title: Laparoscopic drainage of cryptogenic liver abscess.
abstract: BACKGROUND
  To retrospectively compare the outcomes of percutaneously drained and laparoscopically drained liver abscesses.
  
  
  METHODS
  Eight-five consecutive patients with radiological evidence of liver abscess were treated at National University Hospital of Singapore from 2005 to 2011. Multivariable logistic regression was used to identify failures of intervention. This was defined as persistent objective signs of sepsis. Complications, length of antibiotic therapy, and hospital stay were recorded but not used as indicators for failure of intervention. A propensity score analysis was used to adjust for possible confounders.
  
  
  RESULTS
  Twenty-seven (40.3%) patients in the percutaneous group did not respond to primary intervention compared to 2 patients (11.1%) in the laparoscopic group (p = 0.020). Two patients within the percutaneous group died from progression of sepsis despite intervention. In the multivariate model with propensity score, laparoscopic drainage had a protective effect against failure compared to percutaneous drainage of liver abscess (odds ratio [OR], 0.03; 95% confidence interval [CI], [0-0.4]; p = 0.008). There were no differences in complications related to the intervention (p = 0.108). Mean duration of antibiotics (p = 0.437) and hospital stay (p = 0.175) between the groups was similar.
  
  
  CONCLUSIONS
  Laparoscopic drainage of cryptogenic liver abscesses should be considered as an option for drainage of liver abscess.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, National University Hospital of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore 119228, Singapore. liza_bk_tan@nuhs.edu.sg
authors.forename: Liza
authors.initials: L
authors.lastname: Tan
authors.forename: Hui Jun
authors.initials: HJ
authors.lastname: Zhou
authors.forename: Mikael
authors.initials: M
authors.lastname: Hartman
authors.forename: Iyer Shridhar
authors.initials: IS
authors.lastname: Ganpathi
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Madhavan
authors.forename: Stephen
authors.initials: S
authors.lastname: Chang
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D046290:Liver Abscess, Pyogenic / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents