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All Journal e-CliniC Jurnal Ilmiah Universitas Batanghari Jambi Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Tendean, Michael
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Perbandingan antara Skor ALBI, Child-Pugh, dan MELD dalam Memrediksi Kejadian Post Hepatectomy Liver Failure pada Pasien Karsinoma Hepato-seluler di RSUP Prof. Dr. R. D. Kandou Manado Martino, Celine; Tendean, Michael; Mambu, Toar D. B.; Langi, Fredrik G.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.51814

Abstract

Abstract: Hepatocellular carcinoma (HCC) accounts for nearly 90% of hepatic malignancies. ALBI (Albumin-Bilirubin), Child-Pugh, and MELD (Model for End-stage Liver Disease) scores can predict the incidence of Post Hepatectomy Liver Failure (PHLF) in patients undergoing liver resection. This study aimed to obtain the comparison of ALBI, Child-Pugh, and MELD scores in predicting the incidence of PHLF in patients undergoing liver resection. This was a descriptive and retrospective study using medical records of Prof. Dr. R. D. Kandou Hospital, Manado, from 2019 to early 2022. The results obtained 54 patients who had undergone liver resection. The Child Pugh, ALBI, and MELD scores had similar ability in predicting the prognosis of PHLF. The MELD score had the sensitivity dan specifity of 64% and 81%, and the accuracy of 78% meanwhile the ALBI dan Child-Pugh scores had sensitivity less than 50%. In conclusion, compared with the ALBI and Child Pugh scores, the MELD score has higher sensitivity. Keywords: hepatocellular carcinoma; ALBI score; Child-Pugh score; MELD score; post hepatectomy liver failure   Abstrak: Karsinoma hepatoseluler (HCC) menyumbang hampir 90% kasus keganasan pada hepar. Skor ALBI, Child-Pugh dan MELD (Model for End-stage Liver Disease) dapat memrediksi kejadian post hepatectomy liver failure (PHLF) pada pasien yang menjalani reseksi hepar. Penelitian ini bertujuan untuk membandingkan skor ALBI, Child-Pugh dan MELD dalam memrediksi kejadian PHLF pada pasien yang menjalani reseksi hepar. Jenis penelitian ialah deskriptif retrospektif menggunakan data rekam medis di RSUP Prof. Dr. R. D. Kandou Manado dari tahun 2019 sampai awal tahun 2022. Hasil penelitian mendapatkan 54 pasien yang telah menjalani reseksi hati. Skoring Child-Pugh, ALBI dan MELD memiliki kemampuan serupa dalam menentukan prognosis PHLF. Skor  MELD menunjukkan sensitivitas dan spesifisitas berturut-turut sebesar 64% dan 81%, dengan akurasi 78% sedangkan skor ALBI dan Child-Pugh memiliki sensitivitas di bawah 50%. Simpulan penelitian ini ialah dibandingkan dengan skor ALBI dan Child-Pugh, skor MELD memiliki sensitivitas lebih tinggi dalam memrediksi kejadian PHLF. Kata kunci: karsinoma hepatoseluler; skor ALBI; skor Child-Pugh; skor MELD; post hepatectomy liver failure
Development and Validation of a Scoring System for Predicting Complications of Pancreatitis in Patients with Post Endoscopic Retrograde Cholangiopancreatography Melatunan, Leonard A.; Mambu, Toar D. B.; Tendean, Michael; Langi, Fredrik G. L.
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.51815

Abstract

Abstract: Post ERCP pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP) with significant morbidity and mortality rates. Several factors are associated with the occurrence of PEP. There are several methods available to predict such complications, however, they are not yet valid and need some improvement. This study aimed to obtain a scoring system to predict the incidence of post ERCP pancreatitis. This was a retrospective study using medical records of patients who underwent ERCP at Prof. Dr. R. D. Kandou Hospital from 2017 to 2023. The results obtained 372 patients as samples. Gender, previous history of ERCP, cannulation attempt ≥5 times, pancreatogram, double wire technique, EPBD, and pancreatic duct stent failure were independently associated with PEP and included in the model, which achieved AUC 96.7%, sensitivity 95.0% and specificity 89.8%. In conclusion, a predictive scoring system to assess the incidence of post ERCP pancreatitis (PEP) using seven risk factors related to patient, procedure, operator, and technique is used to aid early identification of PEP and therapeutic intervention. This scoring system is simple and easy to use, and has high area under curve (AUC), sensitivity, and specificity. Keywords: endoscopic retrograde cholangiopancreatography (ERCP); post ERCP pancreatitis; scoring system
Rasio Neutrofil Limfosit sebagai Prediktor Kejadian Kebocoran Anastomosis pada Pasien Kanker Kolorektal Panelewen, Jimmy; Tendean, Michael; Langi, Fima; Akmal, Nuzly Q.
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.58246

Abstract

Abstract: Anastomotic leakage is a serious complication following colorectal cancer resection that can increase morbidity and mortality. This study aimed to analyze the potential of the neutrophil-lymphocyte ratio (NLR) as a predictor of anastomotic leakage in colorectal cancer patients. This was a retrospective analytical and observational study involving 30 patients who underwent colorectal cancer resection and anastomosis at Prof. Dr. R. D. Kandou Hospital in Manado. The NLR values were analyzed preoperatively and on the first (D+1), third (D+3), fifth (D+5), and seventh (D+7) postoperative days. The results showed significant differences in NLR values between leakage and non-leakage groups across all phases (p<0.001). The receiver operating characteristic (ROC) curve analysis yielded optimal NLR cut-offs for leakage prediction: preoperative >2.1150, D+1 >3.4750, D+3 >2.7650, D+5 >3.0200, and D+7 >3.2850, with sensitivity and specificity reaching 100% in several phases. In conclusion, neutrophil-lymphocyte ratio has a potential as an accurate predictor of anastomotic leakage, enabling early detection and improved risk management. Further research with larger samples is needed to validate these findings and explore their clinical applications. Keywords: neutrophil-lymphocyte ratio; anastomotic leakage; colorectal cancer    Abstrak: Kebocoran anastomosis merupakan komplikasi serius pasca reseksi kanker kolorektal yang dapat meningkatkan morbiditas dan mortalitas. Penelitian ini bertujuan menganalisis potensi rasio neutrofil limfosit (RNL) sebagai prediktor kejadian kebocoran anastomosis pada pasien kanker kolorektal. Penelitian ini menggunakan metode observasional analitik retrospektif, melibatkan 30 pasien yang menjalani reseksi dan anastomosis kanker kolorektal di RSUP Prof. Dr. R. D. Kandou Manado. Nilai RNL dianalisis pada fase preoperatif, hari pertama (H+1), ketiga (H+3), kelima (H+5), dan ketujuh (H+7) pasca operasi. Hasil penelitian memperlihatkan perbedaan bermakna nilai RNL antara kelompok kebocoran dan tanpa kebocoran pada semua fase (p<0,001). Analisis kurva ROC menghasilkan cut-off optimal RNL untuk prediksi kebocoran: preoperatif >2,1150, H+1 >3,4750, H+3 >2,7650, H+5 >3,0200, dan H+7 >3,2850, dengan sensitivitas dan spesifisitas mencapai 100% pada beberapa fase. Simpulan penelitian ini ialah rasio neutrofil limfosit memiliki potensi sebagai prediktor yang akurat untuk kebocoran anastomosis, serta memungkinkan deteksi dini dan manajemen risiko yang lebih baik. Penelitian lebih lanjut dengan sampel yang lebih besar diperlukan untuk memvalidasi temuan ini dan mengeksplorasi aplikasi klinisnya. Kata kunci: rasio neutrofil limfosit; kebocoran anastomosis; kanker kolorektal
Konsensus Perhimpunan Dokter Spesialis Bedah Digestif Indonesia tentang Pedoman Diagnosis dan Tatalaksana Batu Saluran Empedu Rivai, Muhammad Iqbal; Lalisang, Arnetta Naomi Louise; Nugroho, Adianto; Wibowo, Agung Ary; Handaya, Adeodatus Yuda; Arifin, Fransiscus; Situmorang, Indah; Prabowo, Erik; Irwan, Irwan; Mayasari, Maria; Tendean, Michael; Rudiman, Reno; Setyadi, Kunsemedi; Niam, Muhammad Shobachun; Suprapto, Bambang; Putra, Jeffri; Lesmana, Tommy; Mazni, Yarman; Muhar, Adi Muradi; Mulyawan, I Made; Warsinggih, Warsinggih; Lalisang, Toar Jean Maurice
Majalah Kedokteran Indonesia Vol 74 No 2 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.2-2024-1188

Abstract

Introduction: Choledocholithiasis, the presence of stones in the common bile duct (CBD), is a challenge in the field of digestive surgery due to the wide range of cases with varying levels of difficulty. Until now, the options for diagnostic and therapeutic modalities have been increasingly evolving, ranging from non-invasive to invasive procedures. Therefore, the Indonesian Society of Digestive Surgeons provides recommendations for the management of CBD stone cases in Indonesia.Method: The consensus was developed using the Delphi survey method involving digestive surgery experts from various cities in Indonesia. Several issues related to the diagnosis and management of CBD stones were formulated and answered based on current research, while also considering the opinions of the experts.Result: This consensus consists of two parts: 15 recommendations related to the selection of diagnostic modalities and 10 recommendations related to management options. Recommendations regarding diagnosis include the use of ultrasonography, abdominal CT-scan, and magnetic resonance cholangiopancreatography (MRCP). In addition to standard therapeutic procedures, this consensus also provides recommendations regarding contemporary procedures such as endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic common bile duct exploration (LCBDE), and open common bile duct exploration (OCBDE).Conclusion: These recommendations are aimed to assist digestive surgery experts in providing the best management for CBD stone cases.
Delayed Staged Hepatectomy for Metastatic Colorectal Cancer: A Single Case Report Tendean, Michael; Paparang, Steven; Tjandra, Ferdinand; Mambu, Toar; Panelewen, Jimmy; Salem, Billy
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.59701

Abstract

Abstract: Liver metastases are common in patients with colorectal cancer; almost 70% will develop liver metastases during the course. The recommended treatment for colorectal liver metastasis (CRLM) is multidisciplinary, including liver resection and chemotherapy. We reported a 52-year-old female with stage 3B distal third rectal adenocarcinoma which eight months earlier underwent Mile’s procedure plus total mesorectal excision (TME) followed by adjuvant radiotherapy (50gy). During surveillance, liver metastases was found at segments 4B-5. A delayed anatomical staged hepatectomy segments 4B-5 was performed. Intraoperative USG findings suggested liver metastases at segments 7, 8, and 3, and non-anatomical liver resection was performed in accordance with parenchymal liver sparing principles. No post-hepatectomy liver failure (PHLF) was detected, but billoma occured at 1-month post hepatectomy. USG guided percutaneous drainage was performed to resolve the billoma. Colorectal metastasis (CRLM) was detected at six months post-hepatectomy, and the patient underwent adjuvant chemotherapy with improvement in survival rate. In conclusion, delayed staged hepatectomy for CRLM is a safe and beneficial procedure, though there is still no guideline regarding the sequence of resection. Keywords: hepatectomy; colorectal metastasis; billoma; colorectal cancer
Complete Laparoscopic Excision and Bilio-digestive Reconstruction of a Type IA Choledochal Cyst Tendean, Michael; Ayawaila, Marven; Mambu, Toar D B; Tjandra, Ferdinand; Salem, Billy E. Ch.R.; Panelewen, Jimmy; Luciana, Fanni
Jurnal Ilmiah Universitas Batanghari Jambi Vol 25, No 2 (2025): Juli
Publisher : Universitas Batanghari Jambi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33087/jiubj.v25i2.5990

Abstract

Choledochal cysts  (CC) adalah dilatasi langka dari struktur empedu yang dapat muncul sebagai anomali tunggal atau ganda, mempengaruhi saluran empedu intrahepatik atau ekstrahepatik. Kista bawaan ini diklasifikasikan ke dalam berbagai jenis berdasarkan lokasinya, termasuk tipe I, II, III, dan IVa, dengan tipe V mempengaruhi segmen intrahepatik. Secara tradisional, eksisi terbuka telah menjadi pengobatan standar; namun, eksisi laparoskopi telah diterima secara global sejak diperkenalkan. Penelitian menggambarkan kasus yang melibatkan seorang wanita berusia 42 tahun yang mengalami nyeri kuadran perut kanan atas dan penyakit kuning intermiten, dengan MRI sebelumnya mengungkapkan kista koledokal tipe 1A yang mempengaruhi pertemuan saluran hati ke saluran empedu umum. Pasien menjalani eksisi laparoskopi lengkap dari kista koledokal, diikuti oleh hepaticojejunostomi Roux-en-Y untuk rekonstruksi bilio-pencernaan. Meskipun kebocoran empedu pasca operasi diamati di saluran pembuangan, itu sembuh pada hari pasca operasi (POD) 5, dan pasien dipulangkan dengan POD 7 tanpa efek samping. Temuan menunjukkan bahwa operasi laparoskopi untuk Choledochal cysts adalah pilihan yang aman dan efektif, terkait dengan rawat inap yang lebih singkat, komplikasi pasca operasi yang lebih sedikit, dan penurunan kehilangan darah dibandingkan dengan operasi terbuka. Dengan kemajuan berkelanjutan dalam keterampilan dan teknik laparoskopi, eksisi laparoskopi akan menjadi metode yang lebih disukai untuk mengobati kista koleskopi.
Asparaginase-Induced Acute Necrotizing Pancreatitis Resulting in Chronic Pancreatitis and Pseudocyst in an Adult with Acute Lymphocytic Leukemia Adiwinata, Randy; Waleleng, Bradley Jimmy; Haroen, Harlinda; Rotty, Linda; Gosal, Fandy; Rotty, Luciana; Hendratta, Cecillia; Lasut, Pearla; Winarta, Jeanne; Waleleng, Andrew; Tendean, Michael
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 1 (2023): VOLUME 24, NUMBER 1, April, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/241202398-101

Abstract

L-Asparaginase is one of the main chemotherapy regiments for acute lymphocytic leukemia (ALL) management. Acute pancreatitis is one of the serious side effects of l-asparaginase administration and may lead to interruption of chemotherapy cycle. Long term complications may be devastating for patients which include of pseudocyst pancreas and chronic pancreatitis. Asparaginase induced pancreatitis is rare among adult due to the nature of ALL which commonly occurred in children population. The pathophysiology of asparaginase induced pancreatitis is still unclear. Here we present 18-year-old male with ALL and asparaginase induced acute necrotizing pancreatitis which complicated to chronic pancreatitis and pseudocyst. 
Co-Authors Adeodatus Yuda Handaya Adianto Nugroho Agung Ary Wibowo, Agung Ary Akmal, Nuzly Q. Ayawaila, Marven Billy Salem Bradley Jimmy Waleleng Fandy Gosal Fransiscus Arifin Harlinda Haroen Hendratta, Cecillia Indah Situmorang Irwan Irwan Jimmy Panelewen, Jimmy Lalisang, Arnetta Naomi Louise Lalisang, Toar Jean Maurice Langi, Fima Langi, Fredrik G. L. Lesmana, Tommy Linda Rotty Luciana Rotty, Luciana Luciana, Fanni Mambu, Toar Mambu, Toar D B Mambu, Toar D. B. Maria Mayasari Martino, Celine Mazni, Yarman Melatunan, Leonard A. Muhar, Adi Muradi Mulyawan, I Made Niam, Muhammad Shobachun Paparang, Steven Pearla Lasut Prabowo, Erik Putra, Jeffri Randy Adiwinata, Randy Reno Rudiman Rivai, Muhammad Iqbal Salem, Billy E. Ch.R. Setyadi, Kunsemedi Suprapto, Bambang Tjandra, Ferdinand Waleleng, Andrew Warsinggih, Warsinggih Winarta, Jeanne