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"The manual has been split into two volumes for better portability. Volume I, Basic Laparoscopy and Endoscopy covers the fundamentals and procedures performed during surgical residency. Volume I will be the first volume used by students, residents, and allied healthcare professional trainees. Material has been added to these fundamentals and procedures that will also be of interest to experienced surgeons. Volume II, Advanced Laparoscopy and Endoscopy covers more advanced procedures, generally taught during fellowship.All of the sections have been reorganized with a critical eye to the needs of the modern minimal access surgeon. Two new editors have been added. Chapters have been revised by both new authors as well as many stalwart authors from previous editions.These portable handbooks cover all of the major laparoscopic and flexible endoscopic procedures in easy-to-read format. Indications, patient preparation, operative techniques, and strategies for avoiding and managing complications are included for the complete spectrum of both “gold standard” and emerging procedures in diagnostic and therapeutic laparoscopy, thoracoscopy, and endoscopy.The scope, detail, and quality of the contributions confirm and demonstrate the SAGES commitment to surgical education. This manual is sure to find a home in the pocket, locker or briefcase of all gastrointestinal endoscopic surgeons and residents."

"The manual has been split into two volumes for better portability. Volume I, Basic Laparoscopy and Endoscopy covers the fundamentals and procedures performed during surgical residency. Volume I will be the first volume used by students, residents, and allied healthcare professional trainees. Material has been added to these fundamentals and procedures that will also be of interest to experienced surgeons. Volume II, Advanced Laparoscopy and Endoscopy covers more advanced procedures, generally taught during fellowship.All of the sections have been reorganized with a critical eye to the needs of the modern minimal access surgeon. Two new editors have been added. Chapters have been revised by both new authors as well as many stalwart authors from previous editions.These portable handbooks cover all of the major laparoscopic and flexible endoscopic procedures in easy-to-read format. Indications, patient preparation, operative techniques, and strategies for avoiding and managing complications are included for the complete spectrum of both “gold standard” and emerging procedures in diagnostic and therapeutic laparoscopy, thoracoscopy, and endoscopy.The scope, detail, and quality of the contributions confirm and demonstrate the SAGES commitment to surgical education. This manual is sure to find a home in the pocket, locker or briefcase of all gastrointestinal endoscopic surgeons and residents."

"ABSTRAKGallstone is a crystal deposit which is formed in the gallbladder or bile duct. Gallstone is classified into cholesterol stone, pigment stone (black and brown), and mixed stone. Mechanism which underlies the formation of cholesterol or pigment gallstone is different. Information on chemical component of the stone will assist the management and prevention of its recurrence. Analysis of gallstone component can be performed by colorimetry method or even gas liquid chromatography (GLC). Chemical component analysis of gallstone by colorimetry includes examination of cholesterol, bilirubin, and calcium. Stone is classified as cholesterol stone if the cholesterol content is > 80%, pigment stone if cholesterol content is < 20%, and mixed stone if cholesterol content is 25-80%. Gallstone analysis by GLC method is conducted by separation of fatty acid chain and evaluation of fatty acid quantity in the methylester derivatives form, which is fatty acid methyl estered. Fatty acid content in cholesterol stone (310.09 + 49.7 mg/gram) is higher compared to pigment stone (55.59 +7.71 mg/gram). Saturated to unsaturated fatty acid (S/U) ration in cholesterol stone (8.6 + 3.1) is higher compared to pigment stone (4.8 + 1.5)."

"Obstructive: jaundice represents the most common complication of biliary tract Malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure"

"ABSTRAKHelicobacter pylori (H. pylori) infection causes various abnormalities in the stomach. Only particular strain can cause severe problems in the stomach. CagA is a microbial virulent factor which is associated with more severe stomach problems, such as: peptic ulcer and stomach cancer. We would like to know the prevalence of CagA in Balinese population, and the association of H. Pylori CagA status with the severity of endoscopic appearance in dyspepsia patients.Method: Study design being used was analytic cross sectional study, involving 71 dyspepsia patients who underwent upper gastrointestinal endoscopic examination in Surya Husada Hospital and Balimed Hospital in June-December 2013. Sample was chosen in consecutive manner. Later, polymerase chain reaction (PCR) examinations of the stomach mucous biopsy tissue to determine H. pylori infection status and CagA status were performed. Further, Chi square test was used to identify the difference in proportion of H. pylori and CagA between mild and severe endoscopic appearance.Results: In this study, we found that the prevalence of H. pylori infection was 22.5% using PCR examination. Prevalence of CagA positive in H. pylori positive was 62.5%. There was significant association between status of H. Pylori infection and severity of endoscopic appearance (p = 0.038; OR= 2.67; 95% CI = 1.18-6.05). Status of CagA in H. pylori infected patients was not associated with the severity of endoscopic appearance. Additionally, there was significant association between patients’ age and severity of endoscopic appearance.Conclusion: The prevalence of CagA in H. pylori positive was 62.5%. H. pylori infection was associated with severity of endoscopic appearance and CagA status in H. pylori infected patients was not associated with severity of endoscopic appearance."

"ABSTRAKThalassemia patients who undergo life-long recurrent blood transfusion will experience iron overload in various organs including the liver and possibly suffer from chronic hepatitis C infection which may lead to liver impairment. The liver produces hepcidin, a hormone which plays role in the regulation of iron level in the blood. Various factors may influence hepcidin level in the blood. Chronic hepatitis C causes iron overload and liver impairment. Liver impairment and haemolytic anaemia due to haemoglobinopathy will suppress hepcidin production. Anaemia stimulates growth differentiation factor 15 (GDF-15) to increase erythropoiesis and suppress hepcidin production. Iron overload causes increase in hepcidin level. Presence of factors which decrease or increase hepcidin production will express various levels of hepcidin. This study aimed to identify the expression of hepcidin and GDF-15 levels in thalassemia patients with iron overload and positive anti-HCV. Information on hepcidin and GDF-15 levels are beneficial in the management of iron overload in thalassemia with positive anti-HCV.Method: This study was a descriptive analytic study in thalassemia patients who had received recurrent blood transfusion ≥ 12 times, suffered from iron overload (transferrin saturation > 55% and ferritin > 1,000 ng/mL), which consisted of 31 individuals with positive anti-HCV and 27 individuals with negative anti-HCV. This study was performed in Thalassemia Centre Department of Child Health and Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, in October 2011–January 2012. Serum hepcidin and GDF-15 examinations were performed using enzyme-linked immunosorbent assay (ELISA) method. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) examinations were performed using colorimetry method. Data on ferritin and transferrin saturation were obtained from medical records in the last 3 months. Data was analysed using SPSS Windows version 17 software.Results: Characteristics of subjects in this study included ferritin level, transferrin saturation, AST, and ALT were 5,289 (SD 2,492) ng/mL, 96.7 (SD 9.2)%, 41.8 (SD 26.7) U/L, and 50.6 (24.9) U/L, respectively. It was obtained that the hepcidin levels were within the normal limits with median of 51.5 (19-166) pg/mL, while GDF-15 levels were higher than the normal range with median of 1,936 (643-2,475) pg/mL. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV groups, with p value of 0.842 and 0.115, respectively.Conclusion: We obtained that the hepcidin levels were within normal limits and GDF-15 levels were higher than the normal range. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV group."