Curative effect comparison of percutaneous puncture drainage and incision drainage for huge bacterial liver abscess

Abstract

Objective To compare the curative effect of percutaneous puncture drainage and abscess incision drainage for huge bacterial liver abscess. Methods Clinical data of 31 patients with single huge bacterial liver abscess treated in the First Affiliated Hospital of Xi＇an Jiaotong University between January 2000 and December 2014 were retrospectively studied. Among the 31 patients, 20 were males and 11 were females with the age ranging from 13 to 78 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to the different surgical treatment, the patients were divided into the percutaneous puncture drainage group (puncture group, n=14) and the abscess incision drainage group (incision group, n=17). Percutaneous puncture drainage and abscess incision drainage were performed respectively in the patients of two groups. After admission, all patients were treated with sensitive antibiotics according to the results of antimicrobial susceptibility test. The curative effect and postoperative complication of two groups were observed. The data comparison of two groups was conducted using Wilcoxon rank-sum test, Chi-square test or Fisher's exact test. Results The patients of two groups were all discharged after recovery. The incidence of postoperative complication in the puncture group was 36% (5/14), which was significantly lower than 94% (16/17) in the incision group (χ2=13.55, P<0.05). The secondary treatment rate of the puncture group was 21% (3/14), which was significantly higher than 0 (0/17) of the incision group (P<0.05). The length of stay of the puncture group was 12 (4-36) d, which was significantly shorter than 29 (14-61) d of the incision group (Z=25.53, P<0.05). Conclusions Percutaneous puncture drainage for huge bacterial liver abscess may achieve the same curative effect with the incision drainage, and has the advantages of smaller wound, lower incidence of complication and shorter length of stay. Key words: Liver abscess, pyogenic; Fever; Infection; Drainage