Gupta Shardool Vikram, Akami Kewecho, Garg Siddharth, Bishnoi Srishti, Kumar Bansal Lalit, Jain Atul, Kapur Neeti
Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India.
Turk J Surg. 2024 Dec 27;40(4):275-282. doi: 10.47717/turkjsurg.2024.6563. eCollection 2024 Dec.
Liver abscesses, which are purulent cavities within the liver, pose significant health challenges, particularly in developing countries where treatment resources are limited. Despite advancements in imaging and drainage technologies, conventional methods such as pigtail catheters and surgical interventions are often financially prohibitive and inaccessible in low-resource settings. This study proposes Gupta-Akami technique, an indigenous and economically viable method for percutaneous drainage, utilizes simple, readily available materials and offers a potential solution for these settings.
The study was conducted at a tertiary care hospital over a period of six months. It included 21 patients with liver abscesses meeting specific criteria (abscess volume >500 mL, intervening liver parenchyma <5 cm, and skin-to-abscess distance <10 cm).
The average age of the patients was 45.6 years and there were more men than women. Most patients presented with fever and abdominal pain; nausea/vomiting was observed in the majority, and jaundice was noted in a few. Mean abscess volume was 890 mL. The procedure effectively drained over 87% of the abscess volume and only one patient requiring additional aspiration. Post-procedural pain decreased significantly from an average of 3.15 on a visual analog scale at 0 hours to 0.84 before discharge. The average hospital stay was 2.57 days. No complications or mortality were reported.
The Gupta-Akami technique demonstrates efficacy as a low-cost, accessible method for percutaneous drainage of liver abscesses in resource-limited settings. It offers a promising alternative to more expensive traditional methods, potentially improving patient outcomes and accessibility in low-resource environments.
肝脓肿是肝脏内的脓性腔隙,对健康构成重大挑战,在治疗资源有限的发展中国家尤为如此。尽管影像和引流技术有所进步,但诸如猪尾导管和手术干预等传统方法在资源匮乏地区往往费用高昂且难以获得。本研究提出了古普塔 - 赤kami技术,这是一种本土且经济可行的经皮引流方法,使用简单、易于获取的材料,为这些地区提供了一种潜在的解决方案。
该研究在一家三级护理医院进行,为期六个月。研究纳入了21例符合特定标准的肝脓肿患者(脓肿体积>500 mL,中间肝实质<5 cm,皮肤至脓肿距离<10 cm)。
患者的平均年龄为45.6岁,男性多于女性。大多数患者表现为发热和腹痛;大多数患者有恶心/呕吐症状,少数患者出现黄疸。平均脓肿体积为890 mL。该操作有效地引流了超过87%的脓肿体积,只有一名患者需要额外抽吸。术后疼痛从0小时时视觉模拟量表平均3.15显著降至出院前的0.84。平均住院时间为2.57天。未报告并发症或死亡情况。
古普塔 - 赤kami技术证明了其作为一种低成本、可及的方法在资源有限环境中经皮引流肝脓肿的有效性。它为更昂贵的传统方法提供了一种有前景的替代方案,有可能改善资源匮乏环境下患者的治疗效果和可及性。