Details
Category: Volume 08 Issue 01 January 2020
Hits: 1755

Title: Comparison between Percutaneous Needle Aspiration vs Pigtail Catheter in Liver Abscess Drainage: A Prospective Study

Authors: Dr Sachin K G, Dr Sudarshan Babu K G, Dr Girish H R

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.08

Abstract

Background: Liver abscess is one of the most common condition associated with right upper abdominal Pain and fever. The introduction of Ultrasound guided percutaneous interventions have led to a reduction in morbidity and mortality compared to open surgery. In this study we compared the two most common percutaneous interventions i.e., between percutaneous needle aspiration (PNA) and pigtail catheter drainage (PCD) in outcomes.

Methods: A study was conducted in 60 patients admitted to KIMS hospital, Bengaluru between August 2017-December 2018.patients were divided into two randomised groups 1) PNA and 2) PCD. All interventions were performed under ultrasound guidance.

The success rate was measured in terms of clinical improvement, reduction in abscess cavity and need for redo-procedure.

Results: The success rate is higher with the pigtail catheter than compared to the percutaneous needle aspiration in terms of clinical Improvement and reduction in abscess cavity and need for redo-procedure.

Conclusion: From the study we can conclude that pigtail catheter is better modality of treatment for partially liquefied abscess or full liquified abscess when compared to percutaneous needle aspiration.

Keywords: PNA=Percutaneous Needle Aspiration, PCD=Pigtail Catheter Drainage.

References

  1. Seeto RK, Rockey DC. Pyogenic liver abscess. Changes in etiology, management, and outcome. Medicine (Baltimore). 1996;75(2):99-113.
  2. Krige JE, Beckingham IJ. ABC of diseases of liver, pancreas, and biliary system: liver abscesses and hydatid disease. BMJ. 2001;322(7285):537.
  3. Sharma MP, Sarin SK. Amoebic liver abscess in a north Indian hospital current trends. Br J Clin Pract. 1987;41:789-93.
  4. Farges O, Leese T, Bismuth H. Pyogenic liver abscess: an improvement in prognosis. Br J Surg. 1988;75:862-5.
  5. Barbour G. L. and Juniper K. A clinical comparison of amebic and pyogenic abscess of the liver in sixty- six patients. Am J Surg. 1972;53:323-34.
  6. Lee JF, Block GE. The changing clinical pattern of hepatic abscesses. Archives of Surg. 1972;104(4):465-70.
  7. Ribaudo JM, Ochsner A. Intrahepatic abscesses: amebic and pyogenic. The Am J Surg. 1973;125(5):570-4.
  8. Pitt HA, Zuidema GD. Factors influencing mortality in the treatment of pyogenic hepatic abscess. Surg. Gynecol. Obstet. l 975;140:228-34.
  9. 9Mischinger HJ, Hauser H, Rabl H, Quehenberger F, Werkgartner G, Rubin R, et al. Pyogenic liver abscess: studies of therapy and analysis of risk factors. World J Surg. 1994;18:852-7.
  10. Chou FF, Sheen-Chen SM, Chen YS, Chen MC, Chen FC, Tai DI. Prognostic factors for pyogenic abscess of the liver. J Am Coll Surg. 1994;179:727- 32.
  11. Wong WM, Wong BC, Hui CK, Ng M, Lai KC, Tso WK, et al. Pyogenic liver abscess: retrospective analysis of 80 cases over a 10-year period. J Gastroenterol Hepatol. 2002;17:1001-7.
  12. Fischer JE, Bland KI. Mastery of Surgery. In: Callery MP, Ed. Philadelphia: Wolters Kluwer Health, 5th 2007.
  13. Yanaga K, Kitano S, Hashizume M, Ohta M, Matsumata T, Sugimachi K. Laparoscopic drainage of pyogenic liver abscess. Br J Surg. 1994;81:1022.
  14. Wang W, Lee WJ, Wei PL, Chen TC, Huang MT. Laparoscopic drainage of pyogenic liver abscesses. Surg Today. 2004;34:323-5.
  15. Rajak, C.L., Gupta, S., Jain, S., Chawla, Y., Gulati, M., and Suri, S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR Am J Roentgenol. 1998; 170: 1035–1039.
  16. Simon C.H. Yu, Simon S.M. Ho, Wan Y. Lau, Deacons T.K. Yeung, Edmund H.Y. Yuen, Paul S.F. Lee, and Constantine Metreweli (HEPATOLOGY 2004;39:932–938.)

Corresponding Author

Dr Sachin K G

Junior Resident, Department of General Surgery, Kempegowda Institute of Medical Sciences, Bengaluru