COMPARATIVE STUDY OF OUTCOMES OF PERCUTANEOUS NEEDLE ASPIRATION VERSUS PIGTAIL CATHETER DRAINAGE FOR SOLITARY LIVER ABSCESS.

2021 ◽  
pp. 76-77
Author(s):  
Samir Kumar ◽  
Manish Manish

Objective: The aim of this study was to compare the outcomes of ultrasound guided percutaneous needle aspiration and percutaneous pigtail catheter drainage in the treatment of solitary liver abscess with respect to successful drainage, clinical improvement, reduction in size of abscess cavity, duration of hospital stay and procedure related complications. Methods: Prospective randomized study on 108 patients treated over a period of 30 months. Using standard randomization they were divided equally into two groups A and B. Group A patients underwent usg guided percutaneous needle aspiration for a maximum of three attempts, and Group B patients were treated by pigtail catheter drainage. All the patients received a uniform protocol based supportive care and antimicrobial treatment. Outcomes were compared with respect to successful drainage, resolution of symptom, fty percent reduction in size of abscess cavity, hospital stay duration and procedure related complications. Results: A successful drainage was noted in 52(96%) patients in group B treated with PCD and 46 (84%) patients in group A treated with PNA. 8(11%) patients in group A did not respond to three attempts due to very thick pus and they were offered pigtail catheter drainage. The duration required for initial clinical improvement and fty percent reduction of size of abscess cavity was signicantly lesser in group B. Though the duration of hospital stay was lesser in group B the difference was not statistically signicant. Complication was noted only in group B where one patient developed perihepatic and subdiaphragmatic collection and the other had peritonitis. Both were cured after surgical intervention. Conclusion: Both percutaneous needle aspiration and pigtail catheter drainage are almost equally effective in the treatment of solitary liver abscess. Though pigtail catheter drainage helped in earlier clinical improvement and reduction in cavity size but the difference in duration required for full recovery and complete resolution of abscess cavity was not statistically signicant. Hence the selection of the procedure needs to be individualized and should take into account various factors like patient's general condition, laboratory parameters, and nature of abscess cavity.

2021 ◽  
Author(s):  
Saurabh Kumar ◽  
Kamlesh Ahari ◽  
Naresh Kumar Midha ◽  
Deepak Kumar ◽  
Maya Gopalakrishnan ◽  
...  

Abstract Introduction – Liver abscess (especially amoebic) is an important health concern in tropical countries. Effective management of liver abscess included appropriate antibiotics and drainage of abscess cavity. Percutaneous abscess drainage by pigtail catherization is now gaining popularity. We analysed the role of pigtail catheter drainage in the treatment of liver abscess.Method and Material – This was a retrospective analytical study conducted in a tertiary care center in western India. Data of total 64 patients admitted with diagnosis of liver abscess were analyzed. To find the effectiveness of treatment data were analyzed in three groups based on treatment strategies, Group A (Conservative treatment), Group B (Percutaneous needle aspiration) and Group C (Pigtail catheter drainage).Results – A total of 64 patients of liver abscess were analyzed. There was male predominance (93.75%). Mean abscess volume in Group C (307.9 ± 212.8 ml) was significantly higher when compared to Group A (130.8 ± 72.9 ml, p = 0.03) and Group B (177.2 ± 129.5; p = 0.024). Duration of hospital stay and residual abscess volume at the time of discharge did not show statistically significant difference between treatment groups. Pigtail catheterization of abscess with volume >150ml shortened the hospital stay, whereas it prolonged the hospital stay in patients with abscess volume <150ml.Conclusion - Percutaneous pigtail catherization would be an operative decision for management of liver abscess. We concluded that use of pigtail catherization of patients with abscess volume > 150ml improved the clinical outcome.


2020 ◽  
pp. 21-23
Author(s):  
Manimaran Thangavelu ◽  
Swathika Kumarasamy ◽  
Catherine Sinduja Paulraj ◽  
Durairajan Vaithiyanathan ◽  
Jeyamohan Jayavel

Background: The aim of this study was to determine and compare the therapeutic effectiveness and safety of USG guided percutaneous continuous catheter drainage and USG guided percutaneous needle aspiration in the treatment of liver abscess in Trichy. Methods: This is a prospective randomised comparative study of 50 patients, presented in outpatient and emergency department at the hospital, randomised equally into two groups, percutaneous needle aspiration and pigtail catheter drainage. The effectiveness of their treatment was measured in terms of duration of hospital stay, time taken for improvement of clinical symptoms, time taken for 50% reduction in cavity size and total or near total reduction of abscess cavity. Independent t-test was used to analyse these parameters. Results: The success rate was significantly better in catheter drainage group. Patients in pigtail catheter drainage group showed earlier clinical improvement (p 0.000) and 50% reduction in abscess cavity volume (p 0.000) and near total reduction of abscess cavity was earlier (p 0.019) as compared to those who underwent percutaneous needle aspiration. Conclusion: Our study concludes that percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration in respect to clinical improvement, reduction of cavity and success rate.


2017 ◽  
Vol 8 (4) ◽  
pp. 506-509
Author(s):  
Mallesh Pawar ◽  
◽  
Vinay G ◽  
Sunil Kumar A.P.V ◽  
◽  
...  

2019 ◽  
Vol 6 (3) ◽  
pp. 922
Author(s):  
Unmed Chandak ◽  
Prenoy Araujo ◽  
Arti Mitra

Background: Previously liver abscesses were treated primarily by surgery but with advances in imaging techniques the trend is changing towards use of potent antimicrobials and minimally invasive ultrasound guided interventional procedures and surgery is being done only in selected cases. We conducted this study to find out the feasibility, limitations, effectiveness, outcome and complications of therapeutic needle aspiration and continuous catheter drainage of liver abscess.Methods: This was a hospital based randomized control prospective study in which patients with liver abscess were included. 100 patients of liver abscess selected by simple randomization to 2 groups namely Group A (needle aspiration) or Group B (continuous catheter drainage) undergo the above two interventional procedures. For statistical purposes P value less that 0.05 was taken as statistically significant.Results: This study consisted of 100 patients out of whom there were 78 (78%) males and 22 (22%) females with a M:F ratio of 1:0.28. Single hepatic abscess (75%) was more common than multiple abscesses (25%) and pyogenic abscess (67%) was more common than amoebic abscess (33%). Right lobe of liver was most commonly involved (61%) followed by left lobe (22%). All patients in both the groups were treated successfully and there was no treatment failure in any of the groups.Conclusions: Therapeutic needle aspiration as well as continuous catheter drainage both are equally effective in management of liver abscess but needle aspiration had the advantage of being less expensive, easily available and requiring less hospital stay.


Author(s):  
RK Vineeth Kumar ◽  
Ashish Pratap Singh ◽  
Ashish Singh ◽  
Priyank Sharma

Introduction: India has second highest incidence of liver abscess worldwide. Image guided drainage methods are increasingly used to treat liver abscesses with fairly high success rates and with low cost and patient preference. But to choose a preferred one among these two methods of Percutaneous Catheter Drainage (PCD) and Percutaneous Needle Aspiration (PNA) still is a dilemma. Aim: To compare the effectiveness and outcome of PCD and PNA in treatment of liver abscess. Materials and Methods: A prospective cohort study was conducted on 150 liver abscess patients in Shyam Shah Medical College in Vindhya region Rewa, Madhya Pradesh, India, from June 2019 to May 2020. They were divided into two groups PNA (n=75) and PCD (n=75) by simple randomisation. Patient outcome was on the basis of duration to attain clinical relief (assessed subjectively), duration of hospital stay and days required for reduction in cavity size below 50%, death, and success rates were assessed in terms of number of attempts for adequate pus drainage. Chi-square test, non-paired Student’s t-test and ANOVA tests were used. Results: In this study mean age was 40.57 years with 92.67% males. Most common lobe to involved was right lobe (87.3%). E.coli was the most common organism. All patients in PCD group were successfully treated in a single attempt. PNA group had a success rate of 84%. Mean number of days of clinical improvement were less for PCD (mean was 5.27 days) than PNA group (mean was 7.49 days) p-value=0.002. Mean days required for reduction in cavity size to less than 50% was lower in PCD (mean was 7.20 days) than PNA group (mean was 8.75 days) p-value=0.01. Total duration of hospital stay was higher in PNA (mean was 11.59 days) than in PCD group (mean was 9.28 days) p-value=0.03. All multiloculated cavities in PNA group were failures. Conclusion: PCD method was found to be more efficacious than needle aspiration method in this study.


2021 ◽  
Vol 12 (7) ◽  
pp. 82-87
Author(s):  
Bhavika Jain ◽  
Nikita Mantri ◽  
Rishika Saraf ◽  
Shivaji Pole ◽  
Devidas Baburao Dahiphale ◽  
...  

Background: Liver abscesses are localized collections of necrotic inflammatory tissue caused by bacterial, parasitic or fungal agents. These abscesses are usually suspected clinically in cases having fever and tender hepatomegaly. The diagnosis is usually confirmed on the basis of imaging such as ultrasound and computerised tomography. Management includes antimicrobial agents and drainage of abscess. Percutaneous drainage of abscess is done using needle aspiration or catheter drainage. Aims and Objective: The main aim of the study was to evaluate the role of pigtail catheterization drainage procedure as a treatment option in cases of liver abscess. Materials and Methods: It was a prospective study conducted ata tertiary care medical college. Fifty patients having hepatic abscess were included in this study over a period of one year from August 2018 to September 2019 on the basis of a predefined inclusion and exclusion criteria. These patients underwent pigtail catheterization of liver abscess as a treatment. The demographic characteristics, hepatic lobe involvement, offending organisms and complications were studies in these patients. Results: Out of 50 patients 35 were male and 15 were femalewith a M: F ratio of 1:0.42. The age ranged from 4 years to 92 years. The mean age of the studied cases was found to be 38.64 +/- 18.17 years. Right lobe was involved in predominant cases. most common individual organism involved in hepatic abscess formation was klebsiella (30%) followed by streptococcus (20%) and E-coli (8%) organisms. Seven patients developed procedure related complications out of which 5 patients had catheter dislodgment requiring repositioning of catheter 1 patient developed pus discharge from catheter site and remaining 1 patient developed subcapsular hematoma. Conclusion: Percutaneous image guided pigtail catheter of liver abscess is an effective minimal procedure as a treatment option for liver abscess with high success rate with no mortality related to procedure.


2017 ◽  
Vol 4 (8) ◽  
pp. 2490 ◽  
Author(s):  
Prakash Babubhai Patel ◽  
Jignesh Shah ◽  
Suyadeep Baria

Background: Liver abscess is a life-threatening disease. Continuous catheter drainage is widely accepted and in combination with antibiotics is considered a safe and effective method of management of liver abscess. The objective of this study was to evaluate predisposing factors and incidence of liver abscess in various age group, sex, social economic study and its comparison with various studies and to evaluate morbidity, mortality and complication rates in patients of liver abscess treated either by percutaneous USG guided catheter drainage.Methods: This is an observational study of 50 patients with pigtail catheter drainage and needle aspiration in liver abscess treated during the period of May 2011 to December 2013 at New Civil Hospital, Surat.Results: In the present study majority of case [11 cases (22.5%)] were observed in the age group of 31-40 years. Male female ratio in our study was 8.2:1. Majority of Liver abscess cases [34 cases (68 %)] belongs to low socio-economic class. The commonest symptoms are pain and fever seen in 64% each. In the present study 100% success rate with no recurrence. None of the patients expired in the present study. Median hospital stay is 5 days with range from 2-25 days.Conclusions: Percutaneous pigtail catheter drainage is more effective in large liver abscess. 


2021 ◽  
Vol 17 (2) ◽  
pp. 180-183
Author(s):  
Shahida Khatoon ◽  
Ayesha Ahmedani ◽  
Sanam Karim Unar ◽  
Riaz Ahmed Memon ◽  
Shahnawaz Khatti ◽  
...  

Objective: To compare the outcome of percutaneous ultrasound guided aspiration V/S open surgical drainage for psoas muscle abscess. Methodology: This comparative study was conducted in department of general surgery at Liaquat medical university hospital Hyderabad/Jamshoro, from June 2017 to November 2017. Diagnosed Patients of psoas muscle abscess size more than 5cm, between 18 to 60 years of age and either of gender were included. Patients were randomly divided into two groups, A and B by odd and even method, patients in group A abscess was aspirated by percutaneous ultrasound guided aspiration and patients in group B was underwent open surgical drainage, all the data were entered in the pre designed performa and analyzed into SPSS V:16.0 Results: A total of 58 patients of Psoas muscle abscess were selected, the mean age of study subjects of group A was 38.5+10.5 and group B was 36.5+12.7 (p-673). Early post-operative pain relief was assessed among patients of group A as compared to group B. As per outcome resolution of abscess cavity was significantly high among patients of group B (p-0.004), while post-operative Hospital stay was significantly lower in group A (p-0.002). Conclusion: Both techniques has their own benefits like percutaneous aspiration has shorter duration of hospital stay while in complete resolution of abscess cavity was found in open surgical drainage group of patients.


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