Application of percutaneous double-catheter drainage in treatment of spontaneous rupture of bacterial liver abscess

Abstract

Objective To evaluate the application of percutaneous double-catheter drainage in treatment of spontaneous rupture of bacterial liver abscess. Methods Clinical data of 9 patients with spontaneous rupture of bacterial liver abscess treated by percutaneous double-catheter drainage in the First People's Hospital of Foshan from June 2001 to December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 7 were male and 2 female, aged 38-66 years with a median age of 51 years. The rupture occurred in the left lobe of 6 patients and in the right posterior lobe of 3 cases. Subphrenic abscess caused by the abscess rupture was observed in 5 cases, left lateral lobe-gastric abscess in 2 cases, and right subphrenic-right paracolic sulci abscess in 2 cases. All patients were treated with percutaneous double-catheter drainage combined with sensitive antibiotics for intrahepatic abscess and perihepatic abdominal abscess. Results All the 9 cases of intrahepatic abscess received placement of a 8 F catheter guided by ultrasound, 8 cases of perihepatic abdominal abscess received placement of a 10 F catheter, and 1 case of perihepatic abdominal abscess received placement of 2 10 F catheters. The average time of placement for intrahepatic abscess patients was (14.2±3.9) d, and (5.0±0.7) d for perihepatic abdominal abscess patients. All 9 patients were cured successfully. All patients were followed up for 6 months without postoperative complications, such as abdominal abscess and intestinal adhesion, etc. Conclusions Percutaneous double-catheter drainage is a convenient, safe and feasible method for spontaneous rupture of bacterial liver abscess, which avoids laparotomy or laparoscopic surgery and has advantage of minimal invasion, especially suitable for the patients with limited abdominal abscess. Key words: Liver abscess; Bacteria; Rupture, spontaneous; Drainage