Clinical studyPercutaneous Hepatic Abscess Drainage: Do Multiple Abscesses or Multiloculated Abscesses Preclude Drainage or Affect Outcome?
Section snippets
Patient Demographics and Medical Record Review
The institutional human studies review committee granted approval for this retrospective review, with a waiver of informed consent. The study was compliant with the Health Insurance Portability and Accountability Act.
From July 1995 to October 2006, 113 consecutive patients with liver abscess(es) were admitted and underwent percutaneous catheter drainage at our hospital. Four patients with amebic liver abscess were excluded. The remaining 109 patients (mean age, 58.4 years; age range, 11–89 y)
Demographics
Details of the patients' demographics are shown in Table 1, Table 2. There were 85 patients with a single abscess and 24 patients with multiple abscesses (two to five lesions per patient; mean, 2.8 ± 1.07). Neither age nor sex were significantly different between these two groups (P = .528 and P = .086, respectively; Table 1).
Thirty-four of 85 patients had multiloculated lesions in the single abscess group (40%), versus 20 of 24 patients in the multiple abscess group (83%), which represented a
Discussion
For the past 20 years, percutaneous catheter drainage has often been performed instead of surgery in the management of pyogenic liver abscesses. Nevertheless, there remains some controversy whether percutaneous drainage can be successful treatment for multiple and/or multiloculated liver abscesses. This report describes 11 years of experience with percutaneous transhepatic abscess drainage with catheters in the treatment of pyogenic liver abscesses and compares the effectiveness of percutaneous
References (18)
- et al.
Pyogenic hepatic abscess with biliary communication
Am J Surg
(2002) - et al.
Solitary and multiple pyogenic liver abscesses: characteristics of the patients and efficacy of percutaneous drainage
Am J Gastroenterol
(1997) - et al.
Laparoscopic drainage of pyogenic liver abscesses
Surg Today
(2004) - et al.
The role of percutaneous transhepatic abscess drainage for liver abscess
J Hepatobiliary Pancreat Surg
(1999) - et al.
Single and multiple pyogenic liver abscesses: clinical course, etiology, and results of treatment
World J Surg
(1997) - et al.
Percutaneous needle aspiration of multiple pyogenic abscesses of the liver: 13-year single-center experience
AJR Am J Roentgenol
(2006) - et al.
Percutaneous drainage of pyogenic liver abscesses
AJR Am J Roentgenol
(1985) - et al.
An appraisal of surgical and percutaneous drainage for pyogenic liver abscesses larger than 5 cm
Ann Surg
(2005) - et al.
Single and multiple pyogenic liver abscessesNatural history, diagnosis and treatment, with emphasis on percutaneous drainage
Medicine (Baltimore)
(1984)
Cited by (68)
A complex presentation of an uncommon disease: Gas-forming pyogenic liver abscess complicated by septic pulmonary emboli and muscle abscesses, a case report and review of the literature
2023, IDCasesCitation Excerpt :Considering the rarity of the disease, a normal TTE, a known primary infective focus (a liver abscess) and a lack of supportive presenting symptoms of endocarditis, a TEE was deemed unnecessary. Treatment of choice entails the combination of radiologically assisted percutaneous drainage or aspiration in addition to effective antimicrobial therapy tailored to identified pathogen(s) [21,10,22]. The combined approach of drainage and antibiotics administration is a safe and effective approach even in critically ill patients [23–25].
Management Practices and Predictors of Outcome of Liver Abscess in Adults: A Series of 1630 Patients from a Liver Unit
2021, Journal of Clinical and Experimental HepatologyCitation Excerpt :PNA under USG is a simple and minimally invasive procedure that allows aspiration of multiple ALAs in one setting. In large abscess, aspiration attempts for at least two times are likely to reduce the overall success rate of PNA (60%) compared with PCD (100%).22 Indications for PCD include if the abscess is large (>10 cm in diameter), subcapsular location, high risk for rupture, superinfected, or if there is poor response to medical treatment.4
Risk factors indicating the need for surgical therapy in patients with pyogenic liver abscesses
2023, Langenbeck's Archives of Surgery
None of the authors have identified a conflict of interest.