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All Journal e-CliniC Jurnal Ilmiah Universitas Batanghari Jambi
Ayawaila, Marven
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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.
Clinical Characteristics and Outcomes of Pancreaticoduodenectomy (Whipple Procedure) in the Last Five Years at Prof. Dr. R. D. Kandou Hospital Tendean, Michael; Tjandra, Ferdinand; Mambu, Toar; Ayawaila, Marven; Sihaloho, Eric
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65822

Abstract

Abstract: Pancreatoduodenectomy (Whipple) is the standard procedure for resectable pancreatic and periampullary neoplasms. Although techniques and postoperative care continue to evolve, this procedure is still associated with high morbidity and significant complications, such as pancreatic fistula and delayed gastric emptying. It is most commonly performed on elderly patients with pancreatic adenocarcinoma and requires ongoing evaluation to improve outcomes. A five-year review is necessary to assess trends, complications, and postoperative outcomes as a basis for improving the quality of surgical management. This was a retrospective descriptive analysis of adult patients who underwent pancreatoduodenectomy at Prof. Dr. R. D. Kandou Hospital between 2020 and 2025. The inclusion criteria were patients with complete medical records, including demographic data, surgical indications, surgical outcomes, and postoperative complications. Cases with incomplete data, surgeries performed outside the study period, or patients who died before postoperative evaluation were excluded. Univariate analysis was performed using SPSS version 30 to describe clinical characteristics and patient outcomes. Of the 35 patients, the distribution of gender and diagnosis (icteric vs. non-icteric obstruction) was relatively balanced. Most underwent a single Whipple procedure (65.7%) using the duct-to-mucosa anastomosis technique (80%). Postoperative complications occurred in 57.1% of patients, and 30-day mortality was 34.3%. The mean age of patients was 55.6 years, the duration of surgery was 370 minutes, the blood loss was 568 cc, and the length of hospital stay was 9.8 days. In conclusion, the Whipple procedure demonstrates variable outcomes with high morbidity and a 30-day mortality rate of 34.3%. End-to-side anastomosis is the most commonly used technique. Age, case complexity, and operative variability influence patient recovery and prognosis. Keywords: pancreatoduodenectomy; pancreatic neoplasm
Co-Authors Jimmy Panelewen, Jimmy Luciana, Fanni Mambu, Toar Mambu, Toar D B Salem, Billy E. Ch.R. Sihaloho, Eric Tendean, Michael Tjandra, Ferdinand