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All Journal The New Ropanasuri Journal of Surgery
Lalisang, Arnetta NL
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology

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Gallstone Ileus in Cipto Mangunkusumo General Hospital, Jakarta: A Case Series Lalisang, Toar JM; Hehuwat, Georgina P.; Lalisang, Arnetta NL; Pratama, Irfan K.; Mazni, Yarman
The New Ropanasuri Journal of Surgery Vol. 4, No. 1
Publisher : UI Scholars Hub

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Introduction. Gallstone ileus is an uncommon mechanical bowel obstruction caused by a gallstone in the gastrointestinal tract which enters due to bile-enteric fistulae. This study aims to describe gallstone ileus and its management. Method. Data were retrospectively collected from medical records. Clinical manifestations, laboratory data, supporting radiographic examinations, treatment, postoperative care, and outcomes were collected. Results. We report two gallstone ileus cases at Cipto Mangunkusumo General Hospital, Jakarta which admitted in the last 20 years. The first case was a woman 33 years in 2002 and the second was man 45 years in 2017. Ileus was the main clinical symptoms. Gallstone ileus was diagnosed with preoperatively based on clinical and radiology findings. Laparotomy was performed and ileostomy for stones evacuation and cholecystectomy were performed without bile-enteric fistula repair. Large black stones were found at terminal ileum which made the obstruction. Conclusion. Gallstone ileus was an uncommon disease which can be treated and has a good prognosis. Plain abdominal x-ray has an important role in diagnosis and treatment approach.
Navigating Wound Closure Strategies: Primary Closure vs. Delayed Primary Closure in Digestive Surgery—A Systematic Review and Meta-Analysis on Surgical Site Infections Sihardo, Lam; Lalisang, Arnetta NL; Putra, Afid B; Suryawiditya, Bagus A
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. Surgical site infection (SSI) is a significant concern following digestive surgery, with varying incidence rates based on wound contamination levels. The choice between Primary Closure (PC) and Delayed Primary Closure (DPC) impacts SSI occurrence, making it essential to evaluate their comparative effectiveness. DPC is hypothesized superior to PC to prevent SSI or wound infection after a contaminated abdominal surgery. Methods. This systematic review study was carried out through PubMed, Scopus, and Cochrane (CENTRAL). Quality was assessed using Risk of Bias (ROB-2) tool. All results were summarized, and quantitative analysis was performed using a random-effect model. This study is reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Eligibility criteria included adult patients undergoing abdominal gastrointestinal surgery, evaluating SSI and hospital stay, directly comparing PC and DPC, and randomized controlled trials (RCT) study. Results. Of 447 published studies, there were 10 eligible RCTs, consist of 672 subjects who received DPC and 668 subjects who received PC. We found no significant difference in SSI occurrence between PC and DPC (RR=0.62, 95%CI: 0.38–1.02; p=0.06) with high heterogeneity (I2=74%, p Conclusion. DPC tend to decrease SSI risk. Our findings revealed that PC is not inferior than DPC to prevent SSI and improve hospital stay in abdominal surgery. The choice between techniques should be individualized, considering patient characteristics and surgical context. Standardized criteria and further research are crucial for refining closure method selection, ultimately enhancing patient outcomes and reducing the burden of SSI.
A Glimpse of Liver Resection Profile in An Indonesian Tertiary Hospital: A Retrospective Descriptive Study Vaniara, Florencia V; Lalisang, Arnetta NL; Lalisang, Toar JM; Mazni, Yarman; Putranto, Agi S; Jeo, Wifanto S; Ibrahim, Febiansyah; Syaiful, Ridho A; Sihardo, Lam; Marbun, Vania MG
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. In-depth liver resection profile is needed for evaluation to improve the procedure’s outcome. This study aims to describe the clinical characteristics and outcomes of liver resection in HCC patients in Cipto Mangunkusumo Tertiary Hospital. Methods. This study retrospectively analyzed the clinical data of 19 HCC patients who underwent liver resection in Cipto Mangunkusumo Tertiary Hospital from 2021 to 2024. Demographic, clinical, laboratory, operative, and pathological data were collected. Postoperative complications were assessed using the Clavien-Dindo classification system within 30- and 90-day postoperative periods. Result. Nineteen patients were included, comprising 12 (63.2%) males and 7 (36.8%) females. Sixteen patients (84.2%) had Child-Pugh (CP) class A liver function with 10 (62.5%) CP A(5) patients and 6 (37.5%) CP A(6) patients; 3 (15.8%) patients had CP class B(7). There were 6 (31.6%) patients with thrombocytopenia and 4 (21.1%) patients with portal hypertension. Liver resection was done laparoscopically in 4 (21.1%) patients and with an open approach in 15 (78.9%) patients. Left hepatectomy was done in 3 patients (15.78%), right hepatectomy in 2 (10.5%), right anterior sectionectomy in 4 (21%), left lateral sectionectomy in 1 (5.26%), bisegmentectomy in 1 (5.26%), segmentectomy in 6 (31.58%), and non-anatomical resection in 2 (10.52%). Based on histopathologic examination, HCC was found in 13 (68.41%) patients. Among 19 patients, 12 (63.2%), 5 (26.3%), and 2 (10.5%) patients had 1 tumor, 2 tumors, and 3 tumors respectively (total tumors resected: n=28). About 16 (84.21%) patients had elevated alpha fetoprotein (AFP) (> 10 ng/mL). The mean intraoperative blood loss was 884 mL. No postoperative complications classified as Clavien-Dindo grade I-IV were observed. Two patients (10.5%) experienced postoperative mortality within 90 days (Clavien-Dindo grade V), both due to circulatory failure. Conclusion. This study presents a descriptive overview of liver resection in an Indonesian tertiary hospital. Comparative conclusions should be interpreted with caution due to the limited sample size.
Co-Authors Hehuwat, Georgina P. Ibrahim, Febiansyah Jeo, Wifanto S Marbun, Vania MG Mazni, Yarman Pratama, Irfan K. Putra, Afid B Putranto, Agi S Sihardo, Lam Suryawiditya, Bagus A Syaiful, Ridho A Toar J.M. Lalisang Vaniara, Florencia V