Specialized Hepatology & Biliary Care
Liver & Gallbladder Conditions
Comprehensive clinical protocols for Fatty Liver (NAFLD/NASH), Liver Cirrhosis, Viral Hepatitis, and Gallbladder/CBD Stones. Overseen by Dr. Randeep Rana at Max Smart Super Speciality Hospital, Saket, New Delhi.
Same-DayFibroScan & CAP Fat Score
Non-InvasivePainless Ultrasound Elastography
ERCP ProtocolIncisionless CBD Stone Removal
AIIMS & PGIMERAcademic Clinical Rigor
Jump To Heading:Fatty Liver DiseaseLiver Cirrhosis & AscitesChronic Hepatitis B & CGallbladder & Common Bile DuctAlcoholic Liver DiseaseLiver Tumors & Cholangiocarcinoma
Heading 01
Fatty Liver Disease (NAFLD & NASH)
Non-Alcoholic Fatty Liver Disease (NAFLD) occurs when excess fat accumulates in liver cells (steatosis). If untreated, it can advance to NASH (inflammation), progressive fibrosis, and irreversible cirrhosis.
Symptoms & Warning Signs
- Chronic fatigue, sluggishness, and persistent midday exhaustion
- Dull ache or heaviness in the right upper abdomen
- Elevated liver enzymes (SGPT / SGOT) on routine health checks
- Often completely silent with zero noticeable symptoms until advanced
Diagnostic Workup
- In-House FibroScan (CAP score for fat percentage + kPa for liver stiffness)
- High-Resolution Abdominal Doppler Ultrasound
- Comprehensive Liver Function Tests (LFT) & Lipid Profile
- Metabolic screening for insulin resistance, HbA1c, and dyslipidemia
Treatment & Protocol
- Quantitative FibroScan fat score monitoring every 6 months
- Clinically structured hepatoprotective dietary and exercise protocols
- Targeted metabolic stabilization and insulin sensitizers
- Gradual 7-10% body weight loss to achieve documented steatosis reversal
Protocol curated by Dr. Randeep Rana(AIIMS & PGIMER Trained, Max Smart Hospital)
Heading 02
Liver Cirrhosis & Ascites
Cirrhosis represents advanced scarring and stiffening of liver architecture resulting from chronic inflammation. Major complications include abdominal fluid build-up (ascites), portal hypertension, and variceal bleeding.
Symptoms & Warning Signs
- Swelling in abdomen (ascites) and lower legs (pedal edema)
- Yellowish discoloration of skin and eyes (jaundice)
- Vomiting of blood (hematemesis) or dark tarry black stools (melena)
- Confusion, forgetfulness, or inverted sleep cycles (hepatic encephalopathy)
- Easy bruising and bleeding tendencies
Diagnostic Workup
- Transient Elastography (FibroScan) kPa stiffness quantification
- Diagnostic abdominal paracentesis (fluid analysis for infection / SBP)
- Upper GI Screening Endoscopy for esophageal and gastric varices
- Multiphasic contrast CT / MRI abdomen to monitor for hepatocellular carcinoma
Treatment & Protocol
- Endoscopic Variceal Band Ligation (EVL) for active bleeding and prophylaxis
- Evidence-based simvastatin therapy to improve post-bleed survival
- Sodium-restricted clinical nutrition and targeted diuretic therapy
- Comprehensive pre-transplant assessment and hepatic decompensation care
Protocol curated by Dr. Randeep Rana(AIIMS & PGIMER Trained, Max Smart Hospital)
Heading 03
Chronic Hepatitis B & C
Viral hepatitis B and C cause persistent, silent liver inflammation that can quietly progress to cirrhosis or hepatocellular carcinoma over decades if left unmonitored.
Symptoms & Warning Signs
- Flu-like symptoms, low-grade fever, and generalized joint aches
- Mild nausea, loss of appetite, and aversion to fatty food
- Persistent fatigue and reduced physical stamina
- Late signs: dark urine, clay-colored stools, and jaundice
Diagnostic Workup
- Hepatitis B Surface Antigen (HBsAg) & Anti-HCV antibody serology
- Quantitative Viral Load (HBV DNA / HCV RNA PCR)
- FibroScan elastography to stage existing liver fibrosis
- Family and household screening protocols
Treatment & Protocol
- Direct-Acting Antivirals (DAAs) for Hepatitis C with >95% cure rates
- Long-term potent oral antivirals (Tenofovir / Entecavir) for Hepatitis B
- Every 6-month ultrasound and Alpha-Fetoprotein (AFP) cancer screening
- Vaccination guidance and counseling for uninfected family members
Protocol curated by Dr. Randeep Rana(AIIMS & PGIMER Trained, Max Smart Hospital)
Heading 04
Gallbladder & Common Bile Duct (CBD) Stones
Gallstones form when bile hardens into crystal-like stones. When a stone slips into the common bile duct, it obstructs bile flow, triggering biliary colic, obstructive jaundice, or life-threatening pancreatitis.
Symptoms & Warning Signs
- Sudden, intense cramping pain in right upper abdomen radiating to back/shoulder
- Pain typically triggered after eating heavy, fatty, or fried meals
- Nausea, bilious vomiting, and high-grade fever with chills (cholangitis)
- Yellowish discoloration of eyes (obstructive jaundice) and dark urine
Diagnostic Workup
- High-definition ultrasound of gallbladder and biliary tree
- MRCP (Magnetic Resonance Cholangiopancreatography)
- Serum Bilirubin, Alkaline Phosphatase, SGOT/SGPT, and Pancreatic Enzymes
Treatment & Protocol
- Emergency ERCP (Endoscopic Retrograde Cholangiopancreatography) to extract CBD stones without open surgery
- Endoscopic sphincterotomy and biliary stent placement for jaundice drainage
- Referral for elective laparoscopic cholecystectomy for gallbladder clearance
- Complete avoidance of severe biliary sepsis and gallstone pancreatitis
Protocol curated by Dr. Randeep Rana(AIIMS & PGIMER Trained, Max Smart Hospital)
Heading 05
Alcoholic Liver Disease (ALD)
Regular heavy alcohol intake causes a progressive spectrum of liver injury: from alcoholic fatty liver to acute alcoholic hepatitis and irreversible alcoholic cirrhosis.
Symptoms & Warning Signs
- Loss of appetite, morning nausea, and persistent fatigue
- Upper right quadrant abdominal tenderness and liver enlargement
- Severe jaundice, high fever, and abdominal fluid accumulation in acute hepatitis
- Tremors, altered sleep patterns, and memory lapses
Diagnostic Workup
- Liver Function Tests (AST typically twice the level of ALT with elevated GGT)
- Ultrasound and FibroScan quantification of liver fibrosis
- Nutritional and vitamin deficiency profiling
Treatment & Protocol
- Strict medically supervised alcohol cessation protocols
- High-protein, high-calorie clinical nutrition and micronutrient repletion
- Corticosteroid therapy for severe acute alcoholic hepatitis (MDF score > 32)
- Antioxidant and hepatoprotective support for cell membrane stabilization
Protocol curated by Dr. Randeep Rana(AIIMS & PGIMER Trained, Max Smart Hospital)
Heading 06
Liver Tumors & Cholangiocarcinoma
Liver tumors include benign lesions (hemangiomas, adenomas) and malignant tumors (Hepatocellular Carcinoma / HCC or Cholangiocarcinoma of the bile ducts). Early detection is critical for curative outcomes.
Symptoms & Warning Signs
- Unexplained rapid weight loss and severe loss of appetite
- Persistent dull pain or palpable mass in upper right belly
- Sudden worsening of jaundice or ascites in a previously stable cirrhotic patient
- Itching, pale clay-colored stools, and dark amber urine
Diagnostic Workup
- Triple-phase dynamic contrast CT or dynamic liver MRI
- Serum Alpha-Fetoprotein (AFP) and CA 19-9 tumor markers
- Endoscopic Ultrasound (EUS) with fine-needle biopsy for deep biliary staging
- Multidisciplinary tumor board evaluation for curative resection
Treatment & Protocol
- Surgical resection or liver transplantation evaluation for early localized tumors
- Transarterial Chemoembolization (TACE) and Radiofrequency Ablation (RFA)
- Endoscopic biliary stenting to relieve bile duct blockages
- Targeted immunotherapy and systemic oncological care
Protocol curated by Dr. Randeep Rana(AIIMS & PGIMER Trained, Max Smart Hospital)
Max Smart Super Speciality Hospital, Saket, New Delhi
Take the First Step Towards Digestive Wellness
Consultant Gastroenterologist, Hepatologist & advanced endoscopist at Max Smart Saket