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  • Title: Percutaneous drainage for giant pyogenic liver abscess--is it safe and sufficient?
    Author: Ahmed S, Chia CL, Junnarkar SP, Woon W, Shelat VG.
    Journal: Am J Surg; 2016 Jan; 211(1):95-101. PubMed ID: 26033361.
    Abstract:
    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.
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