Korelasi antara Volume Kandung Empedu, Jumlah Batu, dan Volume Batu pada Pemeriksaan MRCP terhadap Gangguan Fungsi Hati Pasien dengan Obstruksi Bilier akibat Cholecystolithiasis dan/atau Choledocholithiasis
Markus Yushan Nandiwardhana, Prof. Dr. dr. Lina Choridah, Sp. Rad., Subsp. PRP (K); dr. Wigati Dhamiyati, Sp. Rad., Sp.Onk.Rad. Subsp.Onk (K)
2026 | Tesis | S2 Kedokteran Klinik
Latar Belakang: Penyakit batu empedu
merupakan salah satu penyakit gastrointestinal yang sering ditemukan dengan
komplikasi berupa obstruksi bilier yang dapat menyebabkan gangguan fungsi hati.
Pemeriksaan Magnetic Resonance Cholangiopancreatography (MRCP) mampu
mengevaluasi karakteristik batu empedu, termasuk volume kandung empedu, jumlah
batu, dan volume batu. Namun, hubungan antara parameter radiologis tersebut
dengan gangguan fungsi hati masih belum banyak diteliti.
Tujuan: Mengetahui korelasi antara
volume kandung empedu, jumlah batu, dan volume batu pada pemeriksaan MRCP
terhadap gangguan fungsi hati pasien dengan obstruksi bilier akibat cholecystolithiasis
dan/atau choledocholithiasis.
Metode: Penelitian ini merupakan
penelitian observasional analitik dengan rancangan potong lintang (cross-sectional)
retrospektif. Data diperoleh dari pasien dewasa dengan diagnosis cholecystolithiasis
dan/atau choledocholithiasis yang menjalani pemeriksaan MRCP di RSUP Dr.
Sardjito Yogyakarta. Pengukuran volume kandung empedu dan volume batu dilakukan
menggunakan metode ellipsoid, sedangkan jumlah batu dihitung secara manual.
Parameter fungsi hati meliputi SGOT, SGPT, bilirubin direct, dan
bilirubin indirect diperoleh dari rekam medis. Uji reliabilitas
interobserver dianalisis menggunakan Intraclass Correlation Coefficient (ICC).
Analisi
korelasi dilakukan dengan Korelasi Spearman.
Hasil: Reliabilitas
interobserver menunjukkan kesesuaian yang baik hingga sangat baik pada seluruh
parameter pengukuran. Analisis korelasi menunjukkan tidak terdapat hubungan
yang bermakna antara volume kandung empedu, volume batu, maupun jumlah batu
dengan kadar SGOT, SGPT, bilirubin direct, dan bilirubin indirect
pada kedua observer (seluruh p>0,05). Koefisien korelasi yang diperoleh
menunjukkan hubungan yang sangat lemah hingga lemah.
Kesimpulan: Volume kandung
empedu, volume batu, dan jumlah batu pada pemeriksaan MRCP tidak berkorelasi
secara bermakna dengan parameter fungsi hati pada pasien dengan obstruksi
bilier akibat cholecystolithiasis dan/atau choledocholithiasis.
Background:
Gallstone disease is one of the most common gastrointestinal disorders and may
be complicated by biliary obstruction, leading to liver function impairment.
Magnetic Resonance Cholangiopancreatography (MRCP) enables the evaluation of
gallstone characteristics, including gallbladder volume, stone number, and
stone volume. However, the relationship between these radiological parameters
and liver function impairment has not been extensively investigated.
Objective: To
determine the correlation between gallbladder volume, stone number, and stone
volume measured on MRCP and liver function impairment in patients with biliary
obstruction secondary to cholecystolithiasis and/or choledocholithiasis.
Methods: This
was a retrospective cross-sectional analytic observational study. Data were
obtained from adult patients diagnosed with cholecystolithiasis and/or
choledocholithiasis who underwent MRCP at Dr. Sardjito Hospital, Yogyakarta.
Gallbladder volume and stone volume were measured using the ellipsoid method,
while stone number was counted manually. Liver function parameters, including
serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic
transaminase (SGPT), direct bilirubin, and indirect bilirubin, were obtained
from medical records. Interobserver reliability was assessed using the
Intraclass Correlation Coefficient (ICC). Correlation analysis was performed
using Spearman's rank correlation test.
Results:
Interobserver reliability demonstrated good to excellent agreement for all
measurement parameters. Correlation analysis showed no significant association
between gallbladder volume, stone volume, or stone number and serum SGOT, SGPT,
direct bilirubin, or indirect bilirubin levels for either observer (all p >
0.05). The correlation coefficients indicated very weak to weak relationships.
Conclusion:
Gallbladder volume, stone volume, and stone number measured on MRCP were not
significantly correlated with liver function parameters in patients with
biliary obstruction secondary to cholecystolithiasis and/or
choledocholithiasis.
Kata Kunci : MRCP, batu empedu, volume kandung empedu, volume batu, fungsi hati
