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Mambu, Toar D. B.
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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
Pengaruh Radioterapi Short-course Neoadjuvant terhadap Kadar Carcino-embryonic Antigen pada Adenokarsinoma Rekti Jeffri, Jeffri; Tjandra, Ferdinand; Mambu, Toar D. B.; Napitupulu, Enrico
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.v12i2.51820

Abstract

Abstract: Neoadjuvant therapy is starting to be used as an alternative treatment in type A medical centers, however, there is still no specific consensus in determining the role and type of neoadjuvant therapy in adenocarcinoma recti patients. As a result, the use of neoadjuvant therapy is still not widely used. This study aimed to compare the outcome in the form of carcinoembryonic antigen (CEA) in patients who continued surgery with short-course neoadjuvant radiotherapy with those who did not. This was a descriptive and retrospective study. Samples were recti cancer patients stage II – IV at Prof. Dr. R. D. Kandou Hospital Manado in the medical record of 2017-2022. Patients were divided into two groups, those who received short-course neoadjuvant radiotherapy and the control group with similar characteristics. The results showed that there was a difference in the decrease of CEA in the two groups. The mean decrease of CEA in the short-course neoadjuvant group was 16.54 5 µg/L which was higher compared to the control group 5.64 5 µg/L. In conclusion, neoadjuvant short-course radiotherapy can decrease the CEA level in adenocarcinoma recti patients. Keywords: adenocarcinoma recti; short-course neoadjuvant radiotherapy; carcinoembryonic antigen    Abstrak: Terapi neoadjuvan mulai digunakan sebagai alternatif penanganan pada pusat kesehatan tipe A, namun belum ada konsensus spesifik dalam penentuan peran dan tipe terapi neoadjuvan pada pasien adenokarsinoma rekti sehingga terapi ini belum dapat digunakan secara bebas. Penelitian ini bertujuan untuk membandingkan luaran berupa kadar carcinoembryonic antigen (CEA) pada pasien yang melanjutkan tindakan operasi dan radioterapi short-course neoadjuvant maupun yang tidak. Jenis penelitian ialah deskriptif retrospektif menggunakan pasien kanker rekti stadium II hingga IV di RSUP Prof. Dr. R. D. Kandou Manado yang terdata di rekam medis periode tahun 2017-2022. Pasien dibagi atas dua kelompok yaitu yang menerima radioterapi short-course neoadjuvant dan kelompok kontrol dengan karakteristik serupa. Hasil penelitian memperlihatkan bahwa terdapat perbedaan penurunan kadar CEA yang bermakna pada pasien adenokarsinoma rekti yang dilakukan radioterapi neoadjuvant short-course dibandingkan dengan kontrol. Rerata penurunan nilai CEA pada kelompok yang menjalani radioterapi short-course neoadjuvant sebanyak 16,54 5 µg/L, lebih tinggi dibandingkan pada kelompok kontrol sebanyak 5,64 5 µg/L. Simpulan penelitian ini ialah pemberian radioterapi neoadjuvant short-course dapat menurunkan kadar CEA pada pasien adenokarsinoma rekti. Kata kunci: adenokarsinoma rekti, terapi short-course neoadjuvant; carcinoembryonic antigen
Co-Authors Jeffri, Jeffri Langi, Fredrik G. L. Martino, Celine Melatunan, Leonard A. Napitupulu, Enrico Tendean, Michael Tjandra, Ferdinand