Hepatology

 

The Exeter Liver Centre provides care for all aspects of liver disease for patients across Exeter and East Devon, as well as offering some services to patients in North Devon and Somerset.

We aim to provide a patient-centred and responsive service. We are actively involved in research and both undergraduate and postgraduate teaching.

We treat patients with a range of conditions, including non-alcoholic fatty liver disease, alcohol-related liver disease and viral hepatitis.

More on what we do

We see patients with a range of conditions, such as:

  • Autoimmune liver diseases
  • Autoimmune hepatitis
  • Primary biliary cholangitis
  • Primary sclerosing cholangitis
  • Metabolic and inherited liver diseases
  • Haemochromatosis
  • Wilsons disease
  • Alpha 1 antitrypsin disease
  • Hepatobiliary disease
  • Liver cirrhosis/portal hypertension and its complications
  • Non-cirrhotic portal hypertension
  • Hepatocellular carcinoma
  • Patients who require or who have undergone liver transplantation
  • Patients with end-stage liver disease who are not suitable for liver transplantation

Outpatient services:
We run liver clinics on most days from the medical outpatients department in Wonford. These include general consultant clinics, subspecialty clinics, nurse led clinics for patients with stable cirrhosis or viral hepatitis and fibroscan clinics. There are monthly clinics run with the enhanced supportive care team (including physiotherapy, occupational therapy and palliative medicine) for patients with advanced liver disease. We also run quarterly joint liver transplant clinics with London's Kings College Hospital alongside our partners in University Hospitals Plymouth.

Inpatient care:
Patients who are admitted either electively or as an emergency are cared for on Okement ward, a specialist environment for the management of patients with liver and gastrointestinal disease.

Day-case services:
Our day-case services are provided in the Wynard ambulatory unit (located in the Centre for Women’s Health), and are available on weekdays. The procedures most commonly performed are paracentesis (drainage of ascites) and intravenous infusions.

Multidisciplinary care:
We run regular specialist multidisciplinary meetings for patients with advanced liver disease, liver cancer and autoimmune liver disease. This gives patients with more complex conditions a breadth of expertise throughout their treatment. We are a hub centre for second line primary biliary cholangitis (PBC) therapies, including obeticholic acid.

Treatments

Endoscopy:
Endoscopy involves the insertion of a long, thin tube directly into the body to observe an internal organ or tissue in detail.

We run specialised endoscopy lists for patients with portal hypertension and have advanced endoscopic facilities, including endoscopic ultrasound, ERCP and spyglass for patients with complex hepatobiliary disease.

Portal hypertension/varices lists: Wednesday mornings (am)

Specialist biliary endoscopy (including ERCP, endoscopic ultrasound, spyglass): Mondays, Wednesdays and Fridays

Interventional Radiology:
This a medical specialisation which involves performing a range of procedures to obtain images of the inside of the body.

Our interventional radiology service carries out biopsies, drainage procedures and loco-regional therapies for patients with hepatocellular carcinoma.

Patients who are undergoing day-case procedures are managed via the Wynard Ambulatory Unit, whilst patients who require admission are cared for on Okement ward.

Our team

Dr John Christie, Lead Clinician for Gastroenterology and Hepatologyist

Dr Ben Hudson, Consultant Hepatologist

Dr Lin Lee Wong, Consultant Hepatologist

Dr Jane Chalmers, Consultant Hepatologist

Dr Christina Levick, Consultant Hepatologist

Laura Strang, Lead Hepatology Nurse

Sophie Bamforth, Hepatology Specialist Nurse

Louise Dunn, Lead Alcohol Liaison Nurse

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Level 2, Area F

Contact us

The departmental secretaries’ offices are based in Room 206, Area B, Level 2 and Room D187, West Area, Medical Outpatient Department.

Nurse Specialists: 01392 406108

Dr Christie’s secretary: Jinette Newns, 01392 402791

Dr Wong’s secretary: Claire Andrews, 01392 404615

Dr Hudson’s secretary: Joanna Vigers, 01392 408088

Community services

We run twice weekly, nurse-led, community outreach services for our more vulnerable patients. This includes a weekly clinic for patients resident in Exeter prison, and a weekly outreach clinic in partnership with The Clock Tower surgery, which serves homeless and vulnerably housed patients within Exeter.

Children and young people

Patients moving from paediatric services are reviewed in conjunction with the child health team to ensure a smooth transition to adult services.

Clinics

Consultant clinics:

  • Dr Hudson and Dr Wong – Tuesday pm and Thursday am
  • Dr Christie – Tuesday pm and Wednesday am

Specialist nurse and Fibroscan clinics: Daily

Community outreach: Tuesday and Thursday am

Enhanced supportive care clinics/advanced liver disease clinics: Monthly

Supporting you

There is a specialist nurse helpline, available to all patients under our care. This is staffed Monday-Friday, 9am-5pm. If we are unavailable, there is an answerphone service and we will endeavour to respond to all calls within three working days. This line should not be used for urgent queries or medical emergencies.

You can also call the Liver Nurse Helpline, a nurse specialist helpline, on 01392 406108.

Exeter Liver Support Group:
This group meets every second Tuesday of the month at 6.30pm in the medical outpatients department, level 1 Area D. Family members are welcome. This is an excellent opportunity to learn more about liver disease and meet people who might have a similar problem. It can also be a platform to make suggestions or provide support for our local liver services. This is always attended by members of the hepatology team.

The support group is affiliated with the British Liver Trust. If interested feel free to ask one of our consultants, specialist nurses or secretaries for details.

Information for healthcare professionals

An online advice and guidance system is available to local GPs which is answered on a Monday-Friday basis.

Routine GP referrals should be made via DRSS, with urgent referrals via the fast-track system.

Guidelines for management of patients with abnormal LFTs in the community can be found on the Devon Formulary.

 

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