TREATMENT OF LIVER ABSCESS BY PERCUTANEOUS DRAINAGE

Abstract

By this prospective study we evaluated the usefulness, the effectiveness and the complications of the percutaneous drainage (PD) of liver abscesses. The advances in diagnosis and treatment of liver abscess are secondary to the modern imaging and radiological techniques. Today PD of abscesses using the imaging techniques are accepted as an alternative procedure instead of the surgical procedures of the liver.

In this report we used PD in 27 of the 106 patients who had diagnosis of liver abscess between January 1992 and March 1996. In all cases diagnosis was made by ultrasound and CT. The patients who had multiple cavities of abscess or perforated liver abscesses and the patients who had other pathological processes required laparotomy were omitted from the study. We used nefrostomy catheter with calibre of 8F for PD. The surgical drainage was applied when the PD was incomplete or the septic signs were going on. The mean diameter of abscess was 7.8 cm (range 5-15cm). In 24 cases abscesses were located in right lobe while in 3 cases it was in left lobe of the liver. The mean period of the procedure was 25.7 minutes (range 17-55 minutes). It was difficult to treat the abscess which were located in the dome of the liver or that were connected with the hollow viscera, while the ones in the peripheries of right lobe can be treated quite easily. There were no complications secondary to the procedure, in 24 of 27 patients (88.9%) there was no problem during the period after the procedure. The mean duration of hospitalization was 14.7 days (12-33 days). Only three patients required surgical drainage. Total morbidity rate was 18.5% (in 5 of 27 patients). We had no mortality in our study. We thought that PD of liver abscess can be applied easily with low morbidity and no mortality.