Perbandingan Kadar Serum Bilirubin Pre dan Post Percutaneus Transhepatic Biliary Drainage (PTBD) Pada Pasien Dengan Obstruksi Bilier

ALAN ANDERSON BANGUN, dr. Yana Supriatna, Ph.D, Sp.Rad(K)RI ; dr. Sudarmanta, Sp.Rad(K)RI

2022 | Tesis-Spesialis | RADIOLOGI

Latar Belakang. Obstruksi bilier merupakan suatu kondisi yang terjadi akibat sumbatan pada sistema bilier. Sumbatan pada saluran empedu dapat disebabkan oleh proses keganasan ataupun non keganasan. Evaluasi respon terapi pasca biliary drainage merupakan hal yang penting untuk menilai keberhasilan terapi serta mengetahui seberapa besar efektivitas PTBD pada kasus obstruksi bilier Tujuan. Tujuan penelitian ini untuk mengetahui perbedaan kadar bilirubin total dan bilirubin direk, sebelum dan sesudah prosedur PTBD pada pasien obstruksi bilier Bahan dan Metode. Penelitian ini merupakan studi analitik komparatif, desain retrospective cross-sectional dengan menggunakan data sekunder data bilirubin yang diakses dari SIMETRIS. Sampel adalah 28 pasien dengan obstruksi bilier yang telah menjalani tindakan PTBD di Cathlab Instalasi Radiologi RSUP Dr. Sardjito dari bulan Desember 2018-Juni 2022. Pengambilan data hasil evaluasi bilirubin diambil pada pemeriksaan laboratorium dalam rentang hari ke tiga hingga hari ke tujuh pasca tindakan PTBD Hasil. Hasil uji t-test berpasangan menunjukkan bahwa terdapat perbedaan yang signifikan antara nilai pre dan post PTBD terhadap kadar bilirubin total maupun bilirubin direk, dengan nilai nilai signifikansi (2-tailed) p=0.000 (p<0.05). Rata-rata pengurangan kadar bilirubin total pasca PTBD sebesar 30,4% sedangkan pada bilirubin direk sebesar 32,25%. Kesimpulan. Terdapat perbedaan yang signifikan terhadap kadar bilirubin total (p=0.000) dan bilirubin direk (p=0.000) antara pre dan post PTBD, dimana bilirubin total dan bilirubin direk menurun secara bermakna post PTBD.

Background. Biliary obstruction is a condition that occurs due to a blockage in the biliary system. Blockage of the bile ducts can be caused by malignant or non-malignant processes. Evaluation of the response to therapy after biliary drainage is important to assess the success of therapy and find out how much effectiveness PTBD has in cases of biliary obstruction. Objective. The purpose of this study was to determine differences in total and direct bilirubin levels, before and after the PTBD procedure in patients with biliary obstruction Material and Methods. This study is a comparative analytic study, a retrospective cross-sectional design using secondary data of bilirubin data accessed from SIMETRIS. Samples were 28 patients with biliary obstruction who had undergone PTBD procedures at the Radiology Installation Cathlab Dr. Sardjito from December 2018-June 2022. Data collection on the results of the bilirubin evaluation was taken at laboratory examinations in the range of day three to day seven after the PTBD. Results. The results of the paired t-test showed that there was a significant difference between the pre and post PTBD values for total and direct bilirubin levels, with a significance value (2-tailed) p=0.000 (p<0.05). The average reduction in total bilirubin levels after PTBD was 30.4% while in direct bilirubin it was 32.25%. Conclusion. There was a significant difference in total (p=0.000) and direct (p=0.000) bilirubin levels between pre and post PTBD, where total bilirubin and direct bilirubin decreased significantly post PTBD.

Kata Kunci : PTBD, bilirubin, obstruksi bilier