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Percutaneous and surgical treatment of pyogenic liver abscesses: Observation over a 21-year period in 148 patients

2008; Elsevier BV; Volume: 40; Issue: 8 Linguagem: Inglês

10.1016/j.dld.2008.01.016

1878-3562

Giovanna Ferraioli, Anna Lisa Garlaschelli, Domenico Zanaboni, Rosario Gulizia, Enrico Brunetti, Francesco Paolo Tinozzi, Calogero Cammà, Carlo Fìlice,

Diagnosis and treatment of tuberculosis

Background Percutaneous drainage of pyogenic liver abscess has become first-line treatment. In the past surgical drainage was preferred in some centres. Aim The aim of this retrospective study was to assess the effectiveness of percutaneous treatments and surgical drainage, in terms of treatment success, hospital stay and costs. Patients Data of 148 patients (90 males; 58 females; mean age, 61 yrs; range, 30–86 yrs) were retrospectively analysed. Methods Patients' outcomes, including the length of hospital stay, procedure-related complications, treatment failure and death, were recorded. Multiple logistic regression model was used for statistical analysis. Results One hundred and four patients (83 with solitary and 21 with multiple abscesses) were treated percutaneously, either by needle aspiration (91 patients) or catheter drainage (13 patients) depending on the abscess's size, and 44 patients (30 with solitary and 14 with multiple abscesses) were treated surgically. There was no statistically significant difference in patients' demographics or abscess characteristics between groups. Hospital stay was longer, and costs were higher in patients treated surgically (p < 0.001). There was statistically significant difference in morbidity rate between groups (p < 0.001). No death occurred in both groups. Conclusions Percutaneous and surgical treatment of pyogenic liver abscesses are both effective, nevertheless percutaneous drainage carries lower morbidity and is cheaper.