title: Laparoscopic Drainage as First Line Treatment for Complex Pyogenic Liver Abscesses.
abstract: Background/aims: Pyogenic liver abscess (PLA) is a rare but potentially fatal condition if untreated. In available retrospective series successful rate of per- cutaneous drainage (PD) on large multiloculated PLA, that has been definited "complex". In this observation- al study, we report the experience of our Institution in performing laparoscopic drainage of complex liver ab- scess over a 5-years period as first line treatment for selected cases of PLA. Methodology: All cases of large multiloculated liver abscesses admitted to the General and Hepatobiliary Surgery of "Loreto Nuovo" Hospital Naples, Italy over the last 5-years period were treated by laparoscopic drainage and his clinicopathological variables were retrospectively reviewed.
  
  
  RESULTS
  Ten patients with large multiloculated liver abscess has been admitted and treated by only laparoscopic drainage without need of other perioperative procedures. Mean age was 51.5 years (range 41-75y); average hospital stay was 4.6 days (range 2-6 days) and major postoperative morbidity or deaths were not registered. Successful rate was 100% with no recurrence at 2-years follow up (range 12/38 months).
  
  
  CONCLUSIONS
  Laparoscopic drainage seems to be a safe and reproducible mini-invasive treatment of complex liver abscesses and to offer advantages over percutaneous and surgical open approach.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cioffi
authors.forename: Andrea
authors.initials: A
authors.lastname: Belli
authors.forename: Paolo
authors.initials: P
authors.lastname: Limongelli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Russo
authors.forename: Moritz
authors.initials: M
authors.lastname: Arnold
authors.forename: Alberto
authors.initials: A
authors.lastname: D'Agostino
authors.forename: Corrado
authors.initials: C
authors.lastname: Fantini
authors.forename: Giulio
authors.initials: G
authors.lastname: Belli
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome