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All Journal Jurnal Konseling dan Pendidikan Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The New Ropanasuri Journal of Surgery The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Toar J.M. Lalisang
Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Managing Gallstone during Pregnancy Lalisang, Toar JM
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 4, October 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Transient physiological changes in the biliary system during pregnancy increased the risk of gallbladder diseases. Nonoperative management of symptomatic cholelithiasis increases the risk of complications of biliary lithiasis, such as cholecystitis and empyema, while obstruction common bile duct stones with or without cholangitisb and biliary pancreatitis raise maternal mortality. Delay in definitive surgical treatment of biliary diseases during pregnancy increases the likelihood acute biliary pancreatitis which impact on preterm delivery until fetal lost. Laparoscopic cholesystectomy during pregnancy has advantages for the mother in that it speeds up her recovery, giving her less pain and facilitated natural birth without a cesarean section. On the fetus side, laparoscopic cholecystectomy is safe since it does not induce preterm delivery or abortion. Identification of gallbladder stone during pregnancy warrant a preventive laparoscopic cholesystectomy or endoscopic CBD exploration, both of which promise good outcomes. [Indones J Obstet Gynecol 2013; 1-4: 219-21] Keywords: adult choledochal cyst, biliary cyst, biliary dilatation, mixed type
Managing Gallstone during Pregnancy Lalisang, Toar JM
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 4, October 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (81.332 KB) | DOI: 10.32771/inajog.v1i4.370

Abstract

Transient physiological changes in the biliary system during pregnancy increased the risk of gallbladder diseases. Nonoperative management of symptomatic cholelithiasis increases the risk of complications of biliary lithiasis, such as cholecystitis and empyema, while obstruction common bile duct stones with or without cholangitisb and biliary pancreatitis raise maternal mortality. Delay in definitive surgical treatment of biliary diseases during pregnancy increases the likelihood acute biliary pancreatitis which impact on preterm delivery until fetal lost. Laparoscopic cholesystectomy during pregnancy has advantages for the mother in that it speeds up her recovery, giving her less pain and facilitated natural birth without a cesarean section. On the fetus side, laparoscopic cholecystectomy is safe since it does not induce preterm delivery or abortion. Identification of gallbladder stone during pregnancy warrant a preventive laparoscopic cholesystectomy or endoscopic CBD exploration, both of which promise good outcomes. [Indones J Obstet Gynecol 2013; 1-4: 219-21] Keywords: adult choledochal cyst, biliary cyst, biliary dilatation, mixed type
Merit of APACHE II, MPI and ARPI scores as determinants On Demand Relaparotomy Kamil, Radhita F.; Lalisang, Toar JM; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Delayed in decision making to carry out relaparotomy increases the morbidity and mortality. The decision to be made on demand relaparotomy is a kind of one subjectivity on the clinical setting. Therefore, it is necessary to have a thorough physical examination with additional diagnostic tools as the rationale to make an accurate decision that is the scoring system. There were many scoring systems has been proposed, and we run a study aimed to find out the merit of those scoring. Method. We run a case-control study enrolled 32 subjects with on demand relaparotomy and 64 subjects with laparotomy for any indication. APACHE II, MPI, ARPI scores were applied as variables. Data collected retrospectively from those who underwent laparotomy andrelaparotomy in RS dr.Cipto Mangunkusumo General Hospital in period of January 2012 to December 2013. These variables subjected to statistical analysis. Results. Based on statistical analysis of the two groups we found that APACHE II showed no significant difference (p = 0.114), whilst MPI and ARPI showed significant difference (p <0.0001). ROC curve showed that APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10. Conclusion. MPI and ARPI could be used as determinants on demand relaparotomy.
Hemorrhoid: Pathophysiology and Surgical Management A Literature reviews Lalisang, Toar JM
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Epidemiology of Microorganisms in intraabdominal infection/complicated intraabdominal infections in six centers of surgical care in Indonesia: A preliminary study Moenadjat, Yefta; Lalisang, Toar JM.; Saunar, Rofy S.; Usman, Nurhayat; Handaya, Adeodatus Y.; Iswanto, J.; Nasution, Safruddin; Karuniawati, Anis; Loho, Tony; Widyahening, Indah S.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Data of complicated intraabdominal infections (cIAI) and the epidemiology of causative microorganisms which is Indonesian characteristics is required to develop a guideline. Thus, a preliminary study run to find out such characteristics. Method. Data of subjects with cIAI managed in six centers of teaching hospital in Indonesia in period of 2015–2016 were collected. Those data of source of infection, the epidemiology of microorganism and susceptibility of antibiotics were descriptively provided. Results. Source of infection were perforated appendicitis (26.64%), perforated gastric and duodenal ulcer (22.70%), small bowel perforation (11.84%), large bowel perforation (13.16%), postoperative (9.54%), and others (16.2%). Escherichia coli and Klebsiella pneumonia were the most microorganisms found in the pus specimen. The sensitivity of Escherichia coli and Klebsiella pneumonia to cephalosporins were in range of 14.1– 42% and 28.7–35.6%, respectively. Conclusion. Perforated appendicitis, perforated gastric and duodenal ulcer, small bowel perforation, large bowel perforation, and postoperative in sequent are the main causal of cIAIin Indonesia. The epidemiology predominated by Gram negative, particularly Escherichia coli and Klebsiella pneumonia.
Critical Appraisal to Intraabdominal and Complicated Intraabdominal Guidelines to Develop Indonesian Specific Clinical Practice Guidelines Moenadjat, Yefta; Mulya, Dina D.; Lalisang, Toar JM.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. There were many clinical practice guidelines (CPG) intraabdominal infection/complicated intraabdominal infections (cIAI) have been developed since 1992 and were periodically updated recently. But to date, the implementation in Indonesia encountering problems. One is Indonesian characteristics which is differed to the population of where the CPG developed. To adapt a CPG, the quality of CPG should be first critically appraised. The best will be used furthers as the subject to be adapted, with modification regarding Indonesian characteristics. Method. A literature search carried out on guidelines databases to find out CPG on cIAI (1992–2017). The assessment preceded using AGREE II tools (MyAGREE platform) focused on 23 assessments in 6 domains (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence). Such an assessment placed a guideline in rating of 1 to 7. Updated guidelines were assessed using Checklist for the Reporting of Updated Guidelines (CheckUp). Appraised CPG were discussed. Results. There were 33 CPG in full text downloaded and subjected to selection criteria. Duplicates and those irrelevant were excluded. In the assessment there were 18 CPG included and 13 guidelines places the strong recommended category, two can be recommended and other 2 were not recommended. All updated CPG met the criteria of the best quality updates. Conclusion. Two cIAI–CPG were met the criteria of the quality guidelines to be adopted. These guidelines were developed in accordance with appropriateness in development a CPG and were updated.
Clinical Presentation of Abdominal Tuberculosis Putranto, Agi S.; Bakti, Purnama S.; Mazni, Yarman; Jeo, Wifanto S.; Lalisang, Toar JM.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Nowadays, tuberculosis remains an issue of global. It may have affected all gastrointestinal organs, including peritoneum. Thus, diagnostic approach of this abdominal tuberculosis remains challenging as it may present non–specific features and mimics other abdominal pathologies. A study focused on clinical and laboratory findings, imaging and evaluation of management of those diagnosed as abdominal tuberculosis was required. Method. A cross–sectional study proceeded retrospectively aimed for an evaluation. All abdominal tuberculosis managed in dr Cipto Mangunkusumo General Hospital, Jakarta and Fatmawati General Hospital, Jakarta during January 2011 to December 2013 were enrolled. Data collected from data registration, subject’s characteristic, clinical findings, laboratory findings, and imaging were variables subjected to analysis. Results. There were forty–eight subjects recorded. The most symptoms found were abdominal pain (81.25%), abdominal distention (72.9%), fever (68.75%) and weight loss (68.75%). While as most laboratory findings were leukocytosis (52%) and elevated erythrocyte sedimentation rate, ESR (72.9%). And up to 50% subject showed normal chest x–ray while as other showed non–specific features for pulmonary tuberculosis. Conclusion. Clinical presentations showed to be diverse. Laboratory finding, and imaging maybe valuable to diagnose abdominal tuberculosis, although chest x–ray represents non–specific features for pulmonary tuberculosis. Evaluation of these clinical findings and lead to accurate diagnostic approach; which was determine the characteristics associated with abdominal tuberculosis diagnostics value..
How early is early…? The Role of Abdominal Reoperation Predictive Index at dr. Cipto Mangunkusumo General Hospital, Jakarta Marbun, Vania MG; Lalisang, Toar JM
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Determining the right timing of relaparotomy has always been a challenge and hence a simple objective value is required. Abdominal reoperative predictive index (ARPI) proposed to decide when to reoperate. The study aimed to ascertain whether ARPI could be applied in decision making for relaparotomy at dr.Cipto Mangunkusumo General Hospital (RSCM), Jakarta. Method. A cross sectional study carried out on those underwent relaparotomy in Department of Surgery at RSCM during period of 2009–2015. The follow–up carried out by the residents under supervision of attending surgeons, the laboratory findings were reviewed and tabulated in accordance with clinical variables of ARPI. Eight variables of ARPI were reviewed in these subjects. Results. There were 30 subjects reviewed. In this study there were four frequent variables, i.e. persistent symptoms (for more than 4 days after relaparotomy), abdominal pain (that remains for 48 hours after relaparotomy), surgical site infection (90%), and ileus (70%). Seventy–three–point three percent carried out in more than 7 days after primary operation, while as only 10 percent underwent relaparotomy less than 4 days after primary operation. Conclusion. ARPI is practical guide and may be implemented in helping surgeons to decide relaparotomy should there required. Low compliance lead to delay in the management and associated with high mortality.
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
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.
Biology of Glycocalyx: The Essential Role in Maintaining Epithelial Barrier: A Mini-Review Lalisang, Toar J.M.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Co-Authors Achir Yani S. Hamid Adeodatus Yuda Handaya Adi Wijaya Adi Wijaya Adianto Nugroho Agung Ary Wibowo, Agung Ary Akmal Taher Ali Sulaiman Ali Sulaiman Anis Karuniawati Ari F Syam Aria Kekalih Arman A Abdullah Arnold Simanjuntak Bakti, Purnama S. Bennardus Philippi Benny Philippi Bernardus Philippi Dahlia, Debie - Dharmika D Evi Martha Fransisca J Siahaya Fransiscus Arifin Handaya, Adeodatus Y. Hehuwat, Georgina P. Helen, Helen Husniah Th-Akib Indah Gianawati Indah S. Widyahening Indah Situmorang Irmia Kusumadewi Irwan Irwan Iswanto, J. Iwan Darmansjah Jeo, Wifanto S. Johannes Hudiono Kamil, Radhita F. L A Lesmana Lalisang, Arnetta Naomi Louise Lalisang, Arnetta NL Lesmana, Tommy Liberty Tua Panahatan Marbun, Vania MG Maria Mayasari Marini Stephanie Matondang, Sahat Mazni, Yarman Moenadjad, Yefta Muhar, Adi Muradi Mulya, Dina D. Mulyawan, I Made Nasution, Safruddin Niam, Muhammad Shobachun Nurjati C. Siregar Nurjati C. Siregar Prabowo, Erik Pratama, Irfan K. Putra, Jeffri Putranto, Agi S. Raden Sjamsuhidayat Ratna Aryani Ratna Aryani Reno Rudiman Rianto Setiabudy Ristiyanto, Eko Rivai, Muhammad Iqbal Sahat Matondang Saunar, Rofy S. Setyadi, Kunsemedi Soehartati Gondhowiarjo Suprapto, Bambang Syaiful, Ridho A Tendean, Michael Tony Loho Usman, Nurhayat Warsinggih, Warsinggih Wibowo, Taufik A Wicaturatmashudi, Sukma Yarman Mazni Yefta Moenadjad Yefta Moenadjat