Department of
Introduction Hepatobiliary
and Pancreatic
Breast Surgery,
Head and Neck
(Cluster Based)
Silver Team - Upper Gastrointestinal Surgery

L to R: Dr. Sam Wong, Dr. Karen Au Yeung, Dr. Carmen Chu, Dr. Frances Cheung (Team Head), Dr. Tony Cheung

Being one of the general surgical team, Silver team covers upper gastrointestinal surgery, vascular surgery

Upper gastrointestinal surgery concentrates on performing and evaluating various treatments for both benign and malignant diseases, will particular interest in developing minimally invasive surgery.

Our combined endoscopy unit and 24 hours Endo-lap theatre in the operating room facilitate our endoscopic submucosal dissection for early gastric cancer, laparoscopic or robotic assisted gastrectomy, video assisted thoracoscopic esophagectomy, anti-reflux surgery and bariatric surgery.

Upper GI Surgery

It provides investigations and treatments of upper GI problems, from peptic ulcer disease, functional disorders, and bariatric surgery to curative and palliative treatment of esophageal and gastric cancers. Peptic ulcer disease still has a high prevalence in Hong Kong and bleeding peptic ulcer is one of the commonest problems requiring admission. In our combined endoscopic unit, we offer endoscopic diagnosis and therapy for patients with bleeding peptic ulcer.

Twenty four hour emergency endoscopic therapy is supported by Endolap theatre in the operating room where unstable patients undergo endoscopic therapy. It has the advantages of support of the anaesthetists and no additional time delay when emergency operation required. Perforation is another complication of peptic ulcer disease. Our center pioneers the use of laparoscopic assessment and patch repair for perforated peptic ulcer.

This minimally invasive approach markedly reduces the access trauma. Our randomized controlled trial found that it is associated with less postoperative pain, reduced chest complications, shorter hospital stay and earlier return to normal daily activities compared with conventional open repair. Obstruction is another complication of peptic ulcer diseases. For those who failed medical therapy, laparoscopic gastrojejunostomy and vagotomy is a minimally invasive option providing symptom relief for benign obstruction.

Malignancy is an integral part of work of our team. Early gastric and esophageal cancers are diagnosed by endoscopic with assistance of chromoendoscopy and narrow band imaging, making less invasive therapy of cancer possible. Endoscopic submucosal dissection is offered to patients with early esophageal and gastric cancers according to extended criteria. This provides organ preservation, minimal morbidity while achieving high rate of tumor clearance.

For those patients with early cancer while not suitable for endoscopic resection, laparoscopic resection provides less access trauma to patients. Our center performs total and subtotal laparoscopic gastrectomy for gastric cancer and our comparative study showed the result of laparoscopic distal gastrectomy is comparable to traditional open operation.

For esophageal cancer, we perform thoracoscopic resection for a selected group of patients. This combined with laparoscopic gastric mobilization, and cervical anastomosis completed the operation with reduced access trauma. Radical surgery, with combined organ resection if necessary, is performed for those with advanced tumor without metastasis. Small peritoneal metastasis may be skipped by radiological imaging. Diagnostic laparoscopy is very sensitive in detecting peritoneal and small liver metastasis, avoiding futile exploratory laparotomy. It also offers a minimally invasive way of palliating malignant gastric outlet obstruction with laparoscopic gastrojejunostomy. In those patients with inoperable tumor causing obstruction, endoscopic stenting offers a fast and effective way of symptom palliation.

Gastroesophageal reflux and obesity—traditional western problems, has increasing prevalence in Hong Kong. Our center offers investigations and treatments for patients with gastroesophageal reflux disease with chronic recurrent symptoms or those with complications. Investigations include upper endoscopy, manometry and 24hr pH studies are provided in our combined endoscopy and electromedical diagnostic unit. Suitable candidates are offered laparoscopic fundoplication, which provides a safe and minimally invasive method of reducing gastric reflux symptom and medication use.

Obesity is another health hazard getting more and more prevalent among Asian people. Morbid obesity is associated with premature mortality and surgical intervention is the only treatment option proven to be effective in long term management of morbid obesity. We follow the Asian Pacific Bariatric Surgeons Association guideline for intervention: BMI > 37 or BMI >32 with diabetes or > 2 significant medical co-morbidities. Our Integrated Morbid Obesity Clinic provides advice and surgical treatment options for morbidly obese patients. Conventional open surgery is associated with high morbidity. Minimally invasive approach reduces the risk and we offer procedures from endoscopic insertion of intra-gastric balloon, laparoscopic gastric banding, laparoscopic sleeve gastrectomy.


Key Members

Dr. Tai Yuk Ping MBBS(Lond), FRCS(Ed), FCSHK, FHKAM
Part-time Consultant

Dr. Tai specializes in oesophageal and thoracic surgery. He is interested in thoracoscopic surgery and performed the first video-assisted thoracoscopic surgery in Hong Kong in 1992. He is also interested in bronchoscopic intervention, particularly cryotherapy and laser for obstructing tracheo-bronchial tumours.

Dr. Wong Wai Ho, Sam MBChB, FRCS(Ed), FHKAM
Associate Consultant

Dr. Wong is currently an Associate Consultant in the Department of Surgery, PYNEH. He graduated in the Chinese University of Hong Kong in 2001. Dr. Wong joined the Upper Gastrointestinal Team in PYNEH in 2014. He is a specialist in general surgery, with special interest in upper gastrointestinal surgery.

Dr. Chu Chik Wah, Carmen MBChB(CUHK), FRCSEd (Gen Surg), FCSHK, FHKAM
Associate Consultant

Dr. Chu graduated from the Chinese University of Hong Kong in 2007 and has completed her surgical training in PYNEH. She attained her fellowship in general surgery in 2014 and has joined the Upper GI team since 2015. Currently she is the associate consultant in upper GI team. She has vast interests in both endoscopy and minimal invasive surgery. In 2017, she undergone her training in endoscopic ultrasound (EUS) in Mumbai, India.