Chin Yung Ka, Asokkumar Ravishankar
Department of Gastroenterology and Hepatology, Academia, Singapore General Hospital, Singapore.
SAGE Open Med. 2020 May 12;8:2050312120921273. doi: 10.1177/2050312120921273. eCollection 2020.
Antibiotic therapy and percutaneous drainage have been the first-line treatments for liver abscesses. However, percutaneous drainage of abscesses may be challenging in difficult-to-access locations such as the caudate lobe. The aim of this review was to determine the indications, technical feasibility and efficacy of endoscopic ultrasound-guided drainage of difficult-to-access liver abscesses.
A literature review of original articles, abstracts, case series and case reports describing endoscopic ultrasound-guided liver abscess drainage was performed. The indications, techniques and complications associated with endoscopic ultrasound-guided drainage were reviewed.
A total of 15 studies were identified. The main indications were failed antibiotic therapy and difficulty in gaining percutaneous access. The technique involved identification and puncturing of an abscess under endoscopic ultrasound guidance followed by placement of a prosthesis via a guide wire. The technique was 97.5% successful with no major complications reported.
Endoscopic ultrasound-guided drainage was feasible and safe and allowed complete drainage of liver abscesses not accessible by percutaneous drainage.
抗生素治疗和经皮引流一直是肝脓肿的一线治疗方法。然而，对于诸如尾状叶等难以到达部位的脓肿进行经皮引流可能具有挑战性。本综述的目的是确定内镜超声引导下对难以到达的肝脓肿进行引流的适应症、技术可行性和疗效。
对描述内镜超声引导下肝脓肿引流的原始文章、摘要、病例系列和病例报告进行文献综述。对与内镜超声引导下引流相关的适应症、技术和并发症进行了综述。
共确定了15项研究。主要适应症是抗生素治疗失败和经皮穿刺困难。该技术包括在内镜超声引导下识别并穿刺脓肿，然后通过导丝置入假体。该技术成功率为97.5%，未报告重大并发症。
内镜超声引导下引流是可行且安全的，能够对经皮引流无法到达的肝脓肿进行完全引流。
