Pyogenic Liver Abscess: Prospective Evaluation Of USG Guided Percutaneous Therapeutic Aspiration

Abstract

Background: Pyogenic liver abscess (PLA) has been a condition of high mortality, improving over recent decades with combined antibiotic and percutaneous drainage Percutaneous drainage is currently the treatment of choice in liver abscess. Percutaneous needle aspiration(PNA) as an alternative to continuous percutaneous catheter drainage in combination with systemic antibiotics for the treatment of PLA has never been popular. AimsO 15 female; most common age range 40-50 years; mean age 44.34 years) with PLAs (mean diameter 6.52±1.8 cm; range 4.8- 9cm) underwent PNA with ultrasound (USG) guidance and antibiotic therapy. Complete pus removal from each abscess was attempted with 18 gauge thin-walled trocar needles with USG guidance. If necessary, PNA was repeated every 3 day. Results: The percentage of abscesses requiring one, two, three and more sessions of aspiration was 50%, 30%, 18% and 2% respectively. The success rate was unrelated to the largest size or number of abscess in the patient. Cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in all patients (100%).. Patients were hospitalized for 7-22 days (mean11±4.56days) No patient needed imaging-guided percutaneous catheter drainage or open surgical. Neither complications nor deaths ensued. Recurrence of PLA was not observed in any patient during follow-up (6-12) months Conclusions: USG-guided PNA with antibiotic therapy in treatment for PLA is a safe, effective & low-cost procedure. It should be considered as a first line alternative to catheter drainage. Our data suggest that a trial of percutaneous needle aspiration should always be undertaken before catheter drainage or surgery.