Ultrasound-Guided Percutaneous Treatment of Liver Abscesses: Long Term Results in a Single Center
Keywords:Interventional ultrasound, Needle aspiration, Catheter drainage, Pyogenic liver abscess
AbstractAIM: To analyze the results of ultrasound-guided percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of pyogenic liver abscesses. Methods: 71 patients (42 females and 29 males, average age 56.2±12.3) with pyogenic liver abscesses were treated with ultrasound guided PNA and/or PCD. Patients with liver abscess <50 mm and ≥50 mm in diameter were initially treated with PNA and with 8-French catheter drainage, respectively. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, and mortality rates were analyzed. Results: PNA was performed in 35 patients (49.3%) as initial treatment. In 14 patients needle aspiration was a definitive and successful treatment, while 17 out of 35 patients (48.6%) had a recurrence of abscess and required continuous catheter drainage. After PNA three patients were referred for surgery. In 13 patients PCD applied after PNA was a definitive and successful treatment, but 4 patients had to be transferred for surgery in this specific group. In 36 patients (50.7%) PCD was performed initially. In 12 patients PCD was performed twice. In all 7 deceased patients malignancy was the underlying condition. Forty-one patients (57.7%) underwent surgical interventions in the abdomen before percutaneous treatment. Cultures were positive in 54 patients (76 %). There were no complications related to the procedure. Conclusion: Ultrasound-guided percutaneous treatment of liver abscess is a safe and effective alternative to surgery, especially in critically ill patients. We recommend PNA and PCD as primary treatments for liver abscesses <50 mm and ≥50 mm in the longest diameter, respectively.
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