Optimizing Catheter Removal in Amebic Liver Abscess: A Simplified Protocol for Faster Recovery

Percutaneous catheter drainage (PCD) is widely used in the management of large amebic liver abscesses (ALA). However, considerable variation exists in catheter removal practices, and concerns regarding residual cavities often result in prolonged catheterization and hospital stay. This study assessed whether an early catheter removal strategy could improve clinical outcomes without increasing complications.

In this prospective observational study, 40 adult patients with uncomplicated ALA requiring percutaneous drainage were enrolled. Catheter removal was attempted after 72 hours in patients demonstrating sustained clinical improvement, defined by resolution of fever and abdominal pain, declining leukocyte counts, and at least a 50% reduction in abscess cavity volume on ultrasonography. Patients were followed clinically and with serial ultrasound examinations to assess outcomes and the behavior of residual cavities.

The study population was predominantly male (90%), with 62.5% having abscesses larger than 10 cm and 75% involving the right hepatic lobe. Early catheter removal was successfully achieved in 36 patients (90%) without procedure-related complications or mortality. The median duration of catheterization and hospital stay was 3 days each. Residual cavities were frequently observed on follow-up imaging (87.5% at 2 weeks and 82.5% at 1 month) but showed progressive reduction in size over time, decreasing from a mean of 6.5 ± 3.3 cm at discharge to 3.0 ± 1.7 cm at 1 month. Clinical recovery was rapid, with median resolution times of 2 days for fever and 3 days for abdominal pain.

Early removal of percutaneous catheters in patients with uncomplicated amebic liver abscess is safe and effective, significantly reducing catheter duration and length of hospitalization without increasing adverse outcomes. Although residual cavities are common, they regress gradually and do not justify prolonged catheter retention.