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Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance
A Giorgio1, L Tarantino, N Mariniello
1Department of Interventional Ultrasound, Cotugno Hospital for Infectious Disease, Naples, Italy.
Purpose:
To determine the efficacy of percutaneous needle aspiration (PNA) with antibiotic therapy in treatment for pyogenic liver abscess (PLA).
Materials And Methods:
One hundred fifteen patients (59 male; 56 female; age range, 16-86 years; mean age, 45.3 years) with 147 PLAs (mean diameter, 6.8 cm; range, 3-16 cm) underwent PNA with ultrasound (US) guidance and antibiotic therapy. Needle caliber (22-16 gauge) was tailored to PLA volume. If necessary, PNA was repeated every 3-7 days.
Results:
Three hundred one PNAs were performed (range, 1-4 per patient; mean, 2.2 per patient). A single puncture was sufficient in 57 patients. Cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in 113 patients (98.3%). Two patients with large PLAs required surgery. Patients were hospitalized 7-24 days (mean, 9 days). In the last eight patients, all abscesses were evacuated in one session. Neither complications nor deaths ensued. Recurrence of PLA was not observed in any patient during follow-up (6-36 months).
Conclusion:
US-guided PNA with antibiotic therapy in treatment for PLA is a valid alternative to prolonged catheter drainage.