Comparative study of percutaneous catheter drainage versus percutaneous needle aspiration for liver abscess

Abstract

This study aimed to assess the effectiveness and safety of percutaneous needle aspiration (PERCUTANEOUS NEEDLE ASPIRATION) and percutaneous catheter drainage (PER CUTANEOUS DRAINAGE ) in the treatment of liver abscess. Methods: A prospective randomized study was conducted in patients presenting to Department of Surgery, GMERS Medical College, Vadodara between July 2019 and May 2022. 50 patients with liver abscess were randomized into two groups A and B. Complete history, presenting symptoms, medications were noted. The effectiveness of either treatment was measured in terms of duration of intravenous antibiotic, clinical improvement, reduction in the size of cavity, treatment success rate, duration of hospital stay including long-term outcomes such as sonographic resolution of cavity and recurrence rate at 6 months post-treatment. Results: Per Cutaneous Drainage group had statistically significant rate of duration of antibiotics need, days for clinical improvement and time for 50% reduction in abscess cavity and treatment success rate with comparable long-term outcomes. Conclusion: Per Cutaneous Drainage is more efficient than Percutaneous Needle Aspiration and can be used primarily in the treatment of both amoebic and pyogenic liver abscesses along with systemic antibiotics. However, Percutaneous Needle Aspiration can serve as a safe alternative when Per Cutaneous Drainage is not available.

Percutaneous catheter drainage versus needle aspiration for liver abscess management: an updated systematic review, meta-analysis, and meta-regression of randomized controlled trials

“…We assessed the quality of the included studies according to the Cochrane risk of bias tool ( 34 ), as shown in Figure 2 . All of the included trials had a low risk of random sequence generation bias except Abusedera et al 2014 ( 18 ), Bansal et al 2015 ( 20 ), Gajera et al 2022 ( 22 ), Hanumathappa et al 2016 ( 24 ), Kulhari et al 2019 ( 25 ), and Rajak et al 1998 ( 26 ) with an unclear risk of selection bias. All the included studies had a low risk of allocation concealment bias except Abusedera et al 2014 ( 18 ), Ahmed et al 2021 ( 19 ), Batham et al 2016 ( 21 ), Bansal et al 2015 ( 20 ), Gajera et al 2022 ( 22 ), Hanumathappa et al 2016 ( 24 ), Kulhari et al 2019 ( 25 ), and Rajak et al 1998 ( 26 ) with an unclear risk.…”

“…Furthermore, all included trials had an unclear risk of reporting bias except Singh et al 2009 ( 27 ), Singh et al 2013 ( 29 ), and Singh et al 2019 ( 28 ), which had low risk. Finally, all of the included trials had a low risk of other bias except Ahmed et al 2021 ( 19 ), Bansal et al 2015 ( 20 ), Batham et al 2016 ( 21 ), Gajera et al 2022 ( 22 ), Hanumathappa et al 2016 ( 24 ), and Singh et al 2013 ( 29 ). Author judgments are furtherly clarified in Table S2 .…”

“…We moved to full-text screening with 37 articles, 22 articles were excluded. Finally, 15 articles met our inclusion criteria (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). The prisma flow chart of the detailed selection process is demonstrated in Figure 1.…”

“…Our review has a few limitations. First, although we included 15 trials, 12 trials were conducted in India (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), one in Egypt (18), another in China (31), and another in Bosnia and Herzegovina (32). Therefore, the geographical distribution of our review population is limited, limiting the generalizability of our findings.…”