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Percutaneous drainage for giant pyogenic liver abscess--is it safe and sufficient?
Saleem Ahmed1, Clement L K Chia1, Sameer P Junnarkar2
1Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; Ministry of Health Holdings, 1 Maritime Square, Singapore, Singapore.
Background:
Large size is a predictor of failure of percutaneous drainage (PD) for pyogenic liver abscess (PLA). This article serves to establish the safety and sufficiency of PD in giant PLA (GPLA).
Methods:
A retrospective review of all GPLA patients treated at a tertiary care academic hospital from 2001 to 2011 was performed. A GPLA is defined as an abscess greater than or equal to 10 cm size based on imaging.
Results:
Forty patients (24 men, 60%) were treated for GPLA. All but 1 patient (98%) was managed with PD and the mean duration of drainage was 9 days (range 1 to 23 days). One patient underwent operative drainage. Three patients (7.7%) needed secondary procedures after the initial PD. One patient (2.6%) failed PD and subsequently underwent operative drainage. Among the patients who underwent PD, the overall morbidity was 25%; the median length of hospital stay was 13 days (range 5 to 31 days) and 1 (2.6%) mortality.
Conclusions:
Large size itself is not a contraindication for PD. PD is safe and sufficient even in GPLA patients.
