Laparoscopic drainage of liver abscesses.
BACKGROUND
The mainstay of the management of liver abscesses has been intravenous antibiotics and radiologically guided percutaneous drainage. However, not all abscesses are treated successfully in this way, and some require surgical drainage. Laparoscopic drainage of liver abscesses may be an alternative to open surgical drainage.


METHODS
Twenty consecutive patients with liver abscesses treated by laparoscopic drainage in combination with intravenous antibiotics were studied prospectively. Fifteen had had failed percutaneous drainage previously.


RESULTS
There were 13 right lobe and seven left lobe abscesses ranging from 6 to 25 cm in diameter. Mean operating time was 38 min. Seventeen patients were drained successfully. Three patients developed recurrent symptoms of which two resolved with conservative measures, but one required a second laparoscopic procedure. There were no intraoperative or other postoperative complications in the 20 patients. Follow-up ranged from 5 to 12 months.


CONCLUSIONS
Laparoscopic drainage of liver abscesses, in combination with systemic antibiotics, is a safe and viable alternative in all patients who require surgical drainage following failed medical or percutaneous treatment, and in those with large abscesses.
Tay
K H
KH
Department of Surgery, New Changi Hospital, Singapore.
Ravintharan
T
T
Hoe
M N
MN
See
A C
AC
Chng
H C
HC
D000368:Aged; D004322:Drainage / Q000379:methods*; D005260:Female; D005334:Fever / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008100:Liver Abscess / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome