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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Budi Tan Oto
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Medicine & Pharmacology

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Identification and Stenting of Malignant Obstructive Jaundice : Determining the Success Rates of ERCP Budi Tan Oto; Achmad Fauzi; Ari Fahrial Syam; Marcellus Simadibrata; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.041 KB) | DOI: 10.24871/131201219-22

Abstract

Background: Malignant and benign lesions may cause obstructive jaundice. The treatment of these conditions includes biliary stenting drainage, percutaneous transhepatic biliary drainage (PTBD), or surgical procedures. In advanced malignant jaundice, stent placement often turns out to be difficult. The aim of this study was to determine the success rates of malignant obstructive jaundice detection utilising endoscopic retrograde cholangiopancreatography (ERCP) and its stent placement procedure. Method: We conducted a retrospective study in 139 patients who undergone ERCP in Cipto Mangunkusumo Hospital between October 2004 and July 2008. Data was analyzed descriptively with SPSS version 17.0. Results: Of 139 study subjects, 131 (94.2%) of them had clinical obstructive jaundice (direct bilirubin indirect bilirubin level). There were 73 (55.7) male patients, with age range of 20-84 years. Among 114 patients with identified cause of obstruction, 57 (50%) patients had undergone stent placement; however, only 32 (56.1%) patients had successful stent placement. Our descriptive analysis showed that age and sex did not affect the stent success rates, and malignancy was showed to be a factor of stent failure. Conclusion: ERCP appears to be reliable enough for identifying the cause of obstructive jaundice in most patients. In this study, the achieved success rate of stent placement is more than 50%. Moreover, such rate is lower in the malignant obstructive jaundice than the non-malignant counterparts. Papillary carcinoma is the most frequent cause of malignant obstructive jaundice. Keywords: ERCP, obstructive jaundice, stenting, malignancy
Colitis Tuberculosis Budi Tan Oto; Ahmad Fauzi; Ari Fahrial Syam; Marcellus Simadibrata; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
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: 10.24871/1132010143-149

Abstract

Tuberculosis (TB) is a significant public health problem worldwide. Indonesia is a country with the third highest prevalence of TB in the world after China and India. TB infection can attack all organs of the human body. TB in digestive system is one of the extrapulmonary TB manifestations and comprises of 3- 16% of all extrapulmonary TB cases. This type of TB may affect digestive system, peritoneum, mesentery lymphatic glands, liver, and spleen. Digestive system is affected in 66-75% of patients with abdominal TB. The ileocaecal region is most commonly affected. The manifestation of abdominal TB is not specific. Precise diagnostic approach and supporting results are needed to determine final diagnosis. However, there is no single examination adequate enough to diagnose abdominal TB. If the diagnosis can be established early, this disease could then be managed with conventional anti-TB drugs. Treatment for both 6-9 months period and 18-24 months period has been proven effective in management of extrapulmonary TB. In countries with high abdominal TB prevalence, initiation of anti-TB therapy is allowed if there are the clinical features present. Diagnosis can be determined when the patient has therapeutic response against the the anti-TB treatment.   Keywords: tuberculosis, colitis, extrapulmonary, antituberculosis drugs
Proportion and Factors Associated with Zinc Deficiency in Acute Diarrhea Patients Budi Tan Oto; Marcellus Simadibrata; Drupadi Harnopidjati Singh Dillon; Siti Setiati
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (532.494 KB) | DOI: 10.24871/122201172-78

Abstract

Background: Zinc may affect the intestinal immune response. No data has been available on zinc deficiency in adult patients with diarrhea, especially for Indonesian population. Zinc metabolism, etiologies, pathogenesis and clinical course of diarrhea may have various effects on zinc concentration in different population. This study aimed to determine the proportion of zinc deficiency in patients with acute diarrhea, including its associated factors. Method: A cross-sectional study was conducted in patients with acute diarrhea at outpatient clinics and emergency wards of four hospitals between August 2010 and March 2011. A serum zinc concentration of 10.7 µmol/L was set as cut-off value for zinc deficiency. Data was analyzed by using Chi-square test. Results: There were 101 subjects, 54.5% were female, the median age was 26 years, median duration of acute diarrhea was 5 days, and the median frequency was 6 times/day. About 95% patients had nutritional status of subjective global assessment (SGA) A and the mean value of body mass index was 19.3 ± 0.70 kg/m2. Approximately 88.1% patients had severe infective diarrhea based on hydration status. About 69.3% patients were zinc deficient with the mean serum zinc concentration of 9.26 ± 2.95 µ mol/L. We found a significant correlation between the severity of diarrhea and zinc deficiency in patients with acute diarrhea. Conclusion: The proportion of zinc deficiency in acute diarrhea patients was quite large although the mean serum zinc level was still below the National Health and Nutrition Examination Survey (NHANES) reference value. The severity of diarrhea has been proven to be significant that affects zinc deficiency in acute diarrhea patients. Keywords: zinc deficiency, acute diarrhea, adult
Co-Authors Abdul Aziz Rani Abdul Aziz Rani ACHMAD FAUZI Achmad Fauzi Ahmad Fauzi Ari Fahrial Syam Chudahman Manan Chudahman Manan Dadang Makmun Daldiyono Daldiyono Daldiyono Daldiyono Drupadi Harnopidjati Singh Dillon Fauzi Ahmad Muda Marcellus Simadibrata Marcellus Simadibrata Murdani Abdullah Murdani Abdullah Siti Setiati