Efficacy of laparoscopic surgery in the treatment of hepatic abscess: A systematic review and meta-analysis

Ndong, Abdourahmane; Tendeng, Jacques Noël; Diallo, Adja Coumba; Dièye, A.; Diao, Mohamed Lamine; Diallo, S.; Diop, Samba; Diallo, Mariama Dalanda; Diedhiou, Moustapha; Fall, Mohamed Lamine; Nyemb, Philippe Manyacka Ma; Konaté, Ibrahima

doi:10.1016/j.amsu.2022.103308

Cited by 6 publications

(8 citation statements)

References 20 publications

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“…Nonetheless, the less invasive laparoscopic drainage approach would also have served as a safe and feasible alternative for our patient, but this depended on local expertise. A meta-analysis of 190 studies adopting laparoscopic drainage in 49% of PLA found a low rate of biliary leakage, postoperative residual abscess (4.22% cases) and no mortality 36. Following this, Pickens et al proposed a multimodal algorithm based on the type of abscess, whereby antibiotics alone were used for PLAs <3 cm, PD for unilocular ≥3 cm lesions and laparoscopic drainage for ≥3 cm multiloculated abscesses, which was associated with a lower failure rate than PD (4% vs 28%, p=0.018) 37.…”

Section: Discussionmentioning

confidence: 99%

GiantKlebsiella pneumoniaepyogenic liver abscess in the left liver lobe presenting with dyspepsia and vaginal discharge

Tran

2023

BMJ Case Rep

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Pyogenic liver abscess (PLA) commonly occurs in the right liver lobe, causing the typical symptoms of fever and right upper quadrant pain. Less than one-third of cases occur in the left lobe. We describe an unusual presentation of a giant left-sided PLA that was compressing the stomach and surrounding venous vasculature, causing the respective symptoms of gastro-oesophageal reflux and vaginal discharge from secondary pelvic congestion syndrome. CT revealed a solitary 14 cm×10 cm×10 cm multiloculated lesion, replacing most of the left liver lobe. It was successfully treated with intravenous antibiotics and percutaneous drainage, resulting in complete resolution at 1-year follow-up. This case explores the predisposing risk factor of diabetes in PLA and its association withKlebsiella pneumoniae,which was the offending pathogen in our patient. We also discuss the phenomenon of secondary pelvic venous congestion syndrome and compare similar cases of left-sided PLA, highlighting the different modes of presentation and treatment options.

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Section: Discussionmentioning

confidence: 99%

GiantKlebsiella pneumoniaepyogenic liver abscess in the left liver lobe presenting with dyspepsia and vaginal discharge

Tran

2023

BMJ Case Rep

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“…Whenever possible, a laparoscopic drainage should be preferred over the open surgery. Laparoscopic surgical drainage provides better cosmetics, a quicker recovery, a shorter hospital stay, fewer surgical site infections, and much lesser mortality risk[ 112 ]. ALA in the caudate lobe of the liver is often considered a challenging location for percutaneous drainage due to its proximity to major vessels, and a surgical drainage is often recommended for this location.…”

Section: Evidence-based Management and Changing Treatment Paradigmmentioning

confidence: 99%

Amebic liver abscess: An update

Kumar,

Patel,

Priyadarshi

et al. 2024

World J Hepatol

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Amebic liver abscess (ALA) is still a common problem in the tropical world, where it affects over three-quarters of patients with liver abscess. It is caused by an anaerobic protozoan Entamoeba hystolytica , which primarily colonises the cecum. It is a non-suppurative infection of the liver consisting primarily of dead hepatocytes and cellular debris. People of the male gender, during their reproductive years, are most prone to ALA, and this appears to be due to a poorly mounted immune response linked to serum testosterone levels. ALA is more common in the right lobe of the liver, is strongly associated with alcohol consumption, and can heal without the need for drainage. While majority of ALA patients have an uncomplicated course, a number of complications have been described, including rupture into abdomino-thoracic structures, biliary fistula, vascular thrombosis, bilio-vascular compression, and secondary bacterial infection. Based on clinico-radiological findings, a classification system for ALA has emerged recently, which can assist clinicians in making treatment decisions. Recent research has revealed the role of venous thrombosis-related ischemia in the severity of ALA. Recent years have seen the development and refinement of newer molecular diagnostic techniques that can greatly aid in overcoming the diagnostic challenge in endemic area where serology-based tests have limited accuracy. Metronidazole has been the drug of choice for ALA patients for many years. However, concerns over the resistance and adverse effects necessitate the creation of new, safe, and potent antiamebic medications. Although the indication of the drainage of uncomplicated ALA has become more clear, high-quality randomised trials are still necessary for robust conclusions. Percutaneous drainage appears to be a viable option for patients with ruptured ALA and diffuse peritonitis, for whom surgery represents a significant risk of mortality.With regard to all of the aforementioned issues, this article intends to present an updated review of ALA.

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“…Medical management with or without percutaneous drainage aspiration remains the mainstay of treatment for most liver abscesses, but when this fails, the next alternative is minimally invasive laparoscopic drainage. Other indications for this method include rupture of the abscess, multiloculated abscess, caudate lobe abscess, or associated biliary disease (lithiasis or stricture) [41]. Laparoscopic drainage is preferred because it provides faster recovery, shorter hospital stay, less surgical-site infection, a low recurrence rate, and better cosmetics than open surgical drainage.…”

Section: Laparoscopic Drainagementioning

confidence: 99%

“…It, however, requires the expertise of the laparoscopic hepato-biliary surgical technique, which requires trained radiologists that may not be readily available in certain countries or situations. In addition, the absence of tactile sensation could make the breakdown of septations and perihepatic adhesions difficult [41,43].…”

Section: Laparoscopic Drainagementioning

confidence: 99%

The Silent Killer: A Case Report of Delayed Diagnosis and Successful Treatment of Pancreatic Trauma

Coral

2023

oajs

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Hepatic abscesses are suppurated cavities caused by the invasion and multiplication of microorganisms within the liver parenchyma. This condition is relatively uncommon, with an estimated incidence of 2.3 to 3.6 cases per 100,000 people yearly. However, the incidence is higher in specific populations, such as patients with underlying liver disease, diabetes, or other immune-compromising conditions. The most common cause of liver abscesses is the spread of infection from other parts of the body, such as the biliary tract or gastrointestinal tract. Other causes include trauma to the liver, such as from a penetrating injury or surgery or the presence of a foreign body in the liver. Liver abscesses are broadly divided into two types: amoebic and pyogenic. The clinical presentation might vary, including fever, abdominal pain, nausea and vomiting, jaundice, and weight loss. In some cases, there may be no symptoms. Diagnosis typically involves an ultrasound or CT scan, which can show the presence of a fluid-filled mass in the liver. CT is the standard modality for diagnosis. Blood tests may also evaluate liver function and identify any underlying infections. Treatment typically involves a combination of antibiotics to target the underlying infection and drainage of the abscess. Supportive measures like hydration and pain management may also be necessary. In addition, close monitoring and follow-up are essential to ensure that the abscess has resolved and there are no complications. In some cases, surgical intervention may be necessary to remove the abscess or repair any damage to the liver. Liver abscess drainage is typically indicated in patients with significant, symptomatic abscesses or those who do not respond to medical treatment with antibiotics. In addition, abscesses at risk of rupturing or located close to vital structures, such as major blood vessels, may require drainage to prevent serious complications. Two drainage methods are presently available: non-surgical options, such as percutaneous needle aspiration or percutaneous catheter drainage, and surgical options, such as open drainage or laparoscopic drainage. This review identifies when these alternatives should be used, taking adverse effects, symptoms, and comorbidities into account.

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Efficacy of laparoscopic surgery in the treatment of hepatic abscess: A systematic review and meta-analysis

Cited by 6 publications

References 20 publications

GiantKlebsiella pneumoniaepyogenic liver abscess in the left liver lobe presenting with dyspepsia and vaginal discharge

GiantKlebsiella pneumoniaepyogenic liver abscess in the left liver lobe presenting with dyspepsia and vaginal discharge

Amebic liver abscess: An update

The Silent Killer: A Case Report of Delayed Diagnosis and Successful Treatment of Pancreatic Trauma

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