Endoscopic biliary drainage in patients with amebic liver abscess and biliary communication.

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dc.contributor.authorSandeep, S Men_US
dc.contributor.authorBanait, Vaibhav Sen_US
dc.contributor.authorThakur, Sanjeev Ken_US
dc.contributor.authorBapat, Mukta Ren_US
dc.contributor.authorRathi, Pravin Men_US
dc.contributor.authorAbraham, Philipen_US
dc.date.accessioned2006-05-01en_US
dc.date.accessioned2009-05-29T03:04:38Z
dc.date.available2006-05-01en_US
dc.date.available2009-05-29T03:04:38Z
dc.date.issued2006-05-01en_US
dc.description.abstractBACKGROUND: Percutaneous drainage or surgery is required when amebic liver abscess (ALA) fails to respond to medical management. In some of these patients, non-response may be due to communication of ALA with the biliary tree. This report describes our experience with the use of endoscopic biliary draining in such patients. METHODS: Medical records of patients with ALA undergoing either needle aspiration or percutaneous pigtail drainage were retrieved; the indications for drainage were: abscess volume exceeding 250 mL, a thin rim of tissue (< 1 cm thick) around the abscess, systemic toxic features and failure to improve on medical treatment. Patients with abscess drain output >25 mL/day persisting for 2 weeks or presence of bile in the drain fluid underwent endoscopic biliary drainage. RESULTS: A total of 115 patients with ALA underwent percutaneous treatment. None of the 25 patients with needle aspiration needed any further treatment. Of the 90 who underwent catheter drainage, the catheter could be removed within one week in 77 patients; the remaining 13 patients (median age 42 years, range 24-65; all men) had an abscess-biliary communication. In them, the median catheter output was 88 mL/day (range 45-347) and 54 mL/day (28-177) at 2 days and 2 weeks after catheter placement. The drain fluid contained bile in all 13 patients and in addition contained pus in 10 patients. Eleven patients had a solitary abscess and two had multiple abscesses. Cholangiogram showed biliary communication in all 13 patients. All patients were treated with placement of 10F biliary endoprosthesis or 10F nasobiliary drain. Pigtail catheter was removed within 1 week in 11 of 13 patients. CONCLUSION: In patients with amebic liver abscess communicating with the biliary tree, biliary stenting may hasten clinical recovery and allow early removal of liver abscess catheter drain.en_US
dc.description.affiliationDepartment of Gastroenterology, Seth G S Medical College and K E M Hospital, Mumbai - 400 012, India. sandeepmsdoc@rediffmail.comen_US
dc.identifier.citationSandeep SM, Banait VS, Thakur SK, Bapat MR, Rathi PM, Abraham P. Endoscopic biliary drainage in patients with amebic liver abscess and biliary communication. Indian Journal of Gastroenterology. 2006 May-Jun; 25(3): 125-7en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/64906
dc.language.isoengen_US
dc.source.urihttps://www.indianjgastro.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshBiliary Fistula --microbiologyen_US
dc.subject.meshBiliary Tract Surgical Procedures --instrumentationen_US
dc.subject.meshCholangiopancreatography, Endoscopic Retrogradeen_US
dc.subject.meshDrainageen_US
dc.subject.meshEscherichia coli Infections --complicationsen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Abscess, Amebic --microbiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPseudomonas Infections --complicationsen_US
dc.subject.meshPseudomonas aeruginosaen_US
dc.subject.meshStentsen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleEndoscopic biliary drainage in patients with amebic liver abscess and biliary communication.en_US
dc.typeJournal Articleen_US
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