Dr George Webster

Dr George WebsterTel: 020 3447 9229
Fax: 020 3447 9218
Email: george.webster@uclh.nhs.uk

Location:
University College Hospital

Specialities:
Endoscopy Unit, Pancreatobiliary service, Gastrointestinal services

Professional background

I have been a consultant at UCH since 2003. I am clinical lead for hepatopancreaticobiliary (HPB) medicine, which is one of the busiest tertiary referral practices in hepatobiliary and pancreatic disease in the UK, performing > 1000 ERCPs and related biliary procedures each year. I am involved in all forms of interventional endoscopy, with a particular focus on ERCP, cholangioscopy, sphincter of Oddi manometry and advanced luminal endoscopy (including colonic stenting). Our group has the largest experience of autoimmune pancreatitis/IgG4-associated cholangitis in the UK.

Actively involved in endoscopy training locally, nationally (eg Director ‘London Live Endoscopy’ 2007, 2008, 2011) and internationally (expert faculty Gastroenterology and  Endotherapy European Workshop (GEEW) Brussels 2010). Regular postgraduate teaching related to gastroenterology and hepatology (including Royal College of Physicians regional Masterclasses).  I am coauthor of the Oxford Handbook of Gastroenterology and Hepatology (2nd edition in press). Organising Committee 1st International Conference on IgG4 disease (Boston Oct 2011).

External Committees: North Thames Gastroenterology SpR Training; Autoimmune Pancreatitis International Collaborative Study  (APICS) Group. Endoscopy Committee British Society of Gastroenterology.

Research interests

I was awarded an MD (December 2002) for my thesis related to the study of the cellular immune events involved in clearance or persistence of hepatitis B virus infection, and during the natural course of chronic HBV infection. Since completing my thesis I have continued clinical research in various areas of hepatobiliary medicine. I am involved in ongoing research into  Autoimmune Pancreatitis/IgG4-associated cholangitis, and have presented state-of-the-art lectures on this subject at international symposia in UK (BSG 2009), Europe (European Pancreatic Club, Stockholm  2010, EASL, Berlin 2011) and USA (DDW San Diego 2009).

Publications

1. Clinical profile of autoimmune pancreatitis and its histological subtypes: an international multicenter survey. Kamisawa T, Chari ST, Giday SA, Kim MH, Chung JB, Lee KT, Werner J, Bergmann F, Lerch MM, Mayerle J, Pickartz T, Lohr M, Schneider A, Frulloni L, Webster GJ, Reddy DN, Liao WC, Wang HP, Okazaki K, Shimosegawa T, Kloeppel G, Go VL. Pancreas. 2011;40(6):809-14

2. Endoscopic Retrograde Cholangiography Does Not Reliably Distinguish IgG4-Associated Cholangitis From Primary Sclerosing Cholangitis or Cholangiocarcinoma. Kalaitzakis E, Levy M, Kamisawa T, Johnson GJ, Baron TH, Topazian MD, Takahashi N, Kanno A, Okazaki K, Egawa N, Uchida K, Sheikh K, Amin Z, Shimosegawa T, Sandanayake NS, Church NI, Chapman MH, Pereira SP, Chari S, Webster GJ. Clin Gastroenterol Hepatol. 2011;9(9):800-803

3. Recurrent acute pancreatitis as primary manifestation of gangliocytic paraganglioma of the ampulla. Lytras D, Kalaitzakis E, Hatfield AR, Vyas S, Imber CJ, Webster GJ, Malagó M. Pancreas. 2011;40(6):985-6

4. Hepato-biliary Cystadenoma with Intraductal Extension: Unusual Cause of Obstructive Jaundice. Vyas S, Markar S, Ezzat T, Rodriguez-Justo M, Webster G, Imber C, Malago M. J Gastrointest Cancer. 2011 May 28

5. Spyglass cholangioscopy in the evaluation of an intra-hepatic biliary lesion.
Adwan H, Pamecha V, Kalaitzakis E, Winstanley A, Grillo F, Webster G, Davidson B. Dig Endosc. 2011;23(2):199-200

6. Review article: autoimmune pancreatitis - management of an emerging disease. Kalaitzakis E, Webster GJ. Aliment Pharmacol Ther. 2011 Feb;33(3):291-303.

7. R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer. Matull WR, Dhar DK, Ayaru L, Sandanayake NS, Chapman MH, Dias A, Bridgewater J, Webster GJ, Bong JJ, Davidson BR, Pereira SP. Liver Int. 2011 Jan;31(1):99-107

8. Endoscopic retrograde pancreatography criteria to diagnose autoimmune pancreatitis: an international multicentre study. Sugumar A, Levy MJ, Kamisawa T, Webster GJM, Kim MH, Enders F, Amin Z, Baron TH, Chapman MH, Church NI, Clain JE, Egawa N, Johnson GJ, Okazaki K, Pearson RK, Pereira SP, Petersen BT, Read S, Sah RP, Sandanayake NS, Takahashi N, Topazian MD, Uchida K, Vege SS, Chari ST. Gut. 2010 Dec 3.

9. Histopathologic and clinical subtypes of autoimmune pancreatitis: the Honolulu consensus document.Chari ST, Kloeppel G, Zhang L, Notohara K, Lerch MM, Shimosegawa T, Webster GJ Autoimmune Pancreatitis International Cooperative Study Group (APICS).Pancreas. 2010 Jul;39(5):549-54.

10. A diagnosis of an intraluminal carcinoid tumor of the bile duct by using cholangioscopy. Johnson G, Hatfield A, Webster G, Groves C, Rodriguez-Justo M. Gastrointest Endosc. 2010 Mar;71(3):622-3

11. Mesh-metal stents for hilar cholangiocarcinoma. Webster G, Pereira S. Gastrointest Endosc. 2009 Oct;70(4):817-8.

12. Autoimmune pancreatitis/IgG4-associated cholangitis and primary sclerosing cholangitis--overlapping or separate diseases? Webster GJ, Pereira SP, Chapman RW. J Hepatol. 2009 Aug;51(2):398-402

13.  Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis. Sandanayake NS, Church NI, Chapman MH, Johnson GJ, Dhar DK, Amin Z, Deheragoda MG, Novelli M, Winstanley A, Rodriguez-Justo M, Hatfield AR, Pereira SP, Webster GJ. Clin Gastroenterol Hepatol. 2009 Oct;7(10):1089-96

14. Extrapancreatic manifestations in autoimmune pancreatitis. Webster GJ, Deheregoda MG, Church NI. Minerva Gastroenterol Dietol. 2009 Mar;55(1):41-51

15.  Diagnosis of pancreaticobiliary malignancy by detection of minichromosome maintenance protein 5 in bile aspirates. Ayaru L, Stoeber K, Webster GJ, Hatfield AR, Wollenschlaeger A, Okoturo O, Rashid M, Williams G, Pereira SP. Br J Cancer. 2008 May 6;98(9):1548- 54

16. Complications and diagnostic difficulties arising from biliary self-expanding metal stent insertion before definitive histological diagnosis. Ayaru L, Kurzawinski TR, Shankar A, Webster GJ, Hatfield AR, Pereira SP. J Gastroenterol Hepatol. 008 Feb;23(2):315-20.

17. The utility of IgG4 immunostaining in the diagnosis of pancreatic and extrapancreatic involvement in autoimmune pancreatitis. MG Deheragoda, NI Church, M Rodriguez-Justo, P Munson, N Sandanayake, EW Seward, K Miller, M Novelli, SP Pereira, ARW Hatfield, GJM Webster. Clin Gastroenterol Hepatol 2007 5(10):1229-34


18. Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series. Church NI, Pereira SP,  Deheragoda MG, Sandanayake N, Amin Z,  Lees WR, Gillams A, Rodriguez-Justo M, Novelli M,  Seward EW, Hatfield ARW, Webster GJM. Am J Gastro 2007 Nov;102(11):2417-25.

19. Correlation of MRCP quantification (MRCPQ) with conventional non-invasive pancreatic exocrine function tests. Gillams A, Pereira SP, Webster GJM, Lees WR. Abdom Imaging. 2007 Jul 25

20. Inflammatory pseudotumour of the liver: the residuum of a biliary cystadenoma? Hoosein MM, Tapuria N, Standish RA, Koti RS, Webster GJ, Millar AD, Davidson BR.
Eur J Gastroenterol Hepatol. 2007 Apr;19(4):333-6.

21. Prospective comparison of secretin-stimulated MRCP with manometry in diagnosis of sphincter of Oddi dysfunction types II and III. Pereira SP, Gillams A, Sgouros SN, Webster GJM, Hatfield ARW Gut. 2007 Jun;56(6):809-13

22. The impact of HBV-DNA fluctuations on virus-specific CD8+ T cells in HBeAg+ chronic hepatitis B patients treated with a steroid and lamivudine. Gotto J, Webster GJ, Brown D, Jenkins J, Dusheiko GM, Bertoletti A.
J Viral Hepat. 2006 Jun;13(6):415-25.

23. Optimal dosing frequency of pegylated interferon alfa-2b monotherapy for chronic hepatitis C virus infection. Lurie Y, Rouzier-Panis R, Webster GJ, Dusheiko GM, Laughlin M, Jackson ML, Oren R. Clin Gastroenterol Hepatol. 2005 Jun;3(6):610-5

24. Acalculous cholecystitis, multifocal gastrointestinal infarction and pancreatitis resulting from Varicella-zoster virus. Kurtovic J, Webster GJ, Singh-Grewal I, Bullpitt P, Haindl W, Wakefield D, Riordan SM. Intern Med J. 2005 Jan;35(1):69-70

25.  Effect of HIV Infection and Antiretroviral Therapy on Hepatitis B Virus (HBV)-Specific T Cell Responses in Patients Who Have Resolved HBV Infection.  Lascar RM, Lopes AR, Gilson RJ, Dunn C, Johnstone R, Copas A, Reignat S, Webster GJ, Bertoletti A, Maini MK. J Infect Dis. 2005 Apr 1;191(7):1169-79

26. Portal Vein Thrombosis – New insights into aetiology and management. Webster GJM, Burroughs AK, Riordan SM. Aliment Pharmacol Ther 2005 Jan 1;21(1):1-9.


27. Evolution of hepatitis B virus during primary infection in humans: transient generation of cytotoxic T-cell mutants. Whalley SA, Brown D, Webster GJ, Jacobs R, Reignat S, Bertoletti A, Teo CG, Emery V, Dusheiko GM. Gastroenterology. 2004 Oct;127(4):1131-8
28. Hepatic ischemia associated with coarctation of the aorta in pregnancy: key issues in differential diagnosis. Webster GJM, Kurtovic J, Lowe SA, Riordan SM. Obstet Gynecol. 2004 Nov;104(5 Pt 2):1151-4.
29.  Prevention of hepatotoxicity but loss of antimelanoma effect with combined fotemustine and anti-oxidant treatment. Webster GJ, Kurtovic J, Singh-Grewal I, Friedlander M, Riordan SM. Intern Med J. 2004 May;34(5):298-9.

30. The world through tinted glasses. Bennett DL, Webster GJ, Molyneux P, Descamps MJ, Plant GT, Pereira SP, Reilly MM Lancet. 2004 Jul 24;364(9431):388.

31. Occult hepatitis B virus infection does not affect liver histology or response to therapy with interferon alpha and ribavirin in intravenous drug users with chronic hepatitis C. Fabris P, Brown D, Tositti G, Bozzola L, Giordani MT, Bevilacqua P, De Lalla F, Webster GJM, Dusheiko G. J Clin Virol. 2004 Mar;29(3):160-6.
32. Longitudinal analysis of CD8+ T cells specific for structural and nonstructural hepatitis B virus proteins in patients with chronic hepatitis B: implications for immunotherapy. Webster GJ, Reignat S, Brown D, Ogg GS, Jones L, Seneviratne SL, Williams R, Dusheiko G, Bertoletti A. J Virol. 2004 Jun;78(11):5707-19
33. Tracking the source and function of the reconstituted hepatitis B virus-specific CD8+ cell population during lamivudine treatment. Malacarne F, Webster GJM, Burroughs AK, Dusheiko GM, Williams R, Bertoletti A. J Infect Dis. 2003 Feb 15;187(4):679-82.
34. Escaping high viral load exhaustion: CD8 cells with altered tetramer binding in chronic hepatitis B virus infection.  Reignat S, Webster GJM,  Brown D,  Ogg GS, King A, Seneviratne SL, Dusheiko GM,  Williams R, Maini MK, Bertoletti A.  J Exp Med 2002 May 6;195(9): 1089-101
35. Protecting travellers against hepatitis A. (Editorial) Webster GJM, Barnes E, Dusheiko GM, Fleming I. British Medical Journal 2001 May 19;322(7296):1194-5

36. Kinetics of acute hepatitis B virus infection in humans. Whalley SA, Murray JM, Brown D, Webster GJM, Emery VC, Dusheiko GM, Perelson AS.  J Exp Med 2001 Apr 2;193(7):847-54
37. Incubation phase of acute hepatitis B in man: dynamic of cellular immune mechanisms. Webster GJM, Reignat S, Maini MK, Whalley SA, Ogg GS, King A, Brown D, Amlot PL, Williams R, Vergani D, Dusheiko GM, Bertoletti A. Hepatology 2000 Nov;32(5):1117-24
38. T cell receptor usage of virus-specific CD8 cells and recognition of viral mutations during acute and persistent hepatitis B virus infection.   Maini MK, Reignat S, Boni C, Ogg GS, King AS, Malacarne F, Webster GJM, Bertoletti A. Eur J Immunol  2000 Nov;30(11):3067-78.

39. The molecular epidemiology of a large outbreak of hepatitis B linked to’autohaemotherapy’. Webster GJM, Hallett R, Whalley SA, Meltzer M, Balogun K, Brown D, CP Farrington, Sharma S, Hamilton G, Farrow S, Teo C-G, Ramsay ME, Dusheiko GM. Lancet 2000 Jul 29;356(9227):379-84.
40. The science, economics, and effectiveness of combination therapy for hepatitis C. (Editorial). Dusheiko G, Barnes E, Webster G, Whalley S. Gut 2000 Aug;47(2):159-61
41. Organ transplantation and discrimination. Patients with hepatitis B should not be given low priority. (Letter) Webster GJM, Barnes E, Burroughs A, Dusheiko G. British Medical Journal 2000;320:1600-1

42. Direct ex-vivo analysis of hepatitis B virus-specific CD8+ T cells in patients who control infection.  Maini MK, Boni C, Ogg GS, King AS, Reignat S, Lee CK, Larrubia, Williams R, Webster GJM, McMichael AJ, Vergani D, Ferrari C, Bertoletti A. Gastroenterology 1999;117:1386-96

43. Long-term efficacy of treatment of chronic hepatitis C with alpha-interferon or alpha-interferon and ribavirin Barnes E, Webster GJM, Jacobs R, Dusheiko GM. Journal of Hepatology 1999;31:(Suppl 1):244-249

44. Infection and haemostasis in decompensated liver cirrhosis: A prospective study using thromboelastography.  Papatheodoridis G, Patch D, Webster GJM, Brooker J, Barnes E, Burroughs AK. Hepatology 1999;29(4):1085-1090

45. Oral fluids prior to sedation. (Editorial) Greenfield SM, Webster GJM, Vicary FR. British Medical Journal 1997;314:162

46. Drinking before endoscopy - milk or water?  Webster GJM, Bowling TE, Greenfield SM, Hallyburton E, Kuan AM, Vicary FR, Beck ER. Gastrointestinal Endoscopy 1997;45:406-8

47. Assessment of residual gastric volume and thirst in patients who drink before gastroscopy. Greenfield SM, Webster GJM, Brar AS, Kuan AM, Beck ER, Vicary FR. Gut 1996;39:360-62

48. Streptozotocin-induced diabetes in rats causes neuronal deficits in Tyrosine Hydroxylase and 5-hydroxytyptamine specific to mesenteric perivascular nerves and without loss of nerve fibres.  Webster GJM, Petch EWA, Cowen T Experimental Neurology 1991;113:53-62

GMC/GDC number: 3546985