Objective To formulate an evidence-based treatment plan for a patient with suspected pyogenic liver abscess.
Methods Based on the clinical questions raised by a patient with suspected pyogenic liver abscess, we searched The Cochrane Library (Issue 4, 2007), MEDLINE (1996 to January 2008), ACP Journal Club (1991 to January 2008), and Chinese Journal Full-text Database (1994 to January 2008) for systematic reviews, randomized controlled trials (RCTs) and case-control studies. The quality of the included studies was assessed.
Results We did not find any systematic reviews or large-scale RCTs involving a comparison between laparoscopic drainage and surgical drainage in the treatment of pyogenic liver abscess. Four clinical retrospective studies closely related to our questions were found and assessed. These studies concluded that laparoscopic drainage for liver abscesses was a safe alternative for patients requiring surgical drainage. Based on the current evidence, as well as our clinical expertise and the patient’s values, laparoscopic drainage was not used for this patient and surgical drainage was applied. The patient was recovered and discharged.
Conclusion Current evidence showed that laparoscopic drainage might be effective and safe for liver abscesses but high-quality large-scale randomized controlled trials are still required.
Citation： CHEN Sirui,PENG Bing,JIANG Hui,LIAO Bo,LI Chunlin,CHEN Xiaodong. Evidence-Based Treatment for a Patient with Suspected Pyogenic Liver Abscess. Chinese Journal of Evidence-Based Medicine, 2008, 08(4): 291-294. doi: 10.7507/1672-2531.20080061 Copy
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