Treatment of Liver Abscess

Yoo, Chang Oh; So, Byung Jun; Chae, Kwon Mook

Abstract

BACKGROUND: To evaluate the changing pattern of liver abscess treatment, we did a retrospective analysis of 80 patients with liver abscess, treated surgically and medically at the Department of Surgery and Internal Medicine, Wonkwang University Hospital from January 1985 to December, 1995.
RESULTS
Among 80cases of liver abscess, 59 cases(76%) were pyogenic abscess and 21 cases(24%) were amebic abscess. The liver abscess was more commonly located in the right lobe. In the 59cases of pyogenic liver abscess, etiologic factors were biliary stones with cholangitis(19 cases), cholecystitis(6 cases), hepatobiliary cancer(4 cases), diabetes mellitus(3 cases). All 21 cases of amebic abscess were treated with percutaneous catheter drainage and metronidazole administration; 20 cases were treated successfully and 1 case died of sepsis. Among the 59 cases of pyogenic liver abscess, 38 cases were treated with percutaneous catheter drainage; 30 cases were successful, but 8 cases were not. Operations were performed in 21 cases because of underlying intraabdominal conditions requiring surgical correction( 19cases) and panperitonitis due to rupture of liver abscess(2cases).
CONCLUSION
In the treatment of amebic abscss, percutaneous catheter drainage and metanidazole adminstration should be considered first. Percutaneous catheter drainage and antibiotic treatment tend to increase more than surgical treatment in the pyogenic liver abscess therapy. The liver abscess is no more surgical indication, unless it is associated with underlying intraabdominal conditions requiring surgical correction and panperitonitis due to rupture of liver abscess.