Department of Radiodiagnosis, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Surgical Gastroenterology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Ann Afr Med. 2022 Jan-Mar;21(1):21-25. doi: 10.4103/aam.aam_68_20.
This study aimed to evaluate the safety and efficacy of USG-guided percutaneous drainage in liver abscesses of >5 cm. A lot of literature is available on the minimally invasive treatment of liver abscesses since its introduction in the early 1980s. This study focuses on the eastern Indian population and the outcome of treatment of liver abscess of >5 cm by means of catheter drainage and the use of antibiotics.
This is a retrospective study conducted on a total of fifty patients over a period of 1 year, 1 month (from June 2017 to June 2018). Only patients with liver abscess with size >5 cm were included in the study. The demographic characteristics; comorbidities; and clinical, radiological, and bacteriological characteristics of liver abscesses in the eastern Indian population and the safety and efficacy of catheter drainage were evaluated.
It was found that because of preprocedural empirical antibiotic intake, 70% of the patients had no growth in the pus, whereas 12% had Entamoeba histolytica, 8% had Escherichia coli, and 6% had Klebsiella pneumoniae as the causative agent. The total duration of hospital stay ranged from 3 to 22 days, and the duration of intravenous antibiotics ranged from 1 to 9 days with a clinical success rate of 96% without any drainage-related complications.
In contradiction to the earlier belief, percutaneous drainage is a safe and effective means of treatment in liver abscesses of >5 cm with high clinical success rate and reduced duration of intravenous antibiotic requirement as well as hospital stay.
本研究旨在评估 USG 引导下经皮穿刺引流治疗>5cm 肝脓肿的安全性和有效性。自 20 世纪 80 年代初引入以来,大量文献报道了微创治疗肝脓肿。本研究侧重于印度东部人群,以及通过导管引流和使用抗生素治疗>5cm 肝脓肿的治疗结果。
这是一项回顾性研究,共纳入了 50 名患者,研究时间为 1 年 1 个月(2017 年 6 月至 2018 年 6 月)。仅纳入了肝脓肿大小>5cm 的患者。评估了印度东部人群中肝脓肿的人口统计学特征、合并症;临床、影像学和细菌学特征,以及导管引流的安全性和有效性。
研究发现,由于术前经验性使用抗生素,70%的患者脓液中无细菌生长,而 12%的患者为溶组织内阿米巴,8%的患者为大肠埃希菌,6%的患者为肺炎克雷伯菌。住院时间从 3 天到 22 天不等,静脉用抗生素时间从 1 天到 9 天不等,临床成功率为 96%,无任何与引流相关的并发症。
与早期的观点相反,经皮引流是一种安全有效的治疗方法,适用于>5cm 的肝脓肿,具有较高的临床成功率,减少了静脉用抗生素的需求以及住院时间。