Pyogenic liver abscess - 20 Years' experience: Comparison of results of treatment in two periods

A. Petri, J. Höhn, Z. Hódi, A. Wolfárd, Á Balogh

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background and aims: Our aim is to give an audit of our experience over the past two decades in the form of a retrospective study. Patients/methods: In two equal periods between 01.01.1982 and 31.03.2001, 56 patients (37 males and 19 females) with pyogenic liver abscess were treated. Image-guided percutaneous drainage was performed in 22.2%/20.6% of the patients; the remainder were treated with open drainage with or without biliary tract reconstruction and liver resection. For antibiotic perfusion of the liver an umbilical vein cannula was inserted in 40.7%/24.1%. Microbiological findings, types of therapy, complications and mortality, etiology, patient characteristics, symptoms, and laboratory data were investigated. The results in the two groups were compared and analyzed statistically. Results: The most common cause of abscess, biliary disease, was seen more often in the second period. Solitary liver abscesses were more frequent. The only characteristic biochemical finding was an elevated alkaline phosphatase level. There were more positive cultures in the second period (70.4%/ 79.3%), and the number of Escherichia coli or Enterobacter aerogenes infections also increased. In the first period the mortality was 18.5%, whereas in the second no patients were lost. Conclusion: We suggest the importance of individualized therapy based on an early and exact diagnosis. The first treatment step should be image-guided drainage, but under well-defined circumstances open drainage can also be performed with good results.

Original languageEnglish
Pages (from-to)27-31
Number of pages5
JournalLangenbeck's Archives of Surgery
Volume387
Issue number1
DOIs
Publication statusPublished - 2002

Fingerprint

Pyogenic Liver Abscess
Drainage
Enterobacter aerogenes
Therapeutics
Liver Abscess
Umbilical Veins
Mortality
Liver
Biliary Tract
Abscess
Alkaline Phosphatase
Early Diagnosis
Retrospective Studies
Perfusion
Escherichia coli
Anti-Bacterial Agents
Infection

Keywords

  • Abscess
  • Liver
  • Microbiology
  • Therapy

ASJC Scopus subject areas

  • Surgery

Cite this

Pyogenic liver abscess - 20 Years' experience : Comparison of results of treatment in two periods. / Petri, A.; Höhn, J.; Hódi, Z.; Wolfárd, A.; Balogh, Á.

In: Langenbeck's Archives of Surgery, Vol. 387, No. 1, 2002, p. 27-31.

Research output: Contribution to journalArticle

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abstract = "Background and aims: Our aim is to give an audit of our experience over the past two decades in the form of a retrospective study. Patients/methods: In two equal periods between 01.01.1982 and 31.03.2001, 56 patients (37 males and 19 females) with pyogenic liver abscess were treated. Image-guided percutaneous drainage was performed in 22.2{\%}/20.6{\%} of the patients; the remainder were treated with open drainage with or without biliary tract reconstruction and liver resection. For antibiotic perfusion of the liver an umbilical vein cannula was inserted in 40.7{\%}/24.1{\%}. Microbiological findings, types of therapy, complications and mortality, etiology, patient characteristics, symptoms, and laboratory data were investigated. The results in the two groups were compared and analyzed statistically. Results: The most common cause of abscess, biliary disease, was seen more often in the second period. Solitary liver abscesses were more frequent. The only characteristic biochemical finding was an elevated alkaline phosphatase level. There were more positive cultures in the second period (70.4{\%}/ 79.3{\%}), and the number of Escherichia coli or Enterobacter aerogenes infections also increased. In the first period the mortality was 18.5{\%}, whereas in the second no patients were lost. Conclusion: We suggest the importance of individualized therapy based on an early and exact diagnosis. The first treatment step should be image-guided drainage, but under well-defined circumstances open drainage can also be performed with good results.",
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