Korelasi Gamma Glutamyl Transferase dan Percutaneous Transhepatic Cholecysto-Cholangiography sebagai Alternatif Kolangiografi Intraoperatif Anak dengan Atresia Bilier
DOI:
https://doi.org/10.32583/pskm.v13i1.276Keywords:
anak, atresia billier, gamma glutamyl transferase, percutaneous transhepatic cholecysto-cholangiographyAbstract
Kolestasis neonatus dapat dibagi menjadi penyakit ekstrahepatik dan intrahepatik. Gamma glutamyl transferase (GGT) adalah pengukuran noninvasif untuk atresia bilier. Gamma glutamyl transferase (GGT) banyak digunakan untuk evaluasi kelainan bilier. Modalitas lain untuk mendiagnosis atresia bilier adalah percutaneous transhepatic cholecysto-cholangiography (PTCC). Penelitian ini merupakan penelitian retrospektif yang dilakukan di Rumah Sakit Umum Daerah Dr.Moewardi Surakarta, Jawa Tengah dari Januari 2019 sampai Oktober 2021. Sampel 26 pasien anak suspek atresia bilier dipilih secara cross sectional study. Data diambil dari rekam medis pasien dan dianalisis dengan uji chi square. Hasil penelitian menunjukkan bahwa cut-off level gamma glutamyl transferase (GGT) 96 U/L, gamma glutamyl transferase (GGT) memiliki sensitivitas 84,2%, spesifisitas 71,4%, nilai prediksi positif 88,9%, 62,5% nilai prediksi negatif, dan 76% nilai AUC. Kadar gamma glutamyl transferase (GGT) memiliki korelasi yang signifikan dengan temuan Percutaneous Transhepatic Cholecysto-Cholangiography (PTCC). Semakin tinggi tingkat gamma glutamyl transferase (GGT) semakin tinggi risiko atresia biliaris. Oleh karena itu didapatkan kadar gamma glutamyl transferase (GGT) >96, Percutaneous Transhepatic Cholecysto-Cholangiography (PTCC) harus segera dilakukan untuk menegakkan diagnosis secara dini.
References
Aʇin, M., Tümgör, G., Alkan, M., Özden, Ö., Satar, M., & Tuncer, R. (2016). Clues to the diagnosis of biliary atresia in neonatal cholestasis. Turkish Journal of Gastroenterology, 27(1), 37–41. https://doi.org/10.5152/tjg.2015.150379/tanggal akses : 15 September 2022.
Bilal, H., Irshad, M., Shahzadi, N., Hashmi, A., & Ullah, H. (2022). Neonatal Cholestasis: The Changing Etiological Spectrum in Pakistani Children. Cureus, 14(6), 12–17. https://doi.org/10.7759/cureus.25882/tanggal akses : 15 September 2022.
Chen, X., Dong, R., Shen, Z., Yan, W., & Zheng, S. (2016). Value of gamma-glutamyl transpeptidase for diagnosis of biliary atresia by correlation with age. Journal of Pediatric Gastroenterology and Nutrition, 63(3), 370–373. https://doi.org/10.1097/MPG.0000000000001168/tanggal akses : 20 Agustus 2022.
Chen, Y., Zhao, D., Gu, S., Li, Y., Pan, W., & Zhang, Y. (2020). Three-color risk stratification for improving the diagnostic accuracy for biliary atresia. European Radiology, 30(7), 3852–3861. https://doi.org/10.1007/s00330-020-06751-7/tanggal akses : 20 Agustus 2022.
Dai, S. Y., Sun, Y. Q., Wu, Y., Chen, G., Sun, S., Dong, R., & Zheng, S. (2021). Development and Assessment of Screening Nomogram for Biliary Atresia Based on Hepatobiliary Ultrasonographic Features. Frontiers in Pediatrics, 9(May), 1–8. https://doi.org/10.3389/fped.2021.625451/tanggal akses : 20 Agustus 2022.
Dong, R., Jiang, J., Zhang, S., Shen, Z., Chen, G., Huang, Y., Zheng, Y., & Zheng, S. (2018). Development and Validation of Novel Diagnostic Models for Biliary Atresia in a Large Cohort of Chinese Patients. EBioMedicine, 34, 223–230. https://doi.org/10.1016/j.ebiom.2018.07.025/tanggal akses : 20 Agustus 2022.
He, L., Ip, D. K. M., Tam, G., Lui, V. C. H., Tam, P. K. H., & Chung, P. H. Y. (2021). Biomarkers for the diagnosis and post-Kasai portoenterostomy prognosis of biliary atresia: a systematic review and meta-analysis. Scientific Reports, 11(1), 1–14. https://doi.org/10.1038/s41598-021-91072-y/tanggal akses : 20 Agustus 2022.
Ismandhani, A. K., Gunadi., Makhmudi A., Dwihantoro A. 2017. Akurasi peningkatan kadar Gamma-glutamyl transferase dan alkaline phosphatase untuk diagnosis atresia bilier di RSUP DR. Sardjito Yogyakarta. Universitas Gajah Mada; 2017. http://etd.repository.ugm.ac.id/penelitian/detail/132053/tanggal akses : 20 Agustus 2022.
Kliegman, R. M & Geme S. J. 2015. Nelson textbook of pediatric. 20th ed. canada: Elsevier/tanggal akses : 20 Agustus 2022.
Lendahl, U., Lui, V. C. H., Chung, P. H. Y., & Tam, P. K. H. (2021). Biliary Atresia – emerging diagnostic and therapy opportunities. EBioMedicine, 74, 103689. https://doi.org/10.1016/j.ebiom.2021.103689/tanggal akses : 20 Agustus 2022.
Moreira, R. K., Cabral, R., Cowles, R. A., & Lobritto, S. J. (2012). Biliary atresia: A multidisciplinary approach to diagnosis and management. Archives of Pathology and Laboratory Medicine, 136(7), 746–760. https://doi.org/10.5858/arpa.2011-0623-RA/tanggal akses : 20 September 2022.
Nakamura, H., & Yamataka, A. (2018). Non-invasive and accurate diagnostic system for biliary atresia. EBioMedicine, 36, 16–17. https://doi.org/10.1016/j.ebiom.2018.09.032/tanggal akses : 20 September 2022.
Shen, Q., Tan, S. S., Wang, Z., Cai, S., Pang, W., Peng, C., & Chen, Y. (2020). Combination of gamma-glutamyl transferase and liver stiffness measurement for biliary atresia screening at different ages: A retrospective analysis of 282 infants. BMC Pediatrics, 20(1), 1–8. https://doi.org/10.1186/s12887-020-02172-z/tanggal akses : 20 Agustus 2022.
Sujka, J., Weaver, K. L., Poola, A. S., Rivard, D. C., & Hendrickson, R. J. (2018). Percutaneous transhepatic cholecysto-cholangiography (PTCC): An alternative to intraoperative cholangiography in high risk infants suspect for biliary atresia. Journal of Pediatric Surgery Case Reports, 38(May), 61–63. https://doi.org/10.1016/j.epsc.2018.05.003/tanggal akses : 20 Agustus 2022.
Tang, K.-S., Huang, L.-T., Huang, Y.-H., Lai, C.-Y., Wu, C.-H., Wang, S.-M., Hwang, K.-P., Huang, F.-C., & Tiao, M.-M. (2007). Gamma-glutamyl transferase in the diagnosis of biliary atresia. Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi, 48(4), 196–200/tanggal akses : 20 Agustus 2022.
Tanpowpong, P., Lertudomphonwanit, C., Phuapradit, P., & Treepongkaruna, S. (2021). Value of the international classification of diseases code for identifying children with biliary atresia. Korean Journal of Pediatrics, 64(2), 80–85. https://doi.org/10.3345/cep.2020.00423/tanggal akses : 20 September 2022
Vij, M., & Rela, M. (2020). Biliary atresia: Pathology, etiology and pathogenesis. Future Science OA, 6(5). https://doi.org/10.2144/fsoa-2019-0153/tanggal akses : 20 September 2022
Zhao, D., Zhou, K., Chen, Y., Xie, W., & Zhang, Y. (2020). Development and validation of bile acid profile-based scoring system for identification of biliary atresia: A prospective study. BMC Pediatrics, 20(1), 1–9. https://doi.org/10.1186/s12887-020-02169-8/tanggal akses : 20 September 2022
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
