title: Clinical Outcome of Endoscopic Ultrasound-Guided Liver Abscess Drainage Using Self-Expandable Covered Metallic Stent (with Video).
abstract: BACKGROUND
  Percutaneous drainage (PCD) is now the first-line drainage method for liver abscess because of its minimal invasiveness and high technical success rate. However, this procedure has several disadvantages, such as extra-drainage and self-tube removal. Recently, EUS-guided liver abscess drainage (EUS-AD) has been developed. However, only a few reports of EUS-AD have been reported. In addition, the clinical benefits of PCD and EUS-AD have not been reported.
  
  
  OBJECTIVE
  In the present study, the safety and feasibility of EUS-AD using fully covered SEMS (FCSEMS) and the clinical outcomes of EUS-AD and PCD were examined retrospectively.
  
  
  METHODS
  Twenty-seven consecutive patients who underwent PCD or EUS-AD between April 2012 and April 2015 were included in this study. EUS-AD was performed using FCSEMS. In addition, to prevent stent migration, 7-Fr pig tail plastic stent was placed within FCSEMS.
  
  
  RESULTS
  Technical success was achieved in all patients of both groups. Clinical success was 100 % in the EUS-AD group although it was 89 % in PCD group (P = 034). Three adverse events were seen in the PCD group (self-tube removal n = 1, tube migration n = 2), but no adverse events were seen in the EUS-AD group. The median hospital stay was significantly shorter in the EUS-AD group than in the PCD group (21 vs 41 days, P = 0.03).
  
  
  CONCLUSIONS
  Because of the short hospital stay, the high clinical success rate, and the low adverse event rate compared to PCD, EUS-AD has potential as a first-line treatment for liver abscess.
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan. oguratakeshi0411@yahoo.co.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Onda
authors.initials: O
authors.lastname: Saori
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Takagi
authors.initials: T
authors.lastname: Wataru
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Sano
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okuda
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Miyano
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitano
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Sohag University, Sohag, Egypt.
authors.forename: Usama M
authors.initials: UM
authors.lastname: Abdel-Aal
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukunishi
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008100:Liver Abscess / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Endoscopic ultrasound; Endoscopic ultrasound-guided drainage; Endoscopic ultrasound-guided fine-needle aspiration; Endoscopic ultrasound-guided liver abscess drainage; Interventional EUS; Liver abscess