Bacterial Liver Abscess: A Retrospective Analysis of Twenty Years’ Experience in Single Center_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Qiang , WANG Yajun , LIU Jiafeng , LI Fei , SUN Jiabang , WANG Yuehua.

Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China;

Corresponding author：

Keywords：

Liver abscess; Diagnosis; Treatment; Laparotomy; Laparoscope; Percutaneous aspiration and drainage

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Objective To analyze the treatment and effect of bacterial liver abscess over the past two decades in one single center. Methods The total 198 patients with bacterial liver abscess during the last twenty years were studied retrospectively. They were divided into three groups according time: 1989-1995 group, 1996-2002 group and 2003-2008 group. Gender and age of patient, location, number and size of abscesses, treatment, hospital days, morbidity of complications and mortality among the groups were compared. Results There were 54, 69, 75 cases in 1989-1995, 1996-2002 and 2003-2008 group respectively. No significant differences were found in gender and age of patient, location, number and size of abscess among three groups （P gt;0.05）. In 1989-1995 group, 35 cases (64.8%) were treated with laparotomy, 8 cases (14.8%) with laparoscope, and 11 cases (20.4%) with percutaneous treatment (needle aspiration or catheter drainage). In 1996-2002 group, 15 cases (21.8%) were treated with laparotomy, 21 cases (30.4%) with laparoscope, 31 cases (44.9%) with percutaneous treatment (needle aspiration or catheter drainage), and 2 cases (2.9%) were treated with antibiotherapy. In 2003-2008 group, 5 cases (6.7%) were treated with laparotomy, 13 cases (17.3%) with laparoscope, 54 cases (72.0%) with percutaneous treatment (needle aspiration or catheter drainage), and 3 cases (4.0%) were treated with antibiotherapy. The constituent ratio of treatment was significantly different among three groups (P＜0.05). The hospital days was (18.5±12.2) d, (16.4±12.8) d and (20.1±14.6) d, the morbidity of complications was 9.3% (5/54), 4.3%(3/69) and 4.0%(3/75), the mortality was 3.7%(2/54), 1.4%(1/69) and 1.3% (1/75) respectively, but there were no significant differences of three indexes among three groups. Conclusion With the development of surgical techniques, effective antibiotic therapy and percutaneous treatment (needle aspiration or catheter drainage) have been the main therapeutic methods, and laparoscopy and laparotomy are necessary supplement.

Citation： LIU Qiang,WANG Yajun,LIU Jiafeng,LI Fei,SUN Jiabang,WANG Yuehua.. Bacterial Liver Abscess: A Retrospective Analysis of Twenty Years’ Experience in Single Center. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(5): 389-392. doi: Copy

1.	[1０]Rajak CL, Gupta S, Jain S, et al. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage [Ｊ]. AJR Am J Roentgenol, 1998; 170(4): 1035-1039.
2.	[1３]Petri A, Hhn J, Hdi Z, et al. Pyogenic liver abscess—20 years’ experience. Comparison of results of treatment in two periods [Ｊ]. Langenbecks Arch Surg, 2002; 387(1): 27-31.
3.	]Ferraioli G, Garlaschelli A, Zanaboni D, et al. Percutaneous and surgical treatment of pyogenic liver abscesses: observation over a 21-year period in 148 patients [Ｊ]. Dig Liver Dis， 2008; 40(8): 690-696.
4.	Tarcoveanu E, Vlad N, Moldovanu R, et al. Pyogenic liver abscesses [Ｊ]. Chirurgia (Bucur)， 2008; 103(4): 417-427.[３]Ochsner A, DeBakey M, Murray S. Pyogenic abscess of the liver: An analysis of forty-seven cases with review of the literature [Ｊ]. Am J Surg, 1938； 40(3): 292-319.[４]Huang CJ, Pitt HA, Lipsett PA, et al. Pyogenic hepatic abscess. Changing trends over 42 years [Ｊ]. Ann Surg, 1996; 223(5): 600-609.[５]Lazarenko VA, Okhotnikov OI, Chukhraev AM, et al. Minimally invasive surgery of liver abscesses [Ｊ]. Vestn Khir Im I I Grek, 2003; 162(2): 88-91.[６]常自健，马志伟，王雁霞, 等. B超引导下穿刺引流腹腔深部脓肿36例体会 [Ｊ]. 中国普外基础与临床杂志, 2002; 9（4）： 231.[７]彭建平，何生. 糖尿病合并肝脓肿的外科治疗(附22例报告) [Ｊ]. 中国普外基础与临床杂志, 2005; 12(2): 173-174.[８]Alvarez Pérez JA, González JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess [Ｊ]. Am J Surg, 2001; 181(2): 177-186.[９]Wang W, Lee WJ, Wei PL, et al. Laparoscopic drainage of pyogenic liver abscesses [Ｊ]. Surg Today, 2004; 34(4): 323-325.
5.	Vogl TJ, Estifan F. Pyogenic liver abscess: interventional versus surgical therapy: technique, results and indications [Ｊ]. Rofo, 2001; 173(7): 663-667.
6.	Okano H, Shiraki K, Inoue H, et al．Clinicopathological analysis of liver abscess in Japan [Ｊ]. Int J Mol Med, 2002; 10(5): 627-630.

1. [1０]Rajak CL, Gupta S, Jain S, et al. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage [Ｊ]. AJR Am J Roentgenol, 1998; 170(4): 1035-1039.
2. [1３]Petri A, Hhn J, Hdi Z, et al. Pyogenic liver abscess—20 years’ experience. Comparison of results of treatment in two periods [Ｊ]. Langenbecks Arch Surg, 2002; 387(1): 27-31.
3. ]Ferraioli G, Garlaschelli A, Zanaboni D, et al. Percutaneous and surgical treatment of pyogenic liver abscesses: observation over a 21-year period in 148 patients [Ｊ]. Dig Liver Dis， 2008; 40(8): 690-696.
4. Tarcoveanu E, Vlad N, Moldovanu R, et al. Pyogenic liver abscesses [Ｊ]. Chirurgia (Bucur)， 2008; 103(4): 417-427.[３]Ochsner A, DeBakey M, Murray S. Pyogenic abscess of the liver: An analysis of forty-seven cases with review of the literature [Ｊ]. Am J Surg, 1938； 40(3): 292-319.[４]Huang CJ, Pitt HA, Lipsett PA, et al. Pyogenic hepatic abscess. Changing trends over 42 years [Ｊ]. Ann Surg, 1996; 223(5): 600-609.[５]Lazarenko VA, Okhotnikov OI, Chukhraev AM, et al. Minimally invasive surgery of liver abscesses [Ｊ]. Vestn Khir Im I I Grek, 2003; 162(2): 88-91.[６]常自健，马志伟，王雁霞, 等. B超引导下穿刺引流腹腔深部脓肿36例体会 [Ｊ]. 中国普外基础与临床杂志, 2002; 9（4）： 231.[７]彭建平，何生. 糖尿病合并肝脓肿的外科治疗(附22例报告) [Ｊ]. 中国普外基础与临床杂志, 2005; 12(2): 173-174.[８]Alvarez Pérez JA, González JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess [Ｊ]. Am J Surg, 2001; 181(2): 177-186.[９]Wang W, Lee WJ, Wei PL, et al. Laparoscopic drainage of pyogenic liver abscesses [Ｊ]. Surg Today, 2004; 34(4): 323-325.
5. Vogl TJ, Estifan F. Pyogenic liver abscess: interventional versus surgical therapy: technique, results and indications [Ｊ]. Rofo, 2001; 173(7): 663-667.
6. Okano H, Shiraki K, Inoue H, et al．Clinicopathological analysis of liver abscess in Japan [Ｊ]. Int J Mol Med, 2002; 10(5): 627-630.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Bacterial Liver Abscess: A Retrospective Analysis of Twenty Years’ Experience in Single Center

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