Menu
Endoscopy
Holy Family Hospital is providing basic upper GI Endoscopic services for more then 24 years. With the establishment of Center Liver and Digestive Diseases be services as further evolved not only to worlds to patients benefits but also improved training services for the health care community.
The center has set a bench mark by introducing the first of its kind Endoscopy Diploma Courses for Doctors and Nursing Staff. About 3200 procedures have been performed in 2023, 2300 in 2024 and more than 3500 cases including diagnostic as well as therapeutic UGI Endoscopies have been performed in the year 2024 respectively. The center provides its UGI endoscopic services 6 days a week and on call team is available round the clock, 24/7 for Emergency procedures.
Colonoscopy
Colonoscopy is a common GI procedure. It is Diagnostic as well as therapeutic day care Procedure with utmost importance in screening and surveillance of colon cancer.
At CLD, 734 colonoscopies performed in 2023, more than 400 in 2024 whereas during the year 2024, underwent colonoscopy, which is the highest number in the last 5 years.
In 2023 out of the total 734 were 411 Male and 323 were Females. The most common indication was per rectal bleed and the commonest positive finding was hemorrhoids followed by growth and polyp. 231 patients didn’t reveal any abnormality and cecal intubation was successful in 313 patients only.
The audit report suggests a more intense supervised approach in the colonoscopy to improve the success rate and avoid chances of missing any lesion.
ERCP
ERCP developed in 1960 as a pacreaticobility diagnostic procedure. ERCP has recently evolved as a therapeutic procedure only. Our center in now performing an average of 700-800 procedures per year. The number subsequently rise to 682 in 2023 and 487 in 2024 respectively.
Commonest indication is choledocholithiasis, stenting was performed in 157 patients with 10 FR x 10cm plastic stent is the commonest stand used at our center this year. Overall success rate was 88% and in 70% of the cases the cannualation time was <3 minutes.
EUS
EUS is a novel minimally invasive technique with very limited availability in Pakistan. Our center is one of the oldest center providing this facility free of cost in public sector of Pakistan. More than 1700 patients took advantage of this procedure since its availability in our center. Our center has also the availability of onsite Histology by consultant histopathologist. The number again raised year to year.
Manometry
Incidence of esophageal motility disorders in patients with dysphagia and chest pain ranges from 25% to 63%. The gold standard diagnostic tool is high resolution impedance manometry. It is a diagnostic modality with limited availability in Pakistan and center for liver and GI diseases, holy family hospital Rawalpindi is the first public sector hospital which has an experience of more than 9 years in conducting this procedure. During the COVID year 34 patients were entertained following all precautionary measures. The number improved to 84 in 2023. And 49 in 2024. In the year 2022 our motility lab underwent upgradation with the latest HRM system and software’s. In 2022 our center also started motility services for anorectal disorders. Achalasia remained the commonest diagnosis. Most of the achalasia patients under went pneumatic dilation successfully at our center and are being followed up in the dedicated motility disorder clinic on every Wednesday. The center is also providing patient support program for Achalasia cases through social media platform https://www.facebook.com/Achalasia-Support-Group-Pakistan-108419877757357/
Fibro Scan
Liver biopsy has long been the gold standard to stage fibrosis, however over the last decade it has been replaced by the non-invasive technique, that works by measuring shear wave velocity. Reliability and reproducibility have been well characterized for elastography with Fibro scan, and it is important to ensure that these technical requirements are achieved to make the scan results valid. Particularly, a valid result requires 8—10 measurements with a 60% success rate and an interquartile range (IQR) less than 0.3.
Our center was the first public sector to start this facility. This year the equipment has been upgraded to Echosens 502 that apart from liver stiffness measurement can also determine steatosis quantification.
RFA
Phototherapy
The Phototherapy Clinic at CLD, Holy Family Hospital, is the first
of its kind in Pakistan to provide photobiomodulation and
photodynamic therapy in the public sector. Using indigenously
developed laser technology, we offer free, cutting-edge light-
based treatments, including Photobiomodulation and
photodynamic therapy for various conditions. Our mission is to
make advanced photomedicine accessible, safe, and patient-
centered.
Hepatitis Clinic
Hepatitis clinic is the most organized and well established clinic, that has been serving even before the development of center for liver and digestive diseases. The dedicated clinic enroll all new cases of hepatitis C and B patients and continued the services with same zeal and fervor even during the COVID era, hence the numbers remain the same with an average enrolment of about 3500 new cases a year. Maintain their data and follow-up. Provide them the free medications through Punjab Hepatitis Prevention program of Government of Pakistan. The clinic also provides vaccination services to the patients and their families.
HCC Clinic
Pakistan being the most prevalent country for Hep C therefore the incidence of HCC is remarkably high and with better availability and easy access to radiological mortalities more and more HCC cause are being reported. HFH has its own CT Scan and MRI facilities. Center for liver and diagnostic disease also has the facility of RFA. A dedicated HCC clinic entertains the patients on every Friday. After formal enrollment and data entry each case is individually discussed in MDM meeting to decide for the best therapeutic modality. Most of the patients are diagnosed late with a BCLC stage C and are thus offered systemic chemotherapy. Our center is also offering RFA for stage appropriate cases.
Mission Statement
Our mission is to provide comprehensive,
patient-centered care for individuals with
hepatocellular carcinoma through timely
diagnosis, advanced treatment options,
and compassionate support. We are
committed to improving survival
outcomes and enhancing quality of life by
integrating cutting-edge therapies,
multidisciplinary expertise, and evidence-
based practices.
Vision Statement
To be a leading and one of the old
regional center of excellence in
hepatocellular carcinoma care,
recognized for innovation, holistic
management, and collaboration,
striving toward early detection,
effective treatment, and ultimately,
reducing the burden of liver cancer in
our community.
IBD Clinic
Established in 2015, the IBD Clinic at the Center for Liver
and Digestive Diseases, Holy Family Hospital, provides
structured care for patients with inflammatory bowel
disease. Each patient is formally registered with an MR
number, assigned a dedicated medical file, and issued
a treatment card to ensure consistent
documentation and follow-up.
Inflammatory bowel disease has become a global disease with accelerating incidence in newly industrialized countries where societies are being westernized with a prevalence of 0.3%. However, the incidence varies from region to region. Furthermore, there is variability in the incidence of crohn’s disease and ulcerative colitis. Center of Liver and digestive diseases has taken a step forward and established a dedicated IBD clinic. So far 261 patients have been enrolled and are in follow up. In 2022, 24 new patients enrolled out of which 2 patients had crohn’s disease. Most of the patients are of Punjabi descend. Maximum patients responded with Sulfasalazine and Azathioprine (+steroids).
Pancreatitis Clinic
The Pancreatic Clinic at the Centre for Liver and Digestive Diseases, Holy Family
Hospital, Rawalpindi, was established in March 2022 and inaugurated on 3rd
March 2022 with the gracious presence of a galaxy of legendary
gastroenterologists.
The clinic is supervised by Dr. Aqsa Naseer, Consultant Gastroenterologist, who
has a special interest in pancreatic disorders with over four years of dedicated
experience in their management. She is currently pursuing a PhD in
Gastroenterology with research focused on the pancreas, bringing both
academic and clinical expertise to the care of her patients
In the year 2022 Center for Liver & digestive diseases have successfully launched a dedicated Pancreatitis clinic, offering its services once weekly on every Tuesday. 208 patients have already been registered with maximum number presenting as acute pancreatitis.
Hepatobiliary Clinic
Mission
To deliver
compassionate,
evidence-based, and
comprehensive care for
patients with liver,
gallbladder, and biliary
disorders.
Vision
To be a leading center
of excellence in
hepatobiliary care,
advancing patient
outcomes through
innovation, expertise,
and education.
MASLD Clinic
The MASLD Clinic was established in October 2024 with the aim of
providing specialized care for patients with MASLD, MASH, and
related metabolic disorders. Our focus is on early diagnosis, lifestyle
modification, and evidence-based medical management. The clinic
also serves as a center for patient education and clinical research to
improve outcomes in fatty liver disease
Gastroentrology Ward
Centre for liver and Digestive Diseases has established its own 14 bedded Indoor ward since March 2017. With a total of 852 patients in 2022, our unit has admitted approx. 80 plus patients per month. The total number of inpatient days were 3588 whereas the bed occupancy rate was 70.21%.
Maximum burden of Indoor patients, depicting more serious illness, ranges from 40 to 60 years of age group and males are predominantly involved. This is the age group providing main economic support to their families. Being most prevalent country in Hepatitis C, the picture is aptly depicted through our data with DCLD being the commonest diagnosis followed by obstructive jaundice and acute pancreatitis.
Emergency
Gastroenterology department provides round the clock emergency services to the GI patients, seven days a week. In the COVID year there was some decline in the ER cases, which reverted back in year 2021-22.
3805 patients have already been registered with maximum in Emergency Department.
Upper GI bleed is the commonest emergency dealt by Gastroenterology team on floor, followed by encephalopathy and pain abdomen. ER mortality is about 2.2%.
OPD
Gastroenterology department apart from its specialized clinics, provides OPD services for patients 3 days a week. During the COVID years there was a relative decline in the GI OPDs, however in 2023 once the limitations were off the number increased to more than 8000. The commonest presentation is dyspepsia followed by decompensated liver disease follow-up. The age group with most foot falling is between 40-50 years.
Our department also extends the OPD services through its specialized clinics as follows:
- Hepatitis Clinic
- IBD clinic
- Pancreatitis Clinic
FCPS
- The Centre was recognized for FCPS Training in 2014.
- Total number of trainees to have registered for FCPS part 2 training till date: 27
- Number of trainees who have cleared FCPS part 2 exam: 18
MD
- The Center was recognized for MD Training in 2008, affiliated with UHS.
- In 2017, when RMU was established, the university started its own MD program.
- Total number of trainees to have registered for MD training till date: 13
- Number of trainees that have cleared part 2 exam: 4
