title: Video-assisted hepatic abscess debridement.
abstract: BACKGROUND
  Pyogenic liver abscesses are currently treated by either percutaneous computer tomography (CT)-guided drainage or by laparoscopic and a conventional liver resection when conservative treatment fails but may be associated with substantial morbidity and mortality.
  
  
  METHODS
  A minimally invasive technique involving debridement of right liver abscesses was employed using a minimally invasive video-assisted hepatic abscess debridement (VAHD) after unsuccessful percutaneous CT-guided drainage. Clinical data, complication rates and outcomes of patients were recorded retrospectively.
  
  
  RESULTS
  Between 2011 and 2014, VAHD was performed on 10 patients at two centres with no observed recurrence of a liver abscess. The median age of the patients was 57 years (range 42-78) with a median pre-operative size of a liver abscess of 78 mm (range 40-115). The median operation time was 47 min (range 23-75), and the median postoperative hospital stay was 9 days (range 7-69). One patient developed a subcutaneous abscess that required further surgery. No patient died, and there were no major complications related to the VAHD.
  
  
  CONCLUSIONS
  Video-assisted hepatic abscess debridement is a feasible technique that shows promising results for the treatment of a recurrent right liver abscess.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Klink
authors.affiliation: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Binnebösel
authors.affiliation: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schmeding
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Cornelis H
authors.initials: CH
authors.lastname: Dejong
authors.affiliation: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Junge
authors.affiliation: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Ulf P
authors.initials: UP
authors.lastname: Neumann
mesh_terms: D000328:Adult; D000368:Aged; D003646:Debridement; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D007902:Length of Stay; D008100:Liver Abscess / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods