Comparative evaluation of interventional radiology modalities in treatment of liver abscess
DOI:
https://doi.org/10.18203/2349-2902.isj20183731Keywords:
Aspiration, Liver abscess, Percutaneous catheter drainage, Percutaneous needle aspirationAbstract
Background: Liver abscess (LA) is a superlative cavity in the liver resulting from the invasion and multiplication of microorganism. With progress of interventional radiology, alternative to surgery in form of percutaneous drainage (PD) have become popular. PD can be accomplished by either percutaneous catheter drainage (PCD) or percutaneous needle aspiration (PCNA). This study was conducted to assess the PD as a definitive treatment modality for LA and comparison of PCD and PCNA.
Methods: The study was conducted in the Radiodiagnosis Department. All patients of LA were evaluated for age, sex, duration of complaints, type of intervention performed, and outcome etc. After diagnosis, patients were managed by PCD or PCNA. Response to treatment, duration of stay, and overall success of both the modalities were evaluated.
Results: The duration of this study was 34 months. During this period, 57 patients were evaluated. Of total, 29 underwent PCD and 28 PCNA. Male to female ratio was 2:1. Right lobe was involved in 48. Mean volume of abscess cavity was 356.44 ml. All patients who underwent PCD responded to the treatment; however, 8 patients who were treated by PCNA did not respond completely. Outcome was statistically related to type of treatment modality. PCD was statistically superior to PCNA (P <0.05).
Conclusions: PD may be regarded as first line of treatment for LA. It appears that PCD is better as compared to PCNA for successful outcome of patients.
References
Behera S, Patra UC, Jena SK, Behera N, Sahoo RP. Comparative study of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PCNA) in liver abscess. J Assoc Physicians India. 2016;64:51.
Mischinger HJ, Hauser H, Rabl H, Quehenberger F, Werkgartner G, Rubin R. Pyogenic liver abscess: studies of therapy and analysis of risk factors. World J Surg. 1994;18:852-8.
Ahmed S, Chia CL, Junnarkar SP, Woon W, Shelat VG. Percutaneous drainage for giant liver abscess- is it safe and sufficient? Am J Surg. 2016;211:95-101.
Rismiller K, Haaga J, Siegel C, Ammori JB. Pyogenic liver abscesses: a contemporary analysis of management strategies at a tertiary institution. HPB (Oxford). 2017;19:889-93.
Bamberger DM. Outcome of medical treatment of bacterial abscesses without therapeutic drainage: review of cases reported in the literature. Clin Infect Dis. 1996;23:592-603.
Chung YFA, Tan YM, Lui HF, Tay KH, Lo RHG, Kurup A, et al. Management of pyogenic liver abscesses percutaneous or open drainage? Singapore Med J. 2007;48:1158-65.
Bowers ED, Robison DJ, Doberneck RC. Pyogenic liver abscess. World J Surg. 1990;14:128-32.
Santos-Rosa OM, Lunardelli HS, Ribeiro-Junior MA. Pyogenic liver abscess: diagnostic and therapeutic management. Arq Bras Cir Dig. 2016;29:194-7.
Peralta R. Liver Abscess. 2018. Available at https://emedicine.medscape.com/article/188802-overview#a5 Accessed 25 June 2018.
Liao WI, Tsai SH, Yu CY, Huang GS, Lin YY, Hsu CW, et al. Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome. Eur J Radiol 2012;81:609-15.
Tan YM, Chung YFA, Chow PKH, Cheow PC, Wong WK, Ooi LL, et al. An appraisal of surgical and percutaneous drainage for pyogenic liver abscesses larger than 5 cm. Ann Surg 2005;241:485-90.
Malik AA, Bari SU, Rouf KA, Wani KA. Pyogenic liver abscess: changing patterns in approach. World J Gastrointest Surg. 2010;2:395-401.
Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. Am J Roentgenol 1998;170:1035-9.
Mobasher-Jannat A, Akhavan-Moghadam J. Percutaneous drainage for giant pyogenic liver abscess-does size matter? Am J Surg. 2017;214:770.
Serraino C, Elia C, Bracco C, Rinaldi G, Pomero F, Silvestri A, et al. Characteristics and management of pyogenic liver abscess: A European experience. Med. 2018;97:e0628.
