Liver abscess: catheter drainage v/s needle aspiration
Keywords:
Liver abscess, Catheter drainage, Needle aspirationAbstract
Background:The aim of the study was to evaluate the clinical presentation, and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses.
Methods:This is a comparative study of 121 patients, presented in outpatient and emergency department at the hospital, randomized double blind trial was done and divide into two groups (percutaneous needle aspiration and pigtail catheter drainage.) about which surgeon did not knew about the division it was marked by evaluator. The effectiveness of either treatment was measured in terms of duration of hospital stay, days to achieve clinical improvement, reduction in abscess cavity size and total/near total resolution of abscess cavity.
Results:The success rate was significantly better in catheter drainage group. The patients in pigtail catheter drainage group showed earlier clinical improvement and decrease in abscess cavity volume as compared to those who underwent percutaneous needle aspiration.
Conclusions:Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus.
Metrics
References
Branum G, Tyson GS, Branum MA, Meyers WC. Hepatic abscess: changes in etiology, diagnosis and management. Ann Surg. 1990;212:655-62.
Hippocrates. The genuine works of Hippocrates, Translation (from the Greek with a preliminary discourse and annotations). In: Hippocrates, eds. A Book. New York: William Wood & Co.; 1886: 57, 58, 266, 267.
Sharma MP, Ahuja V. Management of amoebic and pyogenic liver abscess. Indian J Gastroenterol. 2001;20(Suppl 1):C33-6.
Chen SC, Huang CC, Tsai SJ, Yen CH, Lin DB, Wang PH, et al. Severity of disease as main predictor for mortality in patients with pyogenic liver abscess. Am J Surg. 2009;198(2):164-72.
Cook GC. Gastroenterological emergencies in the tropics. Baillieres Clin Gastroenterol. 1991;5:861-86.
Sepulveda B, Manzo NTG. Clinical manifestations and diagnosis of amebiasis. In: Martinez-Palomo A, eds. Amebiasis: Human Parasitic Diseases. 2nd ed. Amsterdam: Elsevier; 1986: 169-187.
Sukhjeet Singh, Poras Chaudhary, Neeraj Saxena, Sachin Khandelwal, Deva Datta Poddar, Upendra C. Biswal. Treatment of liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Ann Gastroenterol. 2013;26:1-8.
Hughes MA, Petri WA Jr. Amoebic liver abscess. Infect Dis Clin North Am. 2000;14:565-82.
Barnes PF, De Cock KM, Reynolds TN, Ralls PW. A comparison of amoebic and pyogenic abscess of the liver. Medicine (Baltimore). 1987;66:472-83.
Khan R, Hamid S, Abid S, Jafri W, Abbas Z, Islam M, et al. Predictive factors for early aspiration in liver abscess. World J Gastroenterol. 2008;14:2089-93.
Patterson M, Healy GR, Shabot JM. Serologic testing for amoebiasis. Gastroenterology. 1980;78:136-41.
Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO. Common presentations of amoebic liver abscess. Ann Emerg Med. 1999;34:351-5.
Donovan AJ, Yellin AE, Ralls PW. Hepatic abscess. World J Surg. 1991;15:162-9.
Do H, Lambiase RE, Deyoe L, Cronan JJ, Dorfman GS. Percutaneous drainage of hepatic abscesses: comparison of results in abscesses with and without intrahepatic biliary communication. AJR Am J Roentgenol. 1991;157:1209-12.
Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR Am J Roentgenol. 1998;170:1035-9.
Giorgio A, Tarantino L, Mariniello N, Francica G, Scala E, Amoroso P, et al. Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology. 1995;195:122-4.
Saraswat VA, Agarwal DK, Baijal SS, Roy S, Choudhuri G, Dhiman RK, et al. Percutaneous catheter drainage of amoebic liver abscess. Clin Radiol. 1992;45:187-9.
Agarwal DK, Baijal SS, Roy S, Mittal BR, Gupta R, Choudhuri G. Percutaneous catheter drainage of amebic liver abscesses with and without intrahepatic biliary communication: a comparative study. Eur J Radiol. 1995;20:61-4.
Baek SY, Lee MG, Cho KS, Lee SC, Sung KB, Auh YH. Therapeutic percutaneous aspiration of hepatic abscesses: effectiveness in 25 patients. AJR Am J Roentgenol. 1993;160:799-802.
Dietrick RB. Experience with liver abscess. Am J Surg. 1984;147:288-91.
Gupta SS, Singh O, Sabharwal G, Hastir A. Catheter drainage versus needle aspiration in management of large (>10 cm diameter) amoebic liver abscesses. ANZ J Surg. 2011;81:547-51.
Van Sonnenberg E, Ferrucci JT Jr, Mueller PR, Wittenberg J, Simeone JF. Percutaneous drainage of abscesses and fluid collections: technique, results, and applications. Radiology. 1982;142:1-10.