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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Majalah Kesehatan FKUB Smart Medical Journal JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Indonesian Journal of Cancer
Nurcahya Setyawan
Staff Of Digestive Division, Department Of Surgery, Faculty Of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Correlation between alkaline phosphatase, g-glutamyl transpeptidase, and bilirubin with interleukin-1b level in dogs with obstructive jaundice Nurcahya Setyawan; Vicky S. Budipramana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 4 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (481.555 KB) | DOI: 10.19106/JMedSci004704201502

Abstract

Surgical management in obstructive jaundice still contributes to significant morbidity and mortality. One of complications following surgery in obstructive jaundice is sepsis. This complication is caused by the toxic effects of bilirubin and bile salts, endotoxins, bacterial translocation, modulation of the immune-inflammatory cascade, decreased cellular immunity and/or nutritional status. Many studies have shown the elevated inflammatory response indicator, interleukin-1 (IL-1b), in patients with obstructive jaundice. However, only a few report described the association between the indicators of obstructive jaundice (alkaline phosphatase [ALP], g-glutamyl transpeptidase [GGT], and bilirubin)and the indicator of inflammatory response (interleukin-1b [IL-1b]). This study aimed to investigate the association between the indicator of obstructive jaundice (ALP, GGT, and bilirubin) and the level of interleukin-1b (IL-1b) in dogs as the animal model. We performed ligation on distal common bile ducts (CBD) to produce a model of obstructive jaundice. Every three days within a month, the blood samples from ten dogs were extracted to determine the ALP, GGT, direct and total bilirubin, and IL-1b levels. We found a significant correlation between the ALP and GGT with IL-1b level with p-value of 0.036 (r=0.626) and 0.003 (r=0.826). However, there was no association between the increased directbilirubin with the IL-1b level (p=0.068; r=0.537). Moreover, the increased level of ALP and GGT had a strong correlation with the increased level of direct bilirubin with p-value of 0.004 (r=0.810) and p=0.011 (r=0.746). In conclusion, the increased level of GGT was the strongest indicator for inflammatory response in dogs with obstructive jaundice. Furthermore, the increased levels of GGT and ALP might imply the development of obstructive jaundice in dogs.
Transcystic versus transcholedochal laparoscopic common bile duct exploration: Choosing the right approach – A Case Series Singgih Annas Fuadhi; Adeodatus Yuda Handaya; Agus Barmawi; Imam Sofii; Nurcahya Setyawan
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 2, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss2.art15

Abstract

Laparoscopic common bile duct exploration (LCBDE) is a relevant therapeutic option in managing cholecysto-choledocholithiasis. The success of this procedure is highly dependent on selecting an appropriate method, either transcystic or transcoledocal. Intraoperative choledochoscopy proves its importance in evaluating the condition of the choledochal duct and sphincter of Oddi. In this case series, we report 2 cases of patients with complaints of right upper abdominal pain and jaundice. Both patients were diagnosed with multiple cholecysto-choledocholithiasis at Dr. Sardjito Hospital, Yogyakarta. The interventional measures applied to both patients were transcystic and transcoledocal exploration. In the first patient, the transcystic method was chosen because the cystic duct was widening up to 9 mm in diameter. While in the second patient, the transcoledocal method was taken because the diameter of the cystic duct was still within normal limits. The duration of surgery in transcystic surgery was shorter than in transcoledocal surgery, with a time ratio of 129 minutes versus 162 minutes. Postoperatively, both patients were discharged on the second day after the procedure, and both experienced recovery without any significant complications. Overall, LCBDE has been shown to be safe to perform. The one-stage surgical approach has been shown to reduce the risk of complications, cost, and duration of treatment required. The choice between the transcystic or transcoledocal method should be based on each patient’s clinical condition.
Choledochal Cysts in Female Adult: Diagnostic Pitfall and Conservative Therapy for Bile Leak Singgih Annas Fuadhi; Agus Barmawi; Imam Sofii; Nurcahya Setyawan; Adeodatus Yuda Handaya
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.72426

Abstract

Introduction: Choledochal cysts that are accompanied by obstructive jaundice are a rare case. These cysts can cause intrahepatic or extrahepatic ductal dilatation. Their diagnosis is difficult, particulary in adults. Proper management can prevent further complications.Methods: A serial case report of a patient with a choledochal cyst.Results: 2 female patients aged 21 years and 22 years have a painful and fixed lump in the upper right abdomen. The first patient also complained jaundice. Laboratory results showed an increase in total bilirubin and direct bilirubin. The second patient didn’t complaint about jaundice or increased bilirubin, and she had a cholecystectomy when she was ten. The diagnosis was confirmed by a contrast abdominal CT scan, showing type 1A Todani choledochal cysts in both patients. Management of the first patient was cyst excision, cholecystectomy, and Roux n Y hepaticojejunostomy. In the second patient, adhesiolysis, cyst excision, and Roux n Y hepaticojejunostomy were performed. The second patient had no postoperative complications.Conclusion: Choledochal cysts are a rare congenital condition in adulthood. n both cases, two patients were manage surgically. Bile leakage complications can be manage conservatively. Diagnostic and management of choledochal cysts must be correct to prevent pitfall and complications.
Neutrophil to Hemoglobin Lymphocyte Ratio (NHLR) as a Novel Biomarker is Superior to Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as Predictors of Advanced Colorectal Cancer Purnomo, Heri; Handaya, Yuda; Setyawan, Nurcahya
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1099

Abstract

Background: Neutrophils, Hemoglobin, and Lymphocytes are biological markers that may be related to the colorectal cancer stage. Neutrophils to Hemoglobin-Lymphocytes Ratio (NHLR) is a new biomarker that will be tested with Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as common biomarkers that have been shown to have predictive value with colorectal cancer stage. This study aims to prove NHLR as a new biomarker that can predict advanced colorectal cancer in terms of staging and site of cancer compared to NLR and PLR. Methods: This is a retrospective cross-sectional study. Data obtained from the medical records of colorectal cancer patients undergoing surgery at Dr Sardjito Hospital from 2020 until 2022. Results: 386 patients enrolled in the study, and 62 patients met the inclusion criteria. Twentyeight patients (45.16 %) were male, and 34 (54.84 %) were female. The mean age is 58.82 years. Bivariate analysis showed a significant relationship between NHLR, NLR, and PLR with colorectal cancer stage and significant differences between NHLR and NLR with early and advanced colorectal cancer, but not with PLR. There are also significant differences between NHLR, NLR, and PLR with colorectal cancer sites in the colon and rectum. Still, in locally advanced stages of colorectal cancer, there is no significant association between NLR and cancer sites. On the contrary, there are significant differences between colon and rectal cancer sites with NHLR and PLR. Conclusions: NHLR is superior to NLR and PLR in predicting the stage and site of advanced colorectal cancer.
Laporan Kasus: PROSEDUR VAGINOPLASTI SIGMOID PADA DUA KASUS SINDROM MAYER-ROKITANSKY-KÜSTER-HAUSER (MRKH) Pangastuti, Nuring; Fitriani, Annisa; Setyawan, Nurcahya; Widyasari, Anis; Saputra, Akbar Novan Dwi
Majalah Kesehatan Vol. 12 No. 1 (2025): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2025.012.01.9

Abstract

Sindrom Mayer-Rokitansky-Kuster-Hauser (MRKH) atau Mullerian agenesis atau Mullerian aplasia adalah kelainan bawaan yang jarang terjadi pada saluran genetik seorang perempuan dengan agenesis parsial atau kompleks dari uterus, hipoplasia vagina, atau agenesis vagina, tetapi memiliki ovarium dan genitalia eksterna yang normal. Sindrom MRKH terbagi menjadi 3 jenis, dengan manifestasi masing-masing yang bisa berbeda meskipun tergolong jenis MRKH yang sama. Dilaporkan dua kasus sindrom MRKH tipe I dengan keluhan utama amenorea primer. Kasus pertama adalah perempuan berusia 27 tahun menjelang menikah, sedangkan kasus kedua adalah perempuan menikah berusia 26 tahun yang aktif secara seksual namun memiliki keluhan suami tidak bisa melakukan penetrasi pada aktivitas seksual. Kedua kasus dengan keluhan amenore primer. Hasil pemeriksaan fisik dan hormonal dalam batas normal, sedangkan pemeriksaan ultrasonografi transabdominal, Colon in Loop (CIL) dan Magnetic Resonance Imaging (MRI) mendukung diagnosis sindrom MRKH tipe I. Vaginoplasti sigmoid dilakukan untuk tujuan pembuatan neovagina untuk  aktivitas seksual, pada kasus pertama menggunakan teknik iso peristaltik dan pada kasus kedua teknik anti/kontra peristaltik. Pasca operasi, neovagina terbentuk dengan baik tanpa tanda-tanda infeksi pada kedua kasus, meski harus diberikan transfusi darah berupa 500 ml packed red cell serta dilakukan manajemen konservatif terhadap dehisensi luka operasi abdomen pada kasus kedua. Dijumpai stenosis ringan pada kedua kasus, yang dapat diatasi dengan prosedur dilatasi vagina menggunakan dilator Hegar mulai pada 3 pekan pasca operasi. Kesimpulannya, sindrom MRKH merupakan kasus yang jarang terjadi sehingga memerlukan penanganan yang cermat terkait prosedur pembentukan neovagina untuk tujuan penetrasi pada aktivitas seksual. Meskipun memerlukan keahlian khusus dan operasi dilakukan berkolaborasi dengan ahli bedah digestif, pada kedua kasus yang dilaporkan operasi berlangsung dengan baik, tidak terdapat komplikasi yang signifikan, serta menghasilkan kondisi pasca operasi yang memuaskan.
Incarcerated Pelvic Floor Peritoneal Hernia After Abdominoperineal Resection (APR): How To Prevent? Prakosa, Yovan Indra Bayu; Setyawan, Nurcahya; Yushinta, Milleninda Pasca
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1218

Abstract

Introduction: Colorectal cancer is the third most common cancer worldwide. One of the procedures that is often performed in cases of distal rectal cancer is abdominoperineal resection (APR) procedure that leaves the pelvic cavity with an empty space. This condition increases the possibility of pelvic floor peritoneal hernia. We present a rare case of this condition and provide information regarding prevention and treatment.Case Presentation: A male, 74 years old, with recurrent constipation following APR, was retrospectively analyzed. Abdominal CT scan 6 months after surgery showed no residual tumor. On final arrival, he came with typical signs of total small bowel obstruction. Abdominal x-ray results showed signs of small bowel obstruction. The results of the operation found an incarcerated pelvic floor peritoneal hernia. The surgical procedures performed were entrapment release and hernia repair with a peritoneal flap. Complaint of obstruction sign improved two days postoperatively.Conclusion: Pelvic floor peritoneal hernias should not be forgotten in patients who experience recurrent constipation in postoperative APR. Recurrent constipation is caused by a herniation of the small bowel in the hernia sac. Chronic constipation should be considered an abnormal cause of obstruction. Poor wound healing processes cause the neck of the hernia to narrow and cause an incarcerated hernia. Closure of the pelvic floor needs to be restored post-operatively
Co-Authors Adeodatus Yuda Handaya Agus Barmawi Akbar Novan Dwi Saputra Anis Widyasari Annisa Fitriani, Annisa Heri Purnomo Imam Sofii Nuring Pangastuti, Nuring Prakosa, Yovan Indra Bayu Singgih Annas Fuadhi Singgih Annas Fuadhi Vicky S. Budipramana Yushinta, Milleninda Pasca