title: Laparoscopic drainage of pyogenic liver abscess.
abstract: OBJECTIVE
  Pyogenic liver abscesses are mainly treated by percutaneous aspiration or drainage under antibiotic cover. If interventional radiology fails, surgical drainage becomes necessary. Recently, we performed laparoscopic liver abscess drainage successfully, and we aimed to focus on the topic in light of a systematic review of the literature.
  
  
  METHODS
  A 22-year-old man was admitted with a 4.5-cm multiloculated abscess in the left lobe of the liver. The abscess did not resolve with antibiotic-alone therapy. Percutaneous aspiration was unsuccessful due to viscous and multiloculated contents. Percutaneous catheter placement was not amenable. Laparoscopic abscess drainage was preferred over open abscess drainage. We used 3 trocars, operation time was 40 minutes, and blood loss was minimal. In the mean time, we searched PubMed using the key words [(liver OR hepatic) abscess*] AND [laparoscop* OR (minimal* AND invasiv*)].
  
  
  RESULTS
  Postoperative recovery of the patient was uneventful, and the patient was asymptomatic after 3 months of follow-up. In the literature search, we found 53 liver abscesses (51 pyogenic and 2 amebic) that were treated by laparoscopy. Mean success rate was 90.5% (range, 85% to 100%) and conversion rate was zero.
  
  
  CONCLUSIONS
  Treatment of liver abscess is mainly percutaneous drainage. Laparoscopic drainage should be selected as an alternative before open drainage when other modalities have failed.
authors.affiliation: Department of General Surgery, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey.
authors.forename: Cemalettin
authors.initials: C
authors.lastname: Aydin
authors.forename: Turgut
authors.initials: T
authors.lastname: Piskin
authors.forename: Fatih
authors.initials: F
authors.lastname: Sumer
authors.forename: Bora
authors.initials: B
authors.lastname: Barut
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kayaalp
mesh_terms: D004322:Drainage / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D055815:Young Adult