Akurasi pemeriksaan ultrasonografi dalam menegakkan diagnosis kolelitiasis pada pasien post Kolekistektomi

RAYMOND, Indra, Prof.dr. Marijata, SpB-KBD

2007 | Tesis | PPDS I Ilmu Bedah

Latar Belakang Masalah : Kolelitiasis merupakan salah satu masalah bedah yang paling sering di negera yang sudah berkembang. Masalah batu empedu menjadi lebih menonjol seiring dengan bertambahnya usia dan pada wanita batu empedu lebih sering muncul dua kali dibanding pada pria. Dibutuhkan pemeriksaan penunjang yang memiliki sensitifitas dan spesifitas yang tinggi pada penegakan diagnosis kolelitiasis. Subyek dan Metode : Penelitian retrospektif dengan rancang bangun uji diagnostik pemeriksaan ultrasonografi dengan temuan hasil operasi sebagai baku emas. Subyek pada penelitian ini adalah semua pasien yang dilakukan tindakan kolesistektomi selama periode Januari 2005 sampai Desember 2006 di Rumah sakit Dr. Sardjito Yogyakarta. Semua pemeriksaan ultrasonografi pada pasien tersebut dievaluasi, dicatat, dan dianalisis dengan uji diagnostik. Hasil : Didapatkan 117 subjek yang telah mendapat tindakan kolekistektomi, 56 laki-laki, 61 perempuan. Dan didapatkan nilai sensitivitas 98,88% (IK95%: 97 sampai 100), spesifisitas 50% (IK95%: 10 sampai 90), nilai duga positif 96,73% (IK95%: 93 sampai 100), nilai duga negatif 75% (IK95%: 33 sampai 100), dan akurasi 95,83%. Kesimpulan : Sensitifitas, akurasi, nilai duga positif dan negatif pemeriksaan ultrasonografi dalam membantu menegakkan diagnosis kolelitiasis cukup tinggi.

Background : Gallstone remain one of the commonest surgical problems in the developed world. It become more common with increasing age and are at least twice as common in women than man. It is necessary to find an imaging examination with high sensitivity and specificity in establishing the diagnosis of cholelitiasis. Subjects and methods : A retrospective study was conducted, designed with a ultrasonography diagnostic test with a gold standard of operative findings. The subjects were patients that had been performed surgery for cholecystectomy in the digestive department, and than all the ultrasonography that had been done before surgery were evaluated wether there was gallstone or not. The periode of time for this study was begin at January 2005 – Desember 2006 at Dr. Sardjito General Hospital, Yogyakarta. All the examination results were noticed and analyzed by diagnostic test. Results : We evaluated 117 post cholecystectomy patients, 56 men, 61 women, with age range from 18 years to 73 years old. The sensitivity was 98.88% (CI95%: 97-100), with specificity of 50 % (CI95%: 10- 90), positive predictive value of 96,73% (CI95%: 93-100), negative predictive value of 75% (CI95%: 33- 100), and accuracy 95,83%. Conclusions : The sensitivity, accuracy, positive and negative predictive values of ultrasonography in establishing the diagnosis of cholelitiasis are high.

Kata Kunci : Kolelitiasis,Ultrasonografi,Post Kolekistektomi, Ultrasonography, operative findings, cholelitiasis