Title: A Record based Analysis of Percutaneous aspiration Versus Pigtail catheter drainage in the management of Liver abscess at a tertiary care centre in Mandya

Authors: Dr Adithi S Rao, Dr Narasimhaswamy P, Dr Abhijith VK, Dr Suhas GN, Dr Md Saqeeb

 DOI: https://dx.doi.org/10.18535/jmscr/v11i2.05

Abstract

Overview

A liver abscess is an important health concern in tropical countries. Liver abscesses are most commonly due to pyogenic, amebic or mixed infections. Less commonly these may be fungal in origin. Effective management of liver abscesses includes appropriate antibiotics and drainage of the abscess cavity. Percutaneous abscess drainage by pigtail catheterization is now gaining popularity. We analyzed the role of pigtail catheter drainage over percutaneous aspiration in the treatment of liver abscesses.

Retrospective analytical study conducted in a tertiary care center in Mandya. Patients of age ≥ 18 years admitted with the diagnosis of liver abscess were included in this study. Data was analyzed in two groups: Group A (Percutaneous needle aspiration), and Group B (Pigtail catheter drainage).

The catheter drainage group showed significantly better recovery. The patients in pigtail catheter drainage group showed earlier clinical improvement  and 50% decrease in abscess cavity volume  as compared to those who underwent percutaneous needle aspiration or conservative management.

Percutaneous pigtail catheterization would be an operative decision for the management of liver abscess. Percutaneous catheter drainage is a better modality especially in larger abscesses which are partially liquefied or with thick pus.  

References

  1. Thompson JE, Forlenza S, Verma R. Amebic liver abscess: a therapeutic approach. Rev Infect Dis1985:7:171-179
  2. Sherlock S. Dooley Y. Disease of the liver and btharv.cv. cIen:. 9th ed. Oxford: Blackwell, 1993:471-502
  3. Theron P. Surgical aspects of amoebiasis. Br Med J 1947:2:123-126
  4. Satani B, Davidson ED. Hepatic abscesses: improvement in mortality with early diagnosis and treatment. Am J Sung 1978:135:647-650
  5. Gerzof SG, Johnson WC, Robbins AH, Nabseth DC. Intrahepatic pyogenic abscesses: treatment by percutaneous drainage. Am JSurg 1985:149:487-494
  6. Lee JF, Block GE. The changing clinical pattern of hepatic abscesses. Arc-h Sung 1972:104:465-470
  7. Artar B, Levendoglu H, Cuasay NS. CT-guided percutaneous aspiration and catheter drainage of pyogenic liver abscesses. Am J Gasimenteml1986;8:550-555
  8. Seeto RK, Rockey DC. Pyogenic liver abscess: change in aetiology, management. and outcome. Medicine 1996:75:99-I 12
  9. Singh JP, Kashyap A. A comparative evaluation of percutaneous catheter drainage for resistant amebic liver abscesses. Am J Surg 1989;l58:58-62
  10. Van Sonnenberg E. Muller PR, Schiffman HR. et al. Intrahepatic amebic abscesses: indications for and results of percutaneous catheter drainage. Radiology 985:156:631-635
  11. Saraswat VA, Agarwal DK, Baijal 55, et al. Percutaneous catheter drainage of amoebic liver abscesses.1992:45:187-189
  12. Robert JH, Miresew D, Ambroseui P. Khoury G, Greenstein Al. Rohner A. Critical review of the treatment of pyogenic liver abscess. Surg Gyneco-Obstetrics 1992;l74:97-l02
  13. Hashimoto L. Hermann R, Broniatowski 5G. Pyogenic hepatic abscess: results of current management. Am Sung 1995:61 :407-41 1
  14. Back SY. Lee MG, Cho KS, Lee SC, Sung KB, Auh YH. Therapeutic percutaneous aspiration of hepatic abscesses: effectiveness in 25 patients. AIR1993; 160:799-802
  15. Giorgio A, Tarantino L, Marmniello N. et al. Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology 1995;l95: 122-124
  16. Stain SC. Yellin AE, Donovan AJ, Brien HW. Pyogenic liver abscess: modem treatment. Arch Surg1991:126:991-996
  17. Dietrick RB. Experience with liver abscess. Am J Surg 1984:147:288-291
  18. Giorgio A. Amoroso P. Francica G, et al. Echoguided percutaneous puncture: a safe and valuable therapeutic tool for amebic liver abscess. Gastrointestinal Radio 1988;l3:336-340
  19. Bertel CK, vanHeerden JA. Sheedy PF II. Treatment of pyogenic hepatic abscess. Arch Sung 1986;121:554-558
  20. RaIls PW, Quinn MF, Boswell WD Jr, Calletti PM. Radin DR. Halls J. Pattern of resolution in successfully treated hepatic amebic abscess: sonographic evaluation. Radiology 1983;l49:541-543
  21. Lambiase RE, Deyoe L Cronan L Cronan JJ, Dorfman GS. Percutaneous drainage of 335 consecutive abscesses: results of primary drainage with I -year follow-up. Radiology 1992;l84: 167-179
  22. Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR Am J Roentgenol. 1998 Apr;170(4):1035-9. doi: 10.2214/ajr.170.4.9530055. PMID: 9530055.
  23. Kumar S, Midha N K, Ahari K, et al. (December 20, 2021) Role of Pigtail Catheter Drainage Versus Percutaneous Needle Aspiration in the Management of Liver Abscess: A Retrospective Analysis. Cureus 13(12): e20528. doi:10.7759/cureus.20528

Corresponding Author

Adithi S Rao

Department of General Surgery, Mandya Institute of Medical Sciences, Mandya – 571401