Saturday, March 01, 2008
Optimal treatment of hepatic abscess
Am Surg. 2008 Feb
Hope WW, Vrochides DV, Newcomb WL, Mayo-Smith WW, Iannitti DA.
Department of Minimally Invasive and Gastrointestinal Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
Many treatment strategies have been proposed for pyogenic liver abscesses; however, the indications for liver resection for treatment have not been studied in a systematic manner. The purpose of our study was to evaluate the role of surgical treatment in pyogenic abscesses and to determine an optimal treatment algorithm. We retrospectively reviewed the medical records of all patients who had a pyogenic liver abscess at Rhode Island Hospital between 1995 and 2002. Abscesses and treatment strategies were classified into three groups each. The abscess groups included Abscess Type I (small <3>3 cm, unilocular), and Abscess Type III (large >3 cm, complex multilocular). The treatment strategy groups included Treatment Group A (antibiotics alone), Treatment Group B (percutaneous drainage plus antibiotics), and Treatment Group C (primary surgical therapy). Descriptive statistics were calculated and chi2 used for comparison with a P <>3 cm), multiloculated abscesses had a significantly higher success rate than percutaneous drainage plus antibiotic therapy (33% versus 100%, P < or =" 0.01)." p =" 0.40).">
PMID: 18306874 [PubMed - in process]