Clinical SciencePercutaneous drainage for giant pyogenic liver abscess-is it safe and sufficient?

- Size of the abscess in itself is not a contraindication for PD.
- Large pyogenic liver abscess can be treated with antibiotics and PD safely.
- PD is sufficient in majority of patients even with a giant pyogenic liver abscess.

BackgroundLarge 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).MethodsA 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.ResultsForty 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.ConclusionsLarge size itself is not a contraindication for PD. PD is safe and sufficient even in GPLA patients.