Kuntjoro Harimurti
DIvisi Geriatri, Kelompok Staf Medis Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia - RSUPN Dr Cipto Mangunkusumo

Published : 26 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 4 Documents
Search
Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Factors Associated with Surveillance for Early Detection of Hepatocellular Carcinoma in Liver Cirrhosis Patients Ario Perbowo Putra; Andri Sanityoso Sulaiman; Juferdy Kurniawan; Kuntjoro Harimurti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.745 KB) | DOI: 10.24871/1832017153-158

Abstract

Background: Minimal number of KHS patients diagnosed through surveillance is thought to be the cause of continued low survival. It is important knowing the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors.Objective: Determine the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors.Method: Cross-sectional study of patients with liver cirrhosis at RSCM from January to December 2013. Data obtained from medical records and reconfirmed by telephone. Surveillance is required for abdominal ultrasound with or without AFP at least once a year within 3 years after that period. Factors studied were gender, ethnicity, education level, income level, availability of medical assurance, location of residence, surveillance education, cirrhosis etiology, and severity of cirrhosis. Then logistic regression test is used in the multivariate analysis.Results: From 200 patients, 50 patients (25,0%) underwent surveillance, 150 patients (75,0%) did not. Bivariate analysis resulted in 4 variables with p 0.25, gender (p = 0,056), ethnicity (p = 0, 231), surveillance education (p = 0,005), and severity of cirrhosis (p = 0, 005). Multivariate analysis resulted risk factors for surveillance were surveillance education (OR = 2,598; CI 95% (1,325 - 5,094), p = 0,005) and severity of cirrhosis (OR = 1.815; CI 95% = 1,210-2,724; p = 0,004).Conclusion: Surveillance education and severity of cirrhosis are factors associated with surveillance for early detection of KHS in liver cirrhosis patients.
Papilla Vaterƒs Tumor in Elderly: an Interdisciplinary Issue Eric Daniel Tenda; Murdani Abdullah; Kuntjoro Harimurti; Edy Rizal Wahyudi; Czeresna Heriawan Soejono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010155-159

Abstract

Tumors of the papilla Vater are very rare. Papilla Vater’s tumors are benign or malignant tumors in the ampulla of Vater and periampullary region. Blockage of ampulla leads to the development of obstructive jaundice; intermittent cholangitis, epigastric discomfort and weight loss. Treatment possibilities include endoscopic ampulectomy, surgical transduodenal excision of tumors of the ampulla and pancreatoduodenectomy (PDE). Prognosis depends on histological typing of the tumor and their clinical stage. We report a case of papilla Vater’s tumor in elderly with comorbidities based on literature review. A 68-year-old female patient was referred for evaluation of intra and extra hepatic bile duct dilatation noted on abdominal ultrasonography. She complained of intermittent epigastric and right upper abdominal pain, with yellowish skin for two months. The laboratory findings showed leukocytosis, hyperbilirubinemia, abnormal liver function test, and high Ca 19-9. An endoscopic retrograde cholangiopancreatography (ERCP) revealed a distal obstruction caused by papilla Vater’s tumor. Abdominal computed tomography (CT) with contrast, revealed a dilated common bile duct and pancreatic duct. The histologic evaluation was highly suggestive for dysplasia. She is now on a schedule for a Whipple procedure. To make a true diagnosis and optimal treatment of papilla Vater’s tumor is multimodal. By doing a comprehensive geriatric assessment, with a careful modality selection, a Whipple procedure can be performed in elderly (65 years) safely. The post operative morbidity and mortality depends on their multi morbidity. Surgical, endoscopic, or radiologic biliary decompression; relief of gastric outlet obstruction; and adequate pain control may improve the quality of life but do not affect overall survival rate. By building a great interdisciplinary teamwork, the quality of life increased as follows.Keywords: papilla Vater tumor, elderly, Whipple procedure
CD4+ and CD8+ Counts in Liver and Their Correlation with Necroinflammatory and Fibrosis Grades in Chronic Hepatitis C Chyntia Olivia Maurine; Rino Alvani Gani; Ening Krisnuhoni; Kuntjoro Harimurti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (364.96 KB) | DOI: 10.24871/1332012145-150

Abstract

ABSTRACTBackground: Studies on the characteristics CD4+ and CD8+ in hepatitis C and their correlation with the severity of the disease have been rarely conducted. This study was aimed to obtain the mean difference between CD4+ and CD8+ count in liver to evaluate their correlation with fibrosis and necroinflammatory grades in chronic hepatitis C. Method: A cross-sectional study was conducted between March and July 2010 with 30 liver biopsies obtained from patients with non-B and non-HIV chronic hepatitis C who visited the Outpatient Clinic of Hepatology Unit at Cipto Mangunkusumo Hospital in January 2008–February 2010. Fibrosis and necroinflammatory grades were determined using METAVIR methods on liver biopsies. The mean values of CD4+ and CD8+ in portal tracts and hepatic lobules in liver biopsy specimens were evaluated. Statistical analysis was performed by using independent T-test and Spearman test. Results: There was a difference in mean CD4+ counts between portal tracts and the lobules (95% CI = 4.3-17.9; p = 0.002) and also differences in mean CD8+ counts in portal tracts and hepatic lobules (95% CI = 15.4-35.6; p 0.001). There was no correlation between CD4+ and CD8+ counts, either in portal tracts or the lobules, and inflammatory grades as well as the liver fibrosis. Conclusion: CD4+ and CD8+ counts are greater in portal area compared to the hepatic lobules, with greater CD8+ counts than CD4+. However, both CD4+ and CD8+ counts are not correlated to the severity of liver damage.  Keywords: CD4+, CD8+, intrahepatic, chronic hepatitis C, METAVIR
Cardiopulmonary Complications During and After Endoscopy in Elderly Patients:a Prospective Study Yusuf, Sabrina Munggarani; Dwimartutie, Noto; Maulahela, Hasan; Harimurti, Kuntjoro; Rinaldi, Ikhwan; Yunihastuti, Evy; Fauzy, Achmad; Putranto, Rudi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, AGUSTUS, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2622025120-129

Abstract

Background: The high incidence of gastrointestinal and pancreaticobiliary diseases among elderly has led to increased endoscopic procedures in this population. Previous studies indicate a higher risk of cardiopulmonary complications during and after endoscopy in elderly patients compared to younger individuals. This study investigated the incidence and contributing factors of endoscopy-related cardiopulmonary complications in elderly patients.Methods: A prospective cohort study was conducted on 194 patients aged ≥ 60 years undergoing endoscopy at the Gastrointestinal Endoscopy Center, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from August to October 2023. Consecutive sampling method was used. Multivariate analysis with logistic regression was conducted. Results: Among the 194 patients included, 49.52% experienced cardiopulmonary complications. The most common complications were tachycardia (23.20%), hypoxemia (15.03%), and hypotension (6.20%). Multivariate analysis identified the complexity of the procedure (ASGE level ≥ 3) as a significant risk factor (RR 1.505, 95% CI 1.039-2.179; p=0.03), while mild-moderate sedation was associated with a reduced risk of complications (RR 0.668, 95% CI 0.458-0.975; p=0,037). Conclusion: The incidence of cardiopulmonary complications during and after endoscopy is high among Indonesian elderly. Procedure complexity is an independent risk factor, whereas mild-moderate sedation mitigates the risk. In opposite, advanced age, multimorbidities, high ASA class, long duration of procedure, poor nutritional and functional status, and type of procedure did not affect outcomes
Co-Authors . Andriansjah A. Harryanto Achmad Fauzy, Achmad Adityo Susilo, Adityo Agus Joko Susanto, Agus Joko Agus Siswanto Agus Susanto Kosasih, Agus Susanto Andhika Rachman Andra Aswar Andra Aswar, Andra Andri Sanityoso Sulaiman Anis Karuniawati Anna Mira Lubis Antono, Akbarbudhi Ario Perbowo Putra Ario Perbowo Putra, Ario Perbowo Aru W Sudoyo Aru W Sudoyo Aulia Rizka Aulia Rizka, Aulia Birry Karim Bonar, Maruhum Bonar H C Martin Rumende C Martin Rumende C Martin Rumende C Rinaldi A Lesmana C. Martin Rumende, C. Martin Ceva W. Pitoyo Chyntia Olivia Maurine Cleopas M Rumende, Cleopas M Cleopas Martin Rumende Cleopas Martin Rumende Czeresna Heriawan Soejono Dedy G Sudrajat Dedy G Sudrajat, Dedy G Desi Salwani, Desi Dewi Gathmyr Dharmeizar Dharmeizar Dharmeizar Dharmeizar Djafar, Fitria Djumhana Atmakusuma Djumhana Atmakusuma, Djumhana Dono Antono E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Eka Ginanjar Elza Febria Sari Elza Febria Sari Em Yunir Em Yunir, Em Ening Krisnuhoni Eric Daniel Tenda Erni Juwita Nelwan, Erni Juwita Esthika Dewiasty Esthika Dewiasty, Esthika Evy Yunihastuti Fiastuti Witjaksono Fifi Dwijayanti Ginova Nainggolan Gunawan Gunawan Gunawan Gunawan Gurmeet Singh Gurmeet Singh Hakim, Manfaluthy Harini Oktadiana Harini Oktadiana, Harini Harningtyas Jasmin Harryanto, A. Hasan Maulahela, Hasan Hikari Ambara Sjakti, Hikari Ambara HILMAN TADJOEDIN, HILMAN Idrus Alwi Idrus Alwi Idrus Alwi Ika P Wijaya, Ika P Ikhwan Rinaldi Imam Subekti Indra G Mansur, Indra G Irene Yuniar, Irene Iris Rengganis Iris Rengganis Jeo, Wifanto Saditya Juferdy Kurniawan Koesno, Soekamto M Sadikin Martini, Rose D Maruhum B.H. Marbun Megantara, Marcelino A. Mira Yulianti Mira Yulianti, Mira Muhadi Muhadi, Muhadi Muhammad Aini Murdani Abdullah Murdani Abdullah Murti Andriastuti, Murti Mururul Aisyi Nasrun, Martina W. Ni Made Hustrini, Ni Made Noto Dwimartutie Parlindungan Siregar Pringgodigdo Nugroho, Pringgodigdo Rachmat Hamonangan, Rachmat Rika Bur Rini Sekartini Rino Alvani Gani Rino Alvani Gani Roza Mulyana Rudi Putranto Sabrina Munggarani Yusuf Sally A Nasution, Sally A Saputra, Fahreza Setiati, Slti Shufrie Effendy Shufrie Effendy Siti Setiati Siti Setiati Siti Taqwa Fitria Lubis, Siti Taqwa Fitria Sudrajat, Dedy G. Suhardjono Suhardjono Suhardjono Suhardjono Suhendro Suwarto Suhendro Suwarto Suhendro Suwarto, Suhendro Sukamto Koesnoe Sukamto Koesnoe Sulistianingsih, Dyah Purnamasari Susilo Chandra Suzanna Immanuel Tagor, Alvin TB Djumhana TB Djumhana, TB Teguh Harjono Karjadi, Teguh Harjono Teny Tjitra Sari, Teny Tjitra Tri Juli Edi Tarigan Triyani Kresnawan Triyani Kresnawan, Triyani Ujainah Zaini Nasir Utomo, Ahmad Rusdan Handoyo Wahyuni Indawati Wawan Kurniawan Wawan Kurniawan Widayat Djoko Santoso, Widayat Djoko Wifanto Saditya Jeo Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Wirahmadi, Angga Wulyo Rajabto Zulkifli Amin