A Study on the Usefulness of ERCP in Patients with Pyogenic Liver Abscess

Woo, Yong An; Kang, Sung Jin; Park, Jong Seo; Ryu, Sung Sik; Hong, Gun Young; Kang, Myung Won; Lim, Yeun Keun; Yeo, Hyang Soon; Park, Hong Bae

Abstract

BACKGROUND/AIMS: This study was undertaken to evaluate the usefulness of ERCP in patients with pyogenic liver abscess.
METHODS
An endoscopic retrograde cholangiographic study of 70 consecutive cases of pyogenic liver abscess was conducted during the period from January, 1993 to December, 1997. Among 70 cases of pyogenic liver abscess, the male to female ratio was 1.69 :1, and the peak incidence was in the sixth decade.
RESULTS
The common associated diseases were liver cirrhosis (11.4%), diabetes mellitus (8.5%), and malignancy (5.7%). The most common origins of the abscess in decreasing order of frequency were, transbiliary infection (51%), hematogenous spread, and trauma-associated causes. The ascending infection through the biliary tract as the etiology of liver abscess, has been common since the 1970's. The positive rate of abdominal US, CT, and ERCP in the diagnosis of the etiology of the liver abscess was 68, 82, 84% respectively. The treatments of the pyogenic liver abscess were, surgical drainage in 15 cases (21%) and percutaneous drainage in 51 cases (73%). Among 70 patients treated for pyogenic liver abscess, 12 patients had CBD stones and 11 patients were cured by EST.
CONCLUSIONS
The most common origin of liver abscess is ascending infection through the biliary tract and ERCP may be a effective tool in the assessment and management of the etiology of pyogenic liver abscess.