title: Percutaneous drainage for giant pyogenic liver abscess--is it safe and sufficient?
abstract: BACKGROUND
  Large size is a predictor of failure of percutaneous drainage (PD) for pyogenic liver abscess (PLA). This article serves to establish the safety and sufficiency of PD in giant PLA (GPLA).
  
  
  METHODS
  A retrospective review of all GPLA patients treated at a tertiary care academic hospital from 2001 to 2011 was performed. A GPLA is defined as an abscess greater than or equal to 10 cm size based on imaging.
  
  
  RESULTS
  Forty patients (24 men, 60%) were treated for GPLA. All but 1 patient (98%) was managed with PD and the mean duration of drainage was 9 days (range 1 to 23 days). One patient underwent operative drainage. Three patients (7.7%) needed secondary procedures after the initial PD. One patient (2.6%) failed PD and subsequently underwent operative drainage. Among the patients who underwent PD, the overall morbidity was 25%; the median length of hospital stay was 13 days (range 5 to 31 days) and 1 (2.6%) mortality.
  
  
  CONCLUSIONS
  Large size itself is not a contraindication for PD. PD is safe and sufficient even in GPLA patients.
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; Ministry of Health Holdings, 1 Maritime Square, Singapore, Singapore.
authors.forename: Saleem
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; Ministry of Health Holdings, 1 Maritime Square, Singapore, Singapore.
authors.forename: Clement L K
authors.initials: CL
authors.lastname: Chia
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Sameer P
authors.initials: SP
authors.lastname: Junnarkar
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Winston
authors.initials: W
authors.lastname: Woon
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore. Electronic address: vgshelat@gmail.com.
authors.forename: Vishal G
authors.initials: VG
authors.lastname: Shelat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Abscess; Giant; Operative drainage; Percutaneous drainage; Pyogenic liver abscess