Complex Pyogenic Liver Abscess: Outcome of Open vs Laparoscopic Drainage
DOI:
https://doi.org/10.37762/jgmds.10-1.359Keywords:
Laparoscopy, Open Drainage, Pyogenic Liver AbscessAbstract
OBJECTIVES
Our study aimed to evaluate the safety and efficacy of laparoscopic drainage as a management of complex pyogenic liver abscesses in comparison to open surgical drainage.
METHODOLOGY
The comparative research design was used to compare the outcomes, complications, perioperative morbidity, mortality, and potential recurrence of 60 patients with a complex pyogenic liver abscess who were hospitalized at the General Surgery Department of Hayatabad Medical Complex Peshawar and treated either laparoscopically or openly from January 2019 to December 2020. 30 patients had open drainage management, while 30 patients received laparoscopic drainage management. For all patients, pus was examined for culture sensitivity. Patients with a small, solitary and unilocular pyogenic liver abscess that improved with antibiotic therapy and or/and percutaneous drainage were excluded. Each patient had a thorough clinical evaluation, lab tests, ultrasound, computed tomography, or magnetic resonance imaging of the pelvis and abdomen.
RESULTS
All patients underwent abdominal ultrasonography & sonographic diagnosis was made in 43(71.7%), followed by a computed tomography scan (CT) in 12(20%) & magnetic resonance imaging (MRI) diagnosis was made in 5(8.3%) patients respectively. Diabetes mellitus was present in 15(25%) patients, severe chronic obstructive pulmonary disease in 10(16.7%) and severe anemia in 9(15%) patients. All individuals associated with co-morbidity were considered high-risk patients.
CONCLUSION
Laparoscopic drainage of liver abscess has a shorter surgical time, lower morbidity rate, and shorter hospital stay as compared to open surgical drainage.
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Mogahed MM, Zytoon AA, Eysa B, Manaa M, Abdellatif W. Laparoscopic vs open drainage of complex pyogenic liver abscess. World. 2020 Jan;13(1):12
Mischnik A, Kern WV, Thimme R. Pyogenic liver abscess: Changes of Organisms and Consequences for Diagnosis and Therapy. Deutsche Medizinische Wochenschrift (1946). 2017 Jul 20;142(14):1067-74
Czerwonko ME, Huespe P, Bertone S, Pellegrini P, Mazza O, Pekolj J, de Santibañes E, Hyon SH, de Santibañes M. Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes. Hpb. 2016 Dec 1;18(12):1023-30
Ndong A, Diao M, Tendeng J, Thiam O, Diallo A, Diouf A, Dia DA, Diop S, Dieng M, Diedhiou M, Nyemb PM. Limitations and challenges of laparoscopic surgery in a low-income country: example of the Gaston Berger Teaching Hospital of Saint-Louis (Senegal) J. Surg. Simulat. 2021 Jun 11;8:14-7
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. bmj. 2017 Sep 21;358
Dhir U, Ghuman SS, Singhri S. Caudate lobe liver abscess: early surgical drainage. J Liver Res Disord Ther. 2018;4(11):49-51
Groeschl R, Baker E, Bertens K, Siddiqui I, Tee M, Helton WS, Iannitti D. Both laparoscopic and open surgical drainage are highly effective in the treatment of refractory pyogenic liver abscess: a multi-institutional analysis. HPB. 2016 Apr 1;18:e244
Dhir U, Ghuman S, Singhvi S, Rawat S. Caudate lobe liver abscess: laparoscopic drainage the best approach. HPB. 2019 Jan 1;21:S385
Ndong A, Tendeng JN, Diallo AC, Dieye A, Diao ML, Diallo S, Diop S, Diallo MK, Diedhiou M, Fall ML, Nyemb PM. Efficacy of laparoscopic surgery in the treatment of hepatic abscess: A systematic review and meta-analysis. Annals of Medicine and Surgery. 2022 Jan 31:103308
Mavilia MG, Molina M, Wu GY. The evolving nature of hepatic abscess: a review. Journal of clinical and translational hepatology. 2016 Jun 6;4(2):158
Kumanan T, Sujanitha V, Sreeharan N. Amoebic liver abscess: a neglected tropical disease. The Lancet Infectious Diseases. 2020 Feb 1;20(2):160-2
Ndong A, Tendeng JN, Ndoye NA, Diao ML, Dieye A, Diallo AC, Mansouri MR, Dia DA, Nibogora J, Fall F, Sagna SA. Predictive risk factors for liver abscess rupture: a prospective study of 138 cases. Archives of Clinical Gastroenterology. 2020 Jan 25;6(1):001-5
Trillos-Almanza MC, Gutierrez JC. How to manage: liver abscess. Frontline Gastroenterology. 2021 May 1;12(3):225-31
Serraino C, Elia C, Bracco C, Rinaldi G, Pomero F, Silvestri A, Melchio R, Fenoglio LM. Characteristics and management of pyogenic liver abscess: A European experience. Medicine. 2018 May;97(19)
Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E, Vargas M, Connolly S, Bhalla S, Huete Á. Multimodality imaging of liver infections: differential diagnosis and potential pitfalls. Radiographics. 2016 Jul;36(4):1001-23
Dhamodharan SR, Christeena Indrani J. An innovative technique of laparoscopic drainage of liver abscess. Int. J. Dent. Med. Sci. Res. 2018;2(9):1-1
Liu L, Chen W, Lu X, Zhang K, Zhu C. Pyogenic liver abscess: a retrospective study of 105 cases in an emergency department from East China. The Journal of Emergency Medicine. 2017 Apr 1;52(4):409-16
Malik AA, Bari SU, Rouf KA, Wani KA. Pyogenic liver abscess: changing patterns in approach. World journal of gastrointestinal surgery. 2010 Dec 12;2(12):395
Tu JF, Huang XF, Hu RY, You HY, Zheng XF, Jiang FZ. Comparison of laparoscopic and open surgery for pyogenic liver abscess with biliary pathology. World journal of gastroenterology: WJG. 2011 Oct 10;17(38):4339
McNeil T, Daniel S, Gordon DL. Management of pyogenic liver abscess: a South Australian experience. ANZ Journal of Surgery. 2020 Nov;90(11):2274-8
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Copyright (c) 2022 Rashid Aslam, Farrukh Ozair Shah, Muhammad Nadir Shah, Mehtab Abdullah
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