Claim Missing Document
Check
Articles

Found 2 Documents
Search
Journal : e-CliniC

Delayed Staged Hepatectomy for Metastatic Colorectal Cancer: A Single Case Report Tendean, Michael; Paparang, Steven; Tjandra, Ferdinand; Mambu, Toar; Panelewen, Jimmy; Salem, Billy
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.59701

Abstract

Abstract: Liver metastases are common in patients with colorectal cancer; almost 70% will develop liver metastases during the course. The recommended treatment for colorectal liver metastasis (CRLM) is multidisciplinary, including liver resection and chemotherapy. We reported a 52-year-old female with stage 3B distal third rectal adenocarcinoma which eight months earlier underwent Mile’s procedure plus total mesorectal excision (TME) followed by adjuvant radiotherapy (50gy). During surveillance, liver metastases was found at segments 4B-5. A delayed anatomical staged hepatectomy segments 4B-5 was performed. Intraoperative USG findings suggested liver metastases at segments 7, 8, and 3, and non-anatomical liver resection was performed in accordance with parenchymal liver sparing principles. No post-hepatectomy liver failure (PHLF) was detected, but billoma occured at 1-month post hepatectomy. USG guided percutaneous drainage was performed to resolve the billoma. Colorectal metastasis (CRLM) was detected at six months post-hepatectomy, and the patient underwent adjuvant chemotherapy with improvement in survival rate. In conclusion, delayed staged hepatectomy for CRLM is a safe and beneficial procedure, though there is still no guideline regarding the sequence of resection. Keywords: hepatectomy; colorectal metastasis; billoma; colorectal cancer
Clinical Characteristics and Outcomes of Pancreaticoduodenectomy (Whipple Procedure) in the Last Five Years at Prof. Dr. R. D. Kandou Hospital Tendean, Michael; Tjandra, Ferdinand; Mambu, Toar; Ayawaila, Marven; Sihaloho, Eric
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65822

Abstract

Abstract: Pancreatoduodenectomy (Whipple) is the standard procedure for resectable pancreatic and periampullary neoplasms. Although techniques and postoperative care continue to evolve, this procedure is still associated with high morbidity and significant complications, such as pancreatic fistula and delayed gastric emptying. It is most commonly performed on elderly patients with pancreatic adenocarcinoma and requires ongoing evaluation to improve outcomes. A five-year review is necessary to assess trends, complications, and postoperative outcomes as a basis for improving the quality of surgical management. This was a retrospective descriptive analysis of adult patients who underwent pancreatoduodenectomy at Prof. Dr. R. D. Kandou Hospital between 2020 and 2025. The inclusion criteria were patients with complete medical records, including demographic data, surgical indications, surgical outcomes, and postoperative complications. Cases with incomplete data, surgeries performed outside the study period, or patients who died before postoperative evaluation were excluded. Univariate analysis was performed using SPSS version 30 to describe clinical characteristics and patient outcomes. Of the 35 patients, the distribution of gender and diagnosis (icteric vs. non-icteric obstruction) was relatively balanced. Most underwent a single Whipple procedure (65.7%) using the duct-to-mucosa anastomosis technique (80%). Postoperative complications occurred in 57.1% of patients, and 30-day mortality was 34.3%. The mean age of patients was 55.6 years, the duration of surgery was 370 minutes, the blood loss was 568 cc, and the length of hospital stay was 9.8 days. In conclusion, the Whipple procedure demonstrates variable outcomes with high morbidity and a 30-day mortality rate of 34.3%. End-to-side anastomosis is the most commonly used technique. Age, case complexity, and operative variability influence patient recovery and prognosis. Keywords: pancreatoduodenectomy; pancreatic neoplasm