A Prospective Cohort Study of Catheter Drainage versus Percutaneous Needle Aspiration in Treatment of Liver Abscess

Abstract

Introduction: India has second highest incidence of liver abscess worldwide. Image guided drainage methods are increasingly used to treat liver abscesses with fairly high success rates and with low cost and patient preference. But to choose a preferred one among these two methods of Percutaneous Catheter Drainage (PCD) and Percutaneous Needle Aspiration (PNA) still is a dilemma. Aim: To compare the effectiveness and outcome of PCD and PNA in treatment of liver abscess. Materials and Methods: A prospective cohort study was conducted on 150 liver abscess patients in Shyam Shah Medical College in Vindhya region Rewa, Madhya Pradesh, India, from June 2019 to May 2020. They were divided into two groups PNA (n=75) and PCD (n=75) by simple randomisation. Patient outcome was on the basis of duration to attain clinical relief (assessed subjectively), duration of hospital stay and days required for reduction in cavity size below 50%, death, and success rates were assessed in terms of number of attempts for adequate pus drainage. Chi-square test, nonpaired Student’s t-test and ANOVA tests were used. Results: In this study mean age was 40.57 years with 92.67% males. Most common lobe to involved was right lobe (87.3%). E.coli was the most common organism. All patients in PCD group were successfully treated in a single attempt. PNA group had a success rate of 84%. Mean number of days of clinical improvement were less for PCD (mean was 5.27 days) than PNA group (mean was 7.49 days) p-value=0.002. Mean days required for reduction in cavity size to less than 50% was lower in PCD (mean was 7.20 days) than PNA group (mean was 8.75 days) p-value=0.01. Total duration of hospital stay was higher in PNA (mean was 11.59 days) than in PCD group (mean was 9.28 days) p-value=0.03. All multiloculated cavities in PNA group were failures. Conclusion: PCD method was found to be more efficacious than needle aspiration method in this study

Keywords

• abscess drainage
• amoebic liver abscess
• pyogenic liver abscess