Percutaneous Catheter Drainage Versus Needle Aspiration in Management of Bacterial Liver Abscess_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Qiang , CAO Feng , WANG Yajun , LIU Jiafeng.

Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, ChinaCorresponding Author: LIU Qiang, E-mail: xw_liuqiang@163.com;

Corresponding author：

Keywords：

Bacterial liver abscess; Percutaneous catheter drainage; Percutaneous needle aspiration; Complication

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Objective 　To determine the effectiveness of percutaneous catheter drainage (PCD) and to compare PCD with percutaneous needle aspiration (PNA) in the management of bacterial liver abscess.
Methods 　The medical records of 206 patients with bacterial liver abscess admitted to this hospital between January 1989 and December 2009 were analyzed retrospectively. The outcomes of 96 patients receiving percutaneous treatment including PCD (PCD group, n=56) and PNA (PNA group, n=40) were compared, including the length of hospital stay, rates of procedure-related complications, treatment success, and death.
Results 　There was no statistical difference in patients’ demographics or abscess characteristics between two groups (P gt;0.05). The morbidity, mortality, and length of hospital stay in the PCD group and the PNA group were 1.79% vs 2.50%， 1.79% vs 2.50%， and 　(19.2±13.1) d vs (20.2±12.9) d, respectively, and the P values were 1.000, 1.000, and 0.887, respectively. There was statistically significant difference in successful rate between two groups （96.43% vs 75.00%， P=0.002）, but all simple abscesses with diameter of 5 cm or less were successfully managed in both PNA group and PCD group （13/13 vs 16/17， P=1.000）.
Conclusions　 PCD is more effective than PNA in the management of bacterial liver abscess. PNA can be used as a valid alternative for simple abscesses with 5 cm in diameter or smaller.

Citation： LIU Qiang,CAO Feng,WANG Yajun,LIU Jiafeng.. Percutaneous Catheter Drainage Versus Needle Aspiration in Management of Bacterial Liver Abscess. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(10): 1083-1086. doi: Copy

1.	Tsai FC, Huang YT, Chang LY, et al. Pyogenic liver abscess as endemic disease, Taiwan [J]. Emerg Infect Dis, 2008; 14(10): 1592-1600.
2.	Jepsen P, Vilstrup H, Schnheyder HC, et al. A nationwide study of the incidence and 30-day mortality rate of pyogenic liver abscess in Denmark, 1977-2002 [J]. Aliment Pharmacol Ther, 2005; 21(10): 1185-1188.
3.	Petri A, Hhn J, Hódi Z, et al. Pyogenic liver abscess－20 years’ experience. Comparison of results of treatment in two periods [J]. Langenbecks Arch Surg, 2002; 387(1): 27-31.
4.	Yu SC, Ho SS, Lau WY, et al. Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration [J]. Hepatology, 2004; 39(4): 932-938.
5.	蒋力生, 韦靖江. 肝脓肿破溃77例分析 [J].普外基础与临床杂志, 1996； 3(4): 221-223.
6.	〖JP4〗彭其芳, 熊先泽, 程南生. 胆源性肝脓肿的治疗(附12例报道) [J]. 中国普外基础与临床杂志, 2009; 16(10): 847-848.
7.	梁国庆, 黄韬, 陆立平. B超引导下经皮肝穿刺置管引流治疗肝脓肿的临床应用 [J]. 中华肝胆外科杂志, 2007; 13(3): 206-207.
8.	Singh O, Gupta S, Moses S, et al. Comparative study of catheter drainage and needle aspiration in management of large liver abscesses [J]. Indian J Gastroenterol, 2009; 28(3): 88-92.
9.	Trcoveanu E, Vlad N, Moldovanu R, et al. Pyogenic liver abscesses [J]. Chirurgia (Bucur), 2008; 103(4): 417-427.
10.	Rahimian J, Wilson T, Oram V, et al. Pyogenic liver abscess: recent trends in etiology and mortality [J]. Clin Infect Dis, 2004; 39(11): 1654-1659.
11.	Butler TJ, McCarthy CF. Pyogenic liver abscess [J]. Gut, 1969; 10(5): 389-399.
12.	Spellberg MA. Treatment of nonamebic (pyogenic) liver abscess [J]. Am J Gastroenterol, 1969; 51(5): 410-417.
13.	Wang W, Lee WJ, Wei PL, et al. Laparoscopic drainage of pyogenic liver abscesses [J]. Surg Today, 2004; 34(4): 323-325.
14.	McFadzean AJ, Chang KP, Wong CC. Solitary pyogenic abscess of the liver treated by closed aspiration and antibiotics; a report of 14 consecutive cases with recovery [J]. Br J Surg, 1953; 41(166): 141-152.
15.	Chung YF, Tan YM, Lui HF, et al. Management of pyogenic liver abscesses-percutaneous or open drainage? [J]. Singapore Med J, 2007; 48(12): 1158-1165.
16.	Ferraioli G, Garlaschelli A, Zanaboni D, et al. Percutaneous and surgical treatment of pyogenic liver abscesses: observation over a 21-year period in 148 patients [J]. Dig Liver Dis, 2008; 40(8): 690-696.
17.	Alvarez Pérez JA, González JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess [J]. Am J Surg, 2001; 181(2): 177-186.
18.	Rajak CL, Gupta S, Jain S, et al. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage [J]. AJR Am J Roentgenol, 1998; 170(4): 1035-1039.
19.	Zerem E, Hadzic A. Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess [J]. AJR Am J Roentgenol, 2007; 189(3): W138-W142.
20.	刘强, 王亚军, 刘家峰, 等. 细菌性肝脓肿治疗的单中心20年回顾分析 [J]. 中国普外基础与临床杂志, 2009; 16(5): 389-392.
21.	Ng FH, Wong WM, Wong BC, et al. Sequential intravenous/oral antibiotic vs. continuous intravenous antibiotic in the treatment of pyogenic liver abscess [J]. Aliment Pharmacol Ther, 2002; 16(6): 1083-1090.
22.	赵世峰, 沈洪. 第46 例-糖尿病伴细菌性肝脓肿(Internet 网上病例讨论) [J]. 中国危重病急救医学, 2002; 14(8): 511-512.
23.	Chou FF, Sheen-Chen SM, Chen YS, et al. Prognostic factors for pyogenic abscess of the liver [J]. J Am Coll Surg, 1994; 179(6): 727-732.
24.	Chung YF. Pyogenic liver abscess-predicting failure to improve outcome [J]. Neth J Med, 2008; 66(5): 183-184.
25.	Chen SC, Tsai SJ, Chen CH, et al. Predictors of mortality in patients with pyogenic liver abscess [J]. Neth J Med, 2008; 66(5): 196-203.

1. Tsai FC, Huang YT, Chang LY, et al. Pyogenic liver abscess as endemic disease, Taiwan [J]. Emerg Infect Dis, 2008; 14(10): 1592-1600.
2. 　Jepsen P, Vilstrup H, Schnheyder HC, et al. A nationwide study of the incidence and 30-day mortality rate of pyogenic liver abscess in Denmark, 1977-2002 [J]. Aliment Pharmacol Ther, 2005; 21(10): 1185-1188.
3. 　Petri A, Hhn J, Hódi Z, et al. Pyogenic liver abscess－20 years’ experience. Comparison of results of treatment in two periods [J]. Langenbecks Arch Surg, 2002; 387(1): 27-31.
4. 　Yu SC, Ho SS, Lau WY, et al. Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration [J]. Hepatology, 2004; 39(4): 932-938.
5. 　蒋力生, 韦靖江. 肝脓肿破溃77例分析 [J].普外基础与临床杂志, 1996； 3(4): 221-223.
6. 　〖JP4〗彭其芳, 熊先泽, 程南生. 胆源性肝脓肿的治疗(附12例报道) [J]. 中国普外基础与临床杂志, 2009; 16(10): 847-848.
7. 　梁国庆, 黄韬, 陆立平. B超引导下经皮肝穿刺置管引流治疗肝脓肿的临床应用 [J]. 中华肝胆外科杂志, 2007; 13(3): 206-207.
8. 　Singh O, Gupta S, Moses S, et al. Comparative study of catheter drainage and needle aspiration in management of large liver abscesses [J]. Indian J Gastroenterol, 2009; 28(3): 88-92.
9. 　Trcoveanu E, Vlad N, Moldovanu R, et al. Pyogenic liver abscesses [J]. Chirurgia (Bucur), 2008; 103(4): 417-427.
10. 　Rahimian J, Wilson T, Oram V, et al. Pyogenic liver abscess: recent trends in etiology and mortality [J]. Clin Infect Dis, 2004; 39(11): 1654-1659.
11. 　Butler TJ, McCarthy CF. Pyogenic liver abscess [J]. Gut, 1969; 10(5): 389-399.
12. 　Spellberg MA. Treatment of nonamebic (pyogenic) liver abscess [J]. Am J Gastroenterol, 1969; 51(5): 410-417.
13. 　Wang W, Lee WJ, Wei PL, et al. Laparoscopic drainage of pyogenic liver abscesses [J]. Surg Today, 2004; 34(4): 323-325.
14. 　McFadzean AJ, Chang KP, Wong CC. Solitary pyogenic abscess of the liver treated by closed aspiration and antibiotics; a report of 14 consecutive cases with recovery [J]. Br J Surg, 1953; 41(166): 141-152.
15. 　Chung YF, Tan YM, Lui HF, et al. Management of pyogenic liver abscesses-percutaneous or open drainage? [J]. Singapore Med J, 2007; 48(12): 1158-1165.
16. 　Ferraioli G, Garlaschelli A, Zanaboni D, et al. Percutaneous and surgical treatment of pyogenic liver abscesses: observation over a 21-year period in 148 patients [J]. Dig Liver Dis, 2008; 40(8): 690-696.
17. 　Alvarez Pérez JA, González JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess [J]. Am J Surg, 2001; 181(2): 177-186.
18. 　Rajak CL, Gupta S, Jain S, et al. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage [J]. AJR Am J Roentgenol, 1998; 170(4): 1035-1039.
19. 　Zerem E, Hadzic A. Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess [J]. AJR Am J Roentgenol, 2007; 189(3): W138-W142.
20. 　刘强, 王亚军, 刘家峰, 等. 细菌性肝脓肿治疗的单中心20年回顾分析 [J]. 中国普外基础与临床杂志, 2009; 16(5): 389-392.
21. 　Ng FH, Wong WM, Wong BC, et al. Sequential intravenous/oral antibiotic vs. continuous intravenous antibiotic in the treatment of pyogenic liver abscess [J]. Aliment Pharmacol Ther, 2002; 16(6): 1083-1090.
22. 　赵世峰, 沈洪. 第46 例-糖尿病伴细菌性肝脓肿(Internet 网上病例讨论) [J]. 中国危重病急救医学, 2002; 14(8): 511-512.
23. 　Chou FF, Sheen-Chen SM, Chen YS, et al. Prognostic factors for pyogenic abscess of the liver [J]. J Am Coll Surg, 1994; 179(6): 727-732.
24. 　Chung YF. Pyogenic liver abscess-predicting failure to improve outcome [J]. Neth J Med, 2008; 66(5): 183-184.
25. 　Chen SC, Tsai SJ, Chen CH, et al. Predictors of mortality in patients with pyogenic liver abscess [J]. Neth J Med, 2008; 66(5): 196-203.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Percutaneous Catheter Drainage Versus Needle Aspiration in Management of Bacterial Liver Abscess

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