Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: a systematic review and meta-analysis

Cai, Yulong; Xiong, Xian‐Ze; Lu, Jiong; Cheng, Yao; Chen, Yang; Lin, Yixin; Zhang, Jie; Cheng, Nan‐Sheng

doi:10.1111/hpb.12332

Cited by 141 publications

(117 citation statements)

References 25 publications

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“…A meta-analysis comparing catheter drainage vs. repeated needle aspirations of liver abscesses demonstrated the first to be more effective [27]. Other studies showed good results with repeated needle aspiration in simple abscesses smaller than 5 cm, while in larger abscesses catheter drainage has a better outcome [26].…”

Section: Discussionmentioning

confidence: 99%

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Spârchez

Radu²,

Kacsó

et al. 2015

Med Ultrason

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Liver abscess is a potentially lethal condition that requires prompt recognition and adequate treatment for a good outcome. The aim of this study was to assess the value of contrast enhanced ultrasound (CEUS) in the management of liver abscesses in the clinical practice of a single centre. Material and methods: A retrospective analysis was performed including all patients diagnosed with liver abscesses during 5 years (2010-2014) in a tertiary Department of Gastroenterology and Hepatology. The demographic data, the presence of risk factors, the cause of liver abscess, the B-mode conventional US aspect, the CEUS appearance and the patient's outcome were documented and analyzed. Results: The study group included 41 patients diagnosed with liver abscesses (17 women and 24 men, mean age 63.3±13.2 years), 16/41 (39%) of them with diabetes mellitus. A single lesion was found in 28 (68.3%) patients, and 13 (31.7%) patients had multiple abscesses. The CEUS study was conclusive for the diagnosis of liver abscess in clinical context in 38/41 cases (92.7%). All conclusive cases presented rim enhancement in the arterial phase and no enhancement in the liquid areas. The honeycomb appearance with septa enhancement was present in 17/41 (41.5%) patients. Washout of the marginal rim was found in 22/41 (53.6%) lesions. Conclusion: In our group the most frequent CEUS features found were the rim enhancement in the arterial phase and the presence of no enhancement areas, followed by the honeycomb appearance. CEUS was able to be conclusive for the diagnosis of liver abscess in almost 93% of cases.

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Section: Discussionmentioning

confidence: 99%

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Spârchez

Radu²,

Kacsó

et al. 2015

Med Ultrason

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“…In addition, greater age (≥ 55 years), presence of multiple abscesses, malignancy as etiology, and endoscopic intervention were reported to be the risk factors for the development of PLA treatment failure with antibiotics alone [24]. In our cohort, 50 % of MPLPs were larger than 5 cm in diameter and 29 % were multiple.…”

Section: Discussionmentioning

confidence: 68%

“…The antibiotic treatment was optimized afterward according to the results of the bacterial cultures and antimicrobial susceptibility analysis of the isolated pathogens. Patients with abscesses larger than 3 cm in diameter predominantly underwent source control by PCD with 7 Fr catheter drainage within 24 hours, except in the following situations: (a) when the lesions were MPLPs, and (b) when there was a safety concern about PCD such as bleeding tendencies and a moderate-high amount of ascites [13,14,24]. The duration of drainage catheter placement ranged from 4 to 10 days.…”

Section: Principal Treatment Strategies For Plamentioning

confidence: 99%

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Morii¹,

Yamamoto²,

Nakamura³

et al. 2017

GHOA

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Background: Percutaneous catheter drainage (PCD) is currently the preferred therapeutic procedure of pyogenic liver abscesses (PLAs). However, multilocular poorly liquefied PLAs (MPLPs) are unsuitable for PCD. As reports on MPLPs are scarce, we aimed to explore possible therapeutic strategies for this serious type of PLA. Methods:The medical records of patients with PLA who were hospitalized at our institution between January 2011 to December 2015 were retrospectively reviewed. Demographic factors, biochemical, bacteriological, and imaging results, and treatment outcomes were evaluated.Results: Fourteen patients with MPLPs and 37 with drainable PLAs were identified and included in the study. Clinical characteristics were generally similar between the two groups. Klebsiella pneumoniae accounted for the majority of the culprit pathogens in MPLPs. Patients with MPLPs were managed medically without PCD. Despite this, treatment outcomes were not inferior compared to patients with drainable PLAs. Contrast-enhanced images revealed that the intricate septa of the MPLP maintained its blood perfusion. Most MPLPs did not liquefy over the treatment period. Conclusion:We should remember that MPLP is not rare. The septa may have delivered antibiotics adequately into the MPLPs, thus producing good treatment outcomes. Despite our findings, a high level of suspicion of treatment failure is crucial in these patients to ensure favorable treatment outcomes.

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“…Theoretically, mini-invasive procedures including final needle aspiration and persistent catheter drainage will be performed successfully for most of PLA in the nature status [12]. However, the drainage often fails in early stage of PLA because little free fluid found in imaging graphy.…”

Section: Discussionmentioning

confidence: 99%

Pyogenic Liver Abscess after Bile Duct Exploration Drained with Endoscopic Techniques

Lu¹,

Zhu²,

Li³

et al. 2016

Surgery Curr Res

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Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: a systematic review and meta-analysis

Cited by 141 publications

References 25 publications

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Does Contrast Enhanced Ultrasound improve the management of liver abscesses? A single centre experience

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Pyogenic Liver Abscess after Bile Duct Exploration Drained with Endoscopic Techniques

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