Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score > or =15.
BACKGROUND
Most liver abscesses resolve after antimicrobial therapy or percutaneous tube drainage (PD). The aim of this study was to evaluate the results of hepatic resection (HR) for patients with pyogenic liver abscesses and an Acute Physiology and Chronic Health Evaluation II (APACHE II) score > or =15.


METHODS
We compared the clinical outcomes of 81 patients with APACHE II scores > or =15 undergoing PD and/or HR.


RESULTS
The failure rate (3 of 65) and double-treatment rate (32 of 65) in the PD group were significantly higher than in the HR group (3 of 35 vs 0 of 35; P = .0002). The mortality rate in the PD group was significantly higher than the other 2 groups (14 of 46 vs 2 of 19 and 1 of 16; P = .038). The length of hospital stay was significantly shorter and antibiotic use less in the HR group than in the PD group (P < .05).


CONCLUSIONS
Aggressive HR for patients with liver abscesses and APACHE II scores > or =15 produced better clinical outcomes.
Hsieh
Huan-Fa
HF
Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Chen
Teng-Wei
TW
Yu
Chih-Yung
CY
Wang
Ning-Chi
NC
Chu
Heng-Cheng
HC
Shih
Ming-Liang
ML
Yu
Jyh-Cherng
JC
Hsieh
Chung-Bao
CB
D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome