Pankreatitis pasca endoscopic retrograde choalangiopancreatography dan hubungannya dengan beberapa faktor risiko: studi potong lintang pada pasien endoscopic retrograde choalangio pancreatography
DOI:
https://doi.org/10.36216/jpd.v7i1.210Keywords:
ERCP, PEP, faktor risiko, waktu kanulasi, keganasanAbstract
Latar Belakang: Endoscopic Retrograde Cholangiopancreatography (ERCP) adalah tindakan endoskopi untuk diagnostik dan terapi kelainan-kelainan di sistim pankreatobilier. Komplikasi yang paling sering ditemukan pasca tindakan adalah pankreatitis akut atau post-ERCP pancreatitis (PEP), dengan spektrum klinis dari ringan sampai berat, dan memerlukan biaya perawatan yang besar.
Tujuan: Studi ini bertujuan untuk mengetahui faktor-faktor risiko yang berhubungan dengan kejadian PEP pada pasien-pasien yang telah menjalani tindakan ERCP di Rumah Sakit Umum Pusat Sanglah Denpasar.
Metode: Studi ini adalah studi retrospektif yang melibatkan 118 pasien dari Januari 2015 sampai dengan Juni 2019. Sebanyak 12 faktor risiko yang berhubungan dengan pasien dan 6 faktor risiko yang berkaitan dengan prosedur ERCP dikumpulkan. Enzim amilase dan lipase diperiksa 24 jam setelah tindakan ERCP. Data kemudian dianalisis secara bivariat dan multivariat.
Hasil: Tingkat keberhasilan kanulasi didapatkan sebesar 77,1% dan kejadian PEP didapatkan sebesar 31,4%. Dari analisis bivariat terhadap 18 faktor-faktor risiko didapatkan 4 faktor risiko yang memiliki hubungan signifikan dengan PEP, yaitu batu CBD, keganasan, jumlah upaya kanulasi dan waktu kanulasi (p < 0,05). Hasil analisis multivariat dari keempat faktor risiko tersebut menunjukkan terdapat dua faktor risiko yang hasilnya signifikan yaitu keganasan (OR 4,001, p = 0,040, IK95%: 1,062-15,073) dan waktu kanulasi (OR 6,516, p = 0,045, IK95%: 1,039-40,874).
Simpulan: Adanya faktor keganasan dan waktu kanulasi yang melebihi 25 menit merupakan prediktor PEP.
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