title: Pyogenic liver abscess: Changing patterns in approach.
abstract: OBJECTIVE
  To define optimum management of the pyogenic liver abscess and assess new trends in treatment.
  
  
  METHODS
  One hundred and sixty nine patients with pyogenic liver abscess managed at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir (India) from July 2001 to August 2006 were studied to evaluate and define the optimum treatment.
  
  
  RESULTS
  Mortality in the surgically treated group of patients was 9.4% (12/119), while those treated non-surgically had a fatality rate of 16.66% (7/42). Multiple liver abscesses treated surgically had a surprisingly low mortality of 30%. The biliary tract (64.97%) was the most common cause of liver abscess. Multiple abscesses, mixed organisms and abscess complications are all associated with a significantly increased mortality. However, the lethality of the primary disease process was the most important factor in determining survival.
  
  
  CONCLUSIONS
  Transperitoneal surgical drainage and antibiotics are the mainstay of treatment. Percutaneous drainage is recommended for high risk patients only.
authors.affiliation: Ajaz A Malik, Khawaja Abdul Rouf, Khurshid Alam Wani, Department of Surgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir 190006, India.
authors.forename: Ajaz A
authors.initials: AA
authors.lastname: Malik
authors.forename: Shams Ul
authors.initials: SU
authors.lastname: Bari
authors.forename: Khawaja Abdul
authors.initials: KA
authors.lastname: Rouf
authors.forename: Khurshid Alam
authors.initials: KA
authors.lastname: Wani