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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Smart Medical Journal JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Imam Sofii
Digestive Division, Department Of Surgery, Faculty Of Medicine, Gadjah Mada University/RSUP Dr. Sardjito Hospital, Yogyakarta, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Comparison of serum aminotransferase between gas and gasless laparoscopy cholecystectomy Agus Barmawi, Imam Sofii Hendro Wartatmo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 42, No 01 (2010)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.342 KB)

Abstract

Carbondioxide (CO2) insufflations in laparoscopy with gas will increase intraabdominal pressure that influences thehemodynamic, lungs, and kidneys. One of important hemodynamic changes is temporary reduction of hepatic bloodflowbecause of pneumoperitoneum. Pressure caused by pneumoperitoneumcan influence ischemia degree of hepaticcell and cause hepatic enzymes increase. Enzyme that includes in hepatic enzyme is aminotransferase,which consistsof: transaminase (AST) or glutamic oxaloacetic transaminase serum and alanine transaminase (ALT) or glutamicpyruvic transaminase serum. Laparoscopy method by lifting abdomen wall (gasless laparoscopy) without CO2insufflations can decrease the damaging effects of high intraabdominal pressure. This research was an experimentalresearch with single blind randomized clinical trial (RCT) plan, with observation of symptomatic cholelithiasis patientswho underwent cholecystectomy laparoscopic cholecystectomy with gas or CO2 (pneumoperitoneum) or withoutgas (gasless). Hepatic function tests were then held at 24 hours and 72 hours after operation. Research subjectswere symptomatic cholelithiasis patients who fulfilled inclusion and exclusion criteria. Samples needed were 24people in each group. The independent variable was patients with symptomatic cholelithiasis who underwentcholecystectomy laparoscoped with gas compared to those being cholecystectomy laparoscoped without gas. Thedependent variable was aminotransferase enzyme value before operation, and 24, 72 hours postoperation. The datawere analyzed using Kolmogorov Smirnov, independent t-test, pair t-test, and MannWhitney test. It was obtained21 cases for men (43.75%), 27 cases for women (56.25%). The average age of the group laparoscopy with gaswas 47.16±10.76 years old and the group laparoscopy without gas was 45.3±11.48 years old (p>0,05). Theaverage values of AST and ALT 24 hours postoperation of the group laparoscopy without gas were 21.9±7.6 U/L(increase 24%) and 26.3±5.2 U/L (increase 46%) compared to 65.8±18.4 U/L (increase 206%) and 62.8±14.3U/L (increase 280%) in the group laparoscopy with gas (p< 0,05). The average values of AST and ALT 72 hourspostoperation of the group laparoscopywithout gaswere 24.7±8.3 U/L (increase 33%) and 28.9±7.3 U/L (increase17%) compared to 71,5±28,6 U/L (increase 250%) and 75.8±16.9 U/L (increase 360%) in the group laparoscopywith gas (p< 0,05). In conclusion, there were significantly increases of serum aminotransferase values (AST andALT) in cholecystectomy laparoscopy with gas compared to in cholecystectomy laparoscopy without gas.Key words: cholecystectomy laparoscopy – pneumoperitoneum - gasless – serum aminotransferase
Comparison of serum aminotransferase between gas and gasless laparoscopy cholecystectomy Imam Sofii Hendro Wartatmo Agus Barmawi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 42, No 01 (2010)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.342 KB)

Abstract

Carbondioxide (CO2) insufflations in laparoscopy with gas will increase intraabdominal pressure that influences thehemodynamic, lungs, and kidneys. One of important hemodynamic changes is temporary reduction of hepatic bloodflowbecause of pneumoperitoneum. Pressure caused by pneumoperitoneumcan influence ischemia degree of hepaticcell and cause hepatic enzymes increase. Enzyme that includes in hepatic enzyme is aminotransferase,which consistsof: transaminase (AST) or glutamic oxaloacetic transaminase serum and alanine transaminase (ALT) or glutamicpyruvic transaminase serum. Laparoscopy method by lifting abdomen wall (gasless laparoscopy) without CO2insufflations can decrease the damaging effects of high intraabdominal pressure. This research was an experimentalresearch with single blind randomized clinical trial (RCT) plan, with observation of symptomatic cholelithiasis patientswho underwent cholecystectomy laparoscopic cholecystectomy with gas or CO2 (pneumoperitoneum) or withoutgas (gasless). Hepatic function tests were then held at 24 hours and 72 hours after operation. Research subjectswere symptomatic cholelithiasis patients who fulfilled inclusion and exclusion criteria. Samples needed were 24people in each group. The independent variable was patients with symptomatic cholelithiasis who underwentcholecystectomy laparoscoped with gas compared to those being cholecystectomy laparoscoped without gas. Thedependent variable was aminotransferase enzyme value before operation, and 24, 72 hours postoperation. The datawere analyzed using Kolmogorov Smirnov, independent t-test, pair t-test, and MannWhitney test. It was obtained21 cases for men (43.75%), 27 cases for women (56.25%). The average age of the group laparoscopy with gaswas 47.16±10.76 years old and the group laparoscopy without gas was 45.3±11.48 years old (p>0,05). Theaverage values of AST and ALT 24 hours postoperation of the group laparoscopy without gas were 21.9±7.6 U/L(increase 24%) and 26.3±5.2 U/L (increase 46%) compared to 65.8±18.4 U/L (increase 206%) and 62.8±14.3U/L (increase 280%) in the group laparoscopy with gas (p< 0,05). The average values of AST and ALT 72 hourspostoperation of the group laparoscopywithout gaswere 24.7±8.3 U/L (increase 33%) and 28.9±7.3 U/L (increase17%) compared to 71,5±28,6 U/L (increase 250%) and 75.8±16.9 U/L (increase 360%) in the group laparoscopywith gas (p< 0,05). In conclusion, there were significantly increases of serum aminotransferase values (AST andALT) in cholecystectomy laparoscopy with gas compared to in cholecystectomy laparoscopy without gas.Key words: cholecystectomy laparoscopy – pneumoperitoneum - gasless – serum aminotransferase
Differences of alt-ast level and snail gene expression between patients with metastasis and non-metastasis colorectal cancer Chrisna Budi Satriyo; Hendra Susanto; Adeodatus Yuda Handaya; Nurcahya Setiawan; Imam Sofii; Agus Barmawi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art5

Abstract

Background: Colorectal cancer (CRC) is a malignant epithelial tumour in the colon and rectum, and its main cause is distant metastasis. The main process of distant metastasis is the epithelial-mesenchymal transition (EMT) that may cause mesenchymal phenotype and malignant capabilities of tumour cells. Then it is regulated by one of transcription factors, the Snail.Objective: This study aims to determine differences between Snail gene expression in CRC that has not metastasized and Snail gene expression in CRC that has metastasized. Methods: The subjects of this study consisted of two groups of patients. The first group consisted of 20 patients with CRC (tumour), and the second group consisted of 12 patients with CRC with metastasis (metastasis tumour). The Snail gene expression was measured in both groups by using the RT-qPCR method and supported by laboratory examination to measure ALT and AST. Then all obtained data were analysed by using a statistical software analysis.Results: This study indicated that there were differences of the Snail gene expression between both the groups, and the highest expression was in the metastatic tumour group with a significance level of 0.002 (p<0.05). This was also supported by AST and ALT which were significantly correlated between both the groups. The correlation value on the AST was 0.506 with a significance level of 0.003, and the ALT correlation value was 0.532 with a significance level of 0.002. Conclusion: This study suggested that the Snail was a potential marker of metastasis in the CRC. Therefore, further research is needed to determine the role of Snail regulation in the CRC metastasis.
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.
Co-Authors Adeodatus Yuda Handaya Agus Barmawi Chrisna Budi Satriyo Hendra Susanto Nurcahya Setiawan Nurcahya Setyawan Singgih Annas Fuadhi Singgih Annas Fuadhi