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Clinical Outcome of Endoscopic Ultrasound-Guided Liver Abscess Drainage Using Self-Expandable Covered Metallic Stent (with Video)

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Abstract

Background

Percutaneous drainage (PCD) is now the first-line drainage method for liver abscess because of its minimal invasiveness and high technical success rate. However, this procedure has several disadvantages, such as extra-drainage and self-tube removal. Recently, EUS-guided liver abscess drainage (EUS-AD) has been developed. However, only a few reports of EUS-AD have been reported. In addition, the clinical benefits of PCD and EUS-AD have not been reported.

Aims

In the present study, the safety and feasibility of EUS-AD using fully covered SEMS (FCSEMS) and the clinical outcomes of EUS-AD and PCD were examined retrospectively.

Methods

Twenty-seven consecutive patients who underwent PCD or EUS-AD between April 2012 and April 2015 were included in this study. EUS-AD was performed using FCSEMS. In addition, to prevent stent migration, 7-Fr pig tail plastic stent was placed within FCSEMS.

Results

Technical success was achieved in all patients of both groups. Clinical success was 100 % in the EUS-AD group although it was 89 % in PCD group (P = 034). Three adverse events were seen in the PCD group (self-tube removal n = 1, tube migration n = 2), but no adverse events were seen in the EUS-AD group. The median hospital stay was significantly shorter in the EUS-AD group than in the PCD group (21 vs 41 days, P = 0.03).

Conclusion

Because of the short hospital stay, the high clinical success rate, and the low adverse event rate compared to PCD, EUS-AD has potential as a first-line treatment for liver abscess.

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Authors and Affiliations

  1. 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan

    Takeshi Ogura, Daisuke Masuda, Onda Saori, Takagi Wataru, Tatsushi Sano, Atsushi Okuda, Akira Miyano, Toshihisa Takeuchi, Shinya Fukunishi & Kazuhide Higuchi

  2. Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan

    Masayuki Kitano

  3. Division of Gastroenterology, Department of Internal Medicine, Sohag University, Sohag, Egypt

    Usama M. Abdel-aal

Authors
  1. Takeshi Ogura
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  2. Daisuke Masuda
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  3. Onda Saori
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  4. Takagi Wataru
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  5. Tatsushi Sano
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  6. Atsushi Okuda
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  7. Akira Miyano
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  8. Masayuki Kitano
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  9. Usama M. Abdel-aal
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  10. Toshihisa Takeuchi
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  11. Shinya Fukunishi
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  12. Kazuhide Higuchi
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Corresponding author

Correspondence to Takeshi Ogura.

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Electronic supplementary material

Below is the link to the electronic supplementary material.

After liver abscess was punctured, the contrast medium was injected. Then, 0.025 inch guidewire was inserted. To dilate fistula, ERCP catheter was inserted. Fully covered self-expandable metallic stent was successfully placed from liver abscess and the duodenum. Supplementary material 1 (AVI 24657 kb)

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Ogura, T., Masuda, D., Saori, O. et al. Clinical Outcome of Endoscopic Ultrasound-Guided Liver Abscess Drainage Using Self-Expandable Covered Metallic Stent (with Video). Dig Dis Sci 61, 303–308 (2016). https://doi.org/10.1007/s10620-015-3841-3

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  • DOI: https://doi.org/10.1007/s10620-015-3841-3

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