Gastroenterology in Grevenbroich: Prof. Dr Dirk Graf

Prof. Dr Dirk Graf is a specialist in gastroenterology and hepatology. He is Chief Physician of Gastroenterology at the Rhineland Clinic in Grevenbroich. At the Department of Gastroenterology and Oncology, Prof. Graf and his experienced team mainly care for patients with diseases of the abdomen including tumours.

The medical team has access to the most modern equipment and all essential endoscopic techniques for diagnostics and therapy. Their close collaboration with the specialist disciplines within the hospital enables an individual treatment concept to be created for each patient, based on the latest scientific findings. This ensures patient care at a high level and in a human environment.

Clinic for Gastroenterology and Hepatology in Rhein-Kreis Neuss

Prof. Graf and his team have excellent sonographic and endoscopic equipment available at the Clinic for Gastroenterology and Oncology in Grevenbroich near Cologne, which allows comprehensive diagnostics, treatment and prevention of diseases of the abdomen – especially the gastrointestinal tract, as well as liver, gallbladder and pancreas.

His areas of focus are sonographic and endoscopic diagnostics and therapy, as well as oncology. He attaches great importance to providing patients with sophisticated medical care. In order to ensure optimal all-round care, the clinic works closely with registered general practitioners and specialists in the vicinity.

Modern Therapeutic Approaches in Gastroenterology Using Latest-Generation Equipment

The gastroenterologists within the clinic make use of the latest diagnostic and therapeutic possibilities. Whenever necessary, they work together with radiologists, surgeons and oncologists. The high level of competence of the physicians at the Department of Gastroenterology and Oncology in Grevenbroich near Cologne and Dusseldorf enables a high-quality treatment and benefits patients with complex gastrointestinal diseases. The clinic has special endoscopes for treating tumour stenoses and for endoscopy of the bile ducts.

Endoscopic Diagnostics and Therapy

Particularly important for the gastrointestinal specialist Prof. Graf are endoscopy and ultrasound examination of the abdomen, as well as other imaging techniques. These methods allow the examination and treatment of diseases of the digestive system without surgery. 

With the help of a gastroscopy or colonoscopy, not only diagnosis is possible but also smaller incisions can be performed with the endoscopic technique. The medical team led by Prof. Graf has the ability to ablate tumours using a variety of techniques, to reactivate blocked portions of the gut. The methods include application of prostheses or stents, or stemming bleeding vessels. 

Narrow Band Imaging for Depicting Suspicious Regions

High-definition (HD) video endoscopy for gastroscopy and colonoscopy uses special filter techniques leading to improved diagnostics (narrow band imaging). This is an optical technology enabling clinicians to depict even the smallest vascular and mucosal areas and structures. By using only the wavelengths of light absorbed by haemoglobin, maximum contrast between blood vessels and surrounding mucosal areas is possible. This method produces sharper images of the capillaries as compared to traditional measures using white light facilitating the detection of cancer and the assessment of suspicious mucosal areas. In addition, it reduces the risk of any changes being overlooked.

Endosonography

Endosonography combines an endoscopic procedure with ultrasound in order for other organs to be detected from the inside, for example via the oesophagus, stomach or intestine, in addition to the wall assessment of the gastrointestinal tract. Other organs such as the pancreas, the bile tracts, the gallbladder and the adrenal glands can be made visible as well with this process. Depending on the problem at hand, the technique is much more sensitive than sectional imaging approaches like magnetic resonance imaging and computer tomography.

It is also possible to extract tissue samples from abnormal organ structures via endoscopic ultrasound, meaning more complex operations for collecting biopsies are avoided. Further fields of application include therapeutic methods for removing cysts from the pancreas or the drainage of congested bile ducts. The team around Prof. Dirk Graf has a high level of expertise at the highest technical level.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

An ERCP procedure can be used to assess, diagnose and treat the bile or pancreatic duct. This process depicts the gall bladder and the pancreas. The specialist pushes an endoscope – a hose-like, flexible examination device – through mouth and stomach into the small intestine and to the opening of the bile duct. By doing so, the gastroenterologist is able to display and assess the cavities of gallbladder ducts and pancreas.

ERCP is used to identify constrictions in the bile duct and/or pancreatic duct. Cause of these bottlenecks may be inflammation, gallstones or tumours. This method is particularly helpful when other diagnostic procedures, such as ultrasound or magnetic resonance cholangiopancreatography (MRCP) do not allow a clear diagnosis. 

In addition, ERCP is also suitable for treating diseases. For example, once diagnosis has been established, the specialist can immediately remove gallstones located near the opening of the bile duct or near the major duodenal papilla (sometimes called the papilla of Vater). It may be the case that the latter is too narrow and prevents natural discharge of gallstones or flow of the bile.

By means of a papillotomy, in which a small incision is made endoscopically, this constriction can be widened and the path for bile and gallstones cleared. Narrow spots near the papilla can be bridged and kept free by expanding a balloon or using tiny plastic or metal tubes.Finally, if a tumour is suspected, there is the possibility of taking tissue samples for diagnosis.

Simpler, Non-Invasive Assessment of Liver Stiffness

In addition, state-of-the-art equipment for shear wave elastography is available for non-invasive liver stiffness measurement. Liver diseases can be detected with surprisingly little complications using this non-invasive method, even in patients where ultrasound is difficult. Furthermore, it is extremely easy to administer and causes patients no pain. 

Oncology Specialist Clinic and Certified Bowel Cancer Centre

Cancers of the abdominal and digestive organs continue to increase as population ages. Thanks to excellent technical equipment and trained specialist staff, Prof. Graf and his team are able to ensure optimal all-round care for patients. Approximately 20 beds are available for inpatient diagnostics, therapy and palliative care.

For patients with bowel cancer, the Bowel Cancer Centre develops and implements individual therapy concepts based on latest scientific findings and guidelines by means of close interdisciplinary collaboration between medical disciplines.

You can find further information on Prof. Dr Dirk Graf's website.