Pyogenic liver abscess: the role of surgical treatment.
METHODS
We present an analysis of 48 patients with pyogenic liver abscess (PLA) that were treated according to a protocol between 1975 and 1993. In this period, 35 patients with PLA were treated by surgical drainage (SD). The indication for surgical treatment of the abscess were patients in septic conditions, underlying intra-abdominal surgical disease and the failure/contraindication of other therapeutic methods. Thirty-one patients were submitted to surgical treatment as the initial procedure and four patients unsuccessfully treated by percutaneous drainage, underwent SD.


RESULTS
The surgical approach was indicated in patients with severe disease and presented 91.5% of good results, and a mortality rate of 8.5%.


CONCLUSIONS
These results suggest that surgical treatment is a good alternative as a first step not only for the treatment of the primary cause of the abscess but also in septic patients with severe disease where a delay in adequate drainage, frequent in percutaneous management, can lead to high morbidity and mortality rates.
Herman
P
P
Department of Gastroenterology, Hospital das Clinicas, University of São Paulo Medical School, Brazil.
Pugliese
V
V
Montagnini
A L
AL
Salem
M Z
MZ
Machado
M A
MA
da Cunha
J E
JE
Bacchella
T
T
Machado
M C
MC
Pinotti
H W
HW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents