title: Laparoscopic drainage of liver abscess: case report and literature review.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of the minimally invasive surgical approach (laparoscopic drainage) of liver abscesses in selected cases.
  
  
  METHODS
  Male, 58 years old, from a rural area, presented with epigastric abdominal pain, fever, weight loss, loss of appetite, a palpable mass in the epigastrium and neutrophilic leukocytosis. CT revealed a complex multiloculated liver abscess in segments 2-3. Systemic antibiotic therapy alone was ineffective; percutaneous drainage was excluded due to the characteristics of the lesion.
  
  
  RESULTS
  Given the complexity of the lesion, a laparoscopic approach was chosen involving complete drainage of the abscess, debridement and irrigation; the cavity was unroofed using electrocautery and samples were obtained for bacterial culture and drug testing. Two drains were left in the cavity for seven days. No complications were observed.
  
  
  CONCLUSIONS
  In accordance with the scientific literature, after thorough imaging we performed laparoscopic drainage of a large, complex liver abscess as a safe, effective alternative to open surgery when antibiotic therapy alone failed and percutaneous drainage was uncertain.
  
  
  CONCLUSIONS
  Not all liver abscesses can be treated with antibiotic therapy or percutaneous drainage. Laparoscopic drainage in association with systemic antibiotic therapy is a safe and effective minimally invasive approach that should be considered in selected patients.
authors.forename: G
authors.initials: G
authors.lastname: Romano
authors.forename: A
authors.initials: A
authors.lastname: Agrusa
authors.forename: G
authors.initials: G
authors.lastname: Frazzetta
authors.forename: G
authors.initials: G
authors.lastname: De Vita
authors.forename: D
authors.initials: D
authors.lastname: Chianetta
authors.forename: G
authors.initials: G
authors.lastname: Di Buono
authors.forename: G
authors.initials: G
authors.lastname: Amato
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000900:Anti-Bacterial Agents; D004322:Drainage / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008100:Liver Abscess / Q000601:surgery*; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents