Role of Pigtail Catheter Drainage Versus Percutaneous Needle Aspiration in the Management of Liver Abscess: A Retrospective Analysis

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.

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Image Guided percutaneous pigtail catheter drainage of Liver Abscess technique and its outcome

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i7.34897 ◽

2021 ◽

Vol 12 (7) ◽

pp. 82-87

Author(s):

Bhavika Jain ◽

Nikita Mantri ◽

Rishika Saraf ◽

Shivaji Pole ◽

Devidas Baburao Dahiphale ◽

...

Keyword(s):

Liver Abscess ◽

Treatment Option ◽

Antimicrobial Agents ◽

Tertiary Care ◽

Hepatic Abscess ◽

Needle Aspiration ◽

Pigtail Catheter ◽

Catheter Drainage ◽

Individual Organism ◽

Image Guided

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.

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Role of Pigtail Catheter Drainage in the Management of Liver Abscess – A Retrospective Analysis

10.21203/rs.3.rs-576254/v1 ◽

2021 ◽

Author(s):

Saurabh Kumar ◽

Kamlesh Ahari ◽

Naresh Kumar Midha ◽

Deepak Kumar ◽

Maya Gopalakrishnan ◽

...

Keyword(s):

Hospital Stay ◽

Liver Abscess ◽

Health Concern ◽

Western India ◽

Pigtail Catheter ◽

Catheter Drainage ◽

Significant Difference ◽

Group A ◽

Group B

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.

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A profile study of 50 cases of liver abcess treated by percutaneous catheter drainage

International Surgery Journal ◽

10.18203/2349-2902.isj20173381 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2490 ◽

Cited By ~ 2

Author(s):

Prakash Babubhai Patel ◽

Jignesh Shah ◽

Suyadeep Baria

Keyword(s):

Liver Abscess ◽

Needle Aspiration ◽

Percutaneous Catheter Drainage ◽

Complication Rates ◽

Age Group ◽

Pigtail Catheter ◽

Catheter Drainage ◽

Female Ratio ◽

Economic Class ◽

Group Sex

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.

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USG GUIDED PERCUTANEOUS NEEDLE APIRATION VERSUS USG GUIDED PIGTAIL CATHETER DRAINAGE IN THE MANAGEMENT OF LIVER ABSCESS - A PROSPECTIVE RANDOMISED CONTROLLED STUDY

10.36106/ijar/8010189 ◽

2020 ◽

pp. 21-23

Author(s):

Manimaran Thangavelu ◽

Swathika Kumarasamy ◽

Catherine Sinduja Paulraj ◽

Durairajan Vaithiyanathan ◽

Jeyamohan Jayavel

Keyword(s):

Success Rate ◽

Clinical Improvement ◽

Liver Abscess ◽

Needle Aspiration ◽

Abscess Cavity ◽

Controlled Study ◽

Pigtail Catheter ◽

Catheter Drainage ◽

Total Reduction ◽

Drainage Group

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.

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