Comparative study of catheter drainage and needle aspiration in management of large liver abscesses.
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Date
2009-05
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Abstract
Objective To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10 cm diameter) liver
abscesses.
Methods Seventy-two patients with liver abscess (amebic
48, pyogenic 24) were randomly allocated to PCD or PNA
(36 each), which were done within 24 hours of admission.
Both groups received parenteral antibiotics for at least 10
days. PNA was repeated every third day if the cavity size had
not declined to 50% of the original for up to three times.
Persistence of cavity or of clinical symptoms was considered
failure of treatment. Duration to attain clinical relief, duration
of hospital stay, complications, treatment failure, and deaths
were recorded.
Results PNA was successful in 31 of 36 (86%) patients (one
aspiration in 10, two in 18, and three in 3 patients), whereas
PCD was successful in 35 (97%) patients (p=ns). Duration to
attain clinical relief (10.2 [2.0] vs. 8.1 [2.7] days; p=0.02) and
parenteral antibiotics needed (15.5 [1.1] vs. 10.9 [2.7] days;
p=0.04) were significantly lower in PCD group. Duration of
hospital stay was similar in the two groups. One patient with
PNA had a subcapsular hematoma and one with PCD had
continuous bile leakage which stopped spontaneously. One
patient in PCD group died.
Conclusion PCD is a better treatment option than PNA
for the management of large liver abscesses of size >10 cm,
in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed.
Description
Keywords
Amebic liver abscess, Entamoeba histolytica, Pyogenic abscess of liver
Citation
Singh Onkar, Gupta Shilpi, Moses Sonia, Jain Devendra K. Comparative study of catheter drainage and needle aspiration in management of large liver abscesses. Indian Journal of Gastroenterology. 2009 May-Jun; 28(3): 88-92.