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Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP): A Single Centre 5-Year Experience Michael Tendean; Toar D. B. Mambu; Ferdinand Tjandra; Billy Salem; Jimmy Panelewen; Everly Corputty
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.46027

Abstract

Abstract: Endoscopic retrograde cholangiopancreatography (ERCP) and related procedures are established as necessary techniques in the diagnosis and treatment of biliopancreatic diseases. Caution is needed due to the high risk of complications that can be fatal. The main complications are pancreatitis, bleeding, perforation, biliary stents, and lithiasis treatment issues. This study aimed to evaluate the therapeutic ERCP at Prof. Dr. R. D. Kandou Hospital between 2017-2021. This was a retrospective study using patients’ medical record data. The results obtained a total of 196 ERCP procedures performed at Prof. Dr. R. D. Kandou Hospital in that period. Variations of etiology, technical difficulties, and morbidities were recorded. The success rate of endoscopic stone extraction was 77.9 %, EPBD 10.71 %, and stenting for biliary drainage 97.3 %. Etiology varied from bile duct stone (74%); malignancies of the pancreas (8%), duodenum (2%), and periampullary (4%); Klatskin tumor (5.6%); and other malignancies (5%). Associated morbidities were melena 2%, pancreatitis 1%, and cholangitis 0.5%. In conclusion, endoscopic retrograde cholangiopancreatography is a reliable method for the diagnosis and treatment of hepatobiliary and pancreatic diseases, shown by the low incidence of morbidities and mortalities. Keywords: endoscopic retrograde cholangiopancreatography; biliopancreatic diseases
Korelasi antara Neutrophil-to-Lymphocyte Ratio dan Kadar Carcinoembryonic Antigen Pra-Pasca Operasi pada Kanker Kolorektal Michael Iskandar; Michael Tendean; Billy Salem; Fredrik G. Langi
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.46621

Abstract

Abstract: Colorectal cancer is the third most common cancer in Indonesia with a mortality rate at fourth rank. A balance between systemic inflammation and immunity is necessary in the stratification of risk, treatment, and prognosis of various cancers. This study aimed to determine the relationship between neutrophil-to lymphocyte ratio (NLR) and carcinoembryonic antigen (CEA) in the survival of post-operative colorectal cancer patients. This was a retrospective hospital-based cohort study using the R statistical analysis tool version 4.2.2. The results obtained 88 colorectal cancer patients with histopathologically confirmed. Most were nearly 60 years old, with a relatively balanced proportion of men and women. The median of resected mass size was around 6 cm, 80% of tumors located in the rectum and rectosigmoid, a balanced proportion of stage II and III (44%), moderate differentiation (86%), with decreased NLR post-operation (median of 3,8 to 2,6), and decrased CEA post-operation (median 8,6 to 6,3). In conclusion, there is a positive correlation between NLR and CEA level, however, it is limited until three months post operation. After three months, the correlation is undetected anymore. Keywords: neutrophil-to-lymphocyte ratio; carcinoembryonic antigen; colorectal cancer; pre and post operation   Abstrak: Kanker kolorektal merupakan keganasan ketiga terbanyak di dunia dengan angka mortalitas urutan ke-empat. Keseimbangan antara peradangan sistemik dan imunitas diperlukan dalam stratifikasi risiko, pengobatan, dan prognosis berbagai jenis keganasan. Penelitian ini bertujuan untuk mengetahui hubungan antara neutrophil-to lymphocyte ratio (NLR) dan kadar carcinoembryonic antigen (CEA) pada kesintasan pasien kanker kolorektal pasca operasi. Jenis penelitian ialah kohort retrospektif berbasis rumah sakit dengan alat analisis statistik R versi 4.2.2. Hasil penelitian mendapatkan 88 pasien terkonfirmasi histopatologik kanker kolon rektal, berusia hampir 60 tahun, proporsi laki-laki dan perempuan relatif berimbang, median ukuran masa yang direseksi sekitar 6 cm, 80% tumor terletak di daerah rektum dan rektosigmoid, stadium II dan III presentasi berimbang (44%), diferensiasi sedang (86%), NLR menurun pada pasca operasi (median 3,8 menjadi 2,6), dan CEA menurun pada pasca operasi (median 8,6 menjadi 6,3). Simpulan penelitian ini ialah terdapat hubungan positif antara neutrophil-to-lymphocyte ratio (NLR) dan kadar carcinoembryonic antigen (CEA), tetapi hanya terbatas sampai tiga bulan pasca operasi. Korelasi keduanya tidak terdeteksi lagi setelah tiga bulan pasca operasi. Kata kunci: neutrophil-to-lymphocyte ratio; carcinoembryonic antigen: kanker kolon rektal; pre dan pasca operasi