FOLLOW UP KETAHANAN HIDUP DAN KUALITAS HIDUP PASIEN IKTERUS OBSTRUKTIF KARENA TUMOR PANKREAS PASKA PINTASAN BILIODIGESTI YANG MENDERITA DIABETES MELLITUS DIBANDINGKAN YANG TIDAK MENDERITA DIABETES MELLITUS DI RSUP DR.SARDJITO TAHUN 2009-2015

Novelia Dara Monika, dr. Hendro Wartatmo,Sp.B-KBD.

2016 | Tesis-Spesialis | S2 Ilmu Bedah

Latar Belakang : Ikterus obstruktif akibat keganasan sebagian besar disebabkan karsinoma kaput pankreas.85% pasien tidak bisa direseksi kuratif hanya paliatif, dengan kemampuan hidup 5 tahun kurang dari 5%, median 4-6 bulan. DM sering ditemukan bersamaan penyakit keganasan. Komplikasi vaskular DM menciptakan iskemik dan menghambat progresifitas tumor. Metode : Desain penelitian kohort retrospektif. Analisis ketahanan hidup dengan kurva Kaplan Meier,statistik bivariat cox regression. Kualitas hidup dinilai dengan Karnofsky Scale, diuji dengan Mann-Whitney. Hasil :Dari 55 kasus, 16 orang (29%) DM, 39 orang (71%) tidak DM.Ketahanan hidup kelompok DM 201 hari, kelompok tidak DM 347 hari. Analisis Log Rank p = 0.172. Kualitas hidup kelompok DM = 50, kelompok tidak DM = 60. Uji Mann-Whitney p = 0.040. Kesimpulan : Pasien ikterus obstruktif karena tumor pankreas paska pintasan biliodigesti yang DM, ketahanan hidup lebih rendah tidak bermakna, dan kualitas hidup lebih rendah bermakna daripada yang tidak DM.

Background : Obstructive jaundice due to malignancy is mostly caused by head pancreatic cancer. Around 85% are unresectable and only palliative care is feasible, with 5-year survival rate of less than 5%, median 4-6 months. DM is often found in coincidence with malignancy. Vascular complication of DM could cause ischaemic condition on the tumor site, and prevent the progressivity. Methods : Study design was retrospective cohort. Survival rate analysis was using KaplanMeier, bivariat statistical analysis with cox regression. Quality of life was measured with Karnofsky Scale, tested with Mann-Whitney. Results : Among 55 cases, 16 patients (29%) were DM, 39 (71%) were non-DM. Survival rate of DM patients was 201 days, non-DM was 347 days. Log Rank analysis with p=0.172. Quality of life of the DM patients was 50, non-DM was 60. Mann-whitney test was with p=0.04. Conclusion : Obstructive jaundice patients due to pancreatic tumor performed biliodigestive shunt with DM, has lower survival rate although not statistically significant. The quality of life was significanly lower as well, compared with non-DM.

Kata Kunci : obstructive jaundice, pancreatic tumor, DM