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Expanded criteria for percutaneous abscess drainage.

S G Gerzof, W C Johnson, A H Robbins

    Archives of Surgery (Chicago, Ill. : 1960)
    |February 1, 1985
    PubMed
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    Percutaneous abscess drainage criteria were expanded to include complex cases. This approach achieved a 73.6% cure rate for 125 abscesses, demonstrating its effectiveness in broader applications.

    Area of Science:

    • Interventional Radiology
    • Surgical Gastroenterology
    • Infectious Disease Management

    Background:

    • Traditional percutaneous abscess drainage (PAD) was restricted to simple, well-defined abscesses with safe drainage pathways.
    • Increasing complexity of abscess cases necessitated a re-evaluation of PAD eligibility criteria.
    • Previous limitations excluded potentially treatable complex, multiple, or complicated abscesses.

    Purpose of the Study:

    • To evaluate the efficacy and safety of expanded percutaneous drainage criteria for a wider range of abscesses.
    • To assess outcomes for simple versus complex abscesses treated with percutaneous drainage.
    • To determine factors influencing cure rates and complications in percutaneous abscess drainage.

    Main Methods:

    • Retrospective analysis of 125 patients undergoing percutaneous abscess drainage.

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  • Expanded inclusion criteria encompassed complex (loculated, ill-defined, dissecting), multiple, and complicated abscesses (appendiceal, splenic, interloop, pelvic).
  • Outcomes including cure rates, mortality, and complications were recorded and analyzed.

    • Main Results:

    • Overall cure was achieved in 73.6% (92/125) of abscesses with 9% mortality and 9% complication rates.
    • Cure rates were significantly higher for simple abscesses (82%) compared to complex abscesses (45%).
    • Abscess size, depth, drainage route, and etiology did not correlate with cure or complication rates.

    Conclusions:

    • Expanded criteria for percutaneous abscess drainage are feasible and effective for a broader spectrum of abscesses.
    • Clinical response should guide the decision for operative intervention, especially in complex cases.
    • Percutaneous drainage should be considered for all simple and most complex abscesses.