A prospective study of USG guided pigtail catheter drainage in management of liver abscess

Haresh B. Italiya, Pratik Ranchodbhai Shah, Ajay M. Rajyaguru, Jatin G. Bhatt

Abstract


Background: Treatment of the liver abscess of any etiology has evolved in the recent years. Percutaneous drainage of liver abscess has been an important advancement in the treatment of pyogenic liver abscesses. Aim: to evaluate and assess response, morbidity and complication rates of percutaneous pig tail catheter drainage in treatment of liver abscess.  

Methods: During a period of 27 months, 25 patients with liquefied liver abscess ≥5x5 cm underwent percutaneous drainage under sonographic guidance.

Results: 18 had solitary abscess, while 7 had multiple abscesses. Pigtail catheters of various sizes (10 F or 12 F) were introduced in these patients using the Seldinger technique. The volume of pus drained ranged from 150 to 400 ml, while the period of catheter drainage ranged from 6 to 17 days. Complications were minor and included catheter blockage in 2 patients and tract pain in 8 patients. There was no mortality associated with this procedure. This study shows a success rate of 96% (successful treatment in 24 out of 25 patients).

Conclusion: Percutaneous catheter drainage of liver abscesses is successful with a low morbidity and mortality and should be the first line of management in liquefied moderate to large sized liver abscesses.

 


Keywords


Liver abscess, Pigtail catheter, Percutaneous drainage

Full Text:

PDF

References


Pitt HA. Surgical management of hepatic abscesses. World J Surg. 1990;14:498-504.

Courtney M. Townsend, R. Daniel Beauchamp, B. Mark Evers, Kenneth I. Mottox. Liver abscess. In: Courtney M. Townsend, R. Daniel Beauchamp, B. Mark Evers, Kenneth I. Mottox, eds. Sabiston Text Book of Surgery. 17th ed. USA: Elsevier; 2004: 1534-1542.

Pope IM, Thomas PG. Pyogenic liver abscess. In: Pope IM, Thomas PG, eds. Amoebiasis and Biliary Infection; Surgery of Liver and Biliary Tract. 2nd ed. TH Blumgart: Churchill Living Stone; 1974: 1135-1157.

Gerzof SG, Johnson WC, Robbins AH, Nabseth DC. Intrahepatic pyogenic abscesses: treatment by percutaneous drainage. Am J Surg. 1985;149:487-94.

Giorgio A, Tarantino L, Mariniello N, Francica G, Scala E, Amoroso P, et al. Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with USG guidance. Radiology. 1995;195:122-4.

Simon CH. Yu, Simon SM. Ho, Wan Y. Lau, Deacons TK. Yeung, Edmund HY. Yuen, Paul SF. Lee, et al. Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Hepatology. 2004 Apr;39(4):932-8.

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;170:1035-9.

Wong KP. Percutaneous drainage of pyogenic liver abscess. World J Surg. 1990;14:492-7.

Sukhjeet Singh, Poras Chaudhary, Neeraj Saxena, Sachin Khandelwal, Deva Datta Poddar, Upendra C. Biswal. Treatment of liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Ann Gastroenterol. 2013;26(4):332-9.

Enver Zerem, Amir Hadzic. Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess. AJR Am J Roentgenol. 2007 Sep;189(3):W138-42.

Singh O, Gupta S, Moses S, Jain DK. Comparative study of catheter drainage and needle aspiration in management of large liver abscesses. Indian J Gastroenterol. 2009 May-Jun;28(3):88-92.

vanSonnenberg E, Mueller PR, Schiffman HR, Ferrucci JT Jr, Casola G, Simeone JF, et al. Intrahepatic amoebic abscesses: indications for and results of percutaneous catheter drainage. Radiology. 1985;156:631-5.