cancer of the liver, bile duct or pancreas, so that we can discuss your diagnosis, and how best we can manage or treat your cancer.
• You have recently been diagnosed with decompensated cirrhosis, so that we can follow up with you after you’ve been discharged from hospital.
• You have acute decompensation, so that we can manage your condition without you needing to be admitted to hospital.
• You are a transplant patient, so that we can review you.

Clinic times and locations

Royal Cornwall Hospital, Truro	Wednesdays	10am
Camborne and Redruth Community Hospital	Wednesdays	2pm

At our viral hepatology clinics, we see patients with hepatitis B and C. The clinics are nurse-led and coordinate with the weekly viral hepatology multidisciplinary team meetings each week.

Clinic times and locations

Royal Cornwall Hospital, Truro	Thursdays	9am
Camborne and Redruth Community Hospital	Fridays	1.30pm

A fibroscan is a type of ultrasound that can measure the degree of inflammation and 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.

Fibroscan clinic times and locations

Royal Cornwall Hospital, Truro	Tuesdays, Wednesdays and Fridays	Afternoon
West Cornwall Hospital, Penzance	Thursdays	Afternoon
Camborne and Redruth Community Hospital	Fridays	Afternoon

Our jaundice hotline clinics are for patients with acute jaundice. The clinic allows us to assess and manage your jaundice in one day. After your GP has referred you, we’ll aim to see you within two weeks.

When you arrive at the clinic, we’ll do blood tests and an ultrasound. Once your results are ready, you’ll discuss them with a consultant and if you need further investigations, such as a CT scan, we can arrange that for you the same day.

Jaundice Hotline clinic time and location

Royal Cornwall Hospital, Truro

Tuesdays

10am

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.

Clinic location

Day-case paracentesis takes place at the Medical Day Unit at the Royal Cornwall Hospital in Truro, Monday to Friday.

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.

You can find out more about the different procedures in these patient information leaflets:

• Endoscopic Ultrasound
• Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
• Varices banding or injection

If you need more information or to change your appointment, please call 01872 252616 between 8am to 4pm, Monday to Friday.

We help haemochromatosis patients reduce liver damage using a procedure called venesection or phlebotomy. It reduces the amount of iron in your body and helps to relieve some of your symptoms.

Haemochromatosis clinic times and locations

The clinic takes place at the Medical Day Unit at Royal Cornwall Hospital in Truro on Thursdays.

Specific liver conditions

• Autoimmune hepatitis
• Budd-Chiari syndrome (BCS)
• Cirrhosis
• Gilbert’s syndrome (GS)
• Haemochromatosis
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Intrahepatic cholestasis of pregnancy (ICP)
• Liver cancer
• Primary sclerosing cholangitis (PSC)

Advice on living with liver disease

• Alcohol and liver disease
• Diet and liver disease
• Living with liver disease

Consultant Hepatologists

Dr Hyder Hussaini
Secretary to Dr Hussaini: Jo Stonehouse – 01872 252708

Dr Bill Stableforth
Secretary to Dr Stableforth: Rebecca Watts – 01872 253027

Hepatology Nurse Consultant

Liz Farrington
Secretary to Liz Farrington: Jill Braham – 01872 253858

Clinical Nurse Specialist

Mary McKenna
Secretary to Mary McKenna: Pauline Collis – 01872 253592

Viral Hepatitis Specialist Nurse

Keely Lane

Clinical Nurse Specialist (community viral hepatitis)

Helen Hampton

Alcohol liaison team

Toni Edwards
Jenna Davies
Hannah Leruez
Lee Derrick (Addaction hospital outreach team)

Hepatobiliary Cancer Nurse

Lisa Nicolls

Fibroscan Technicians

Helen Salmon
Louise Johns

Hepatology Research Nurses

Belinda Wroath
Fiona Hammonds

Ward Manager – Gastroenterology and Liver Unit

Glyn Belt

Ward Manager – Medical Day Unit

Kim Hicks

Interventional Radiology Lead Nurse

Zoe Martin

Interventional Consultant Radiologists

Dr John Hancock
Dr Andrew Edwards
Dr Richard Morse
Dr Angie Rodgers
Dr Alex Durran

Cancer Specialists

Dr Richard Ellis
Dr Charlotte Thompson

Secretary for Jaundice Hotline

Louise Such – 01872 252717

End of Life Lead Consultant

Dr Caroline Campbell

End of Life Lead Nurse

Liz Thomas

Dietitians

Emma Lamarti
Karen Crudington

Hepatology wards and units

• Gastroenterology and Liver Unit
• Endoscopy Unit
• Medical Day Unit
• Interventional Radiology, Newlyn Unit

Hepatology fax number

01872 253889

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, autoimmune liver disease and Hepatitis E infection.

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’s funded by the National Institute for Health Research.

For further information about our clinical trials research please contact Amanda Datson, Research Project Manager on 01872 256420 or read more about how to get involved with clinical research in Cornwall.