In this study, doctors from Hong Kong, China, compared continuous catheter drainage and intermittent needle aspiration in the percutaneous treatment of pyogenic liver abscesses.
The team treated 64 consecutive patients over a 5-year period. Patients were treated with intravenous antibiotics (ampicillin, cefuroxime, and metronidazole) and randomized into 2 percutaneous treatment groups.
One group received continuous catheter drainage (with an 8F multi-sidehole pigtail catheter), and the other group, intermittent needle aspiration (18G disposable trocar needle).
There was no difference between the 2 groups regarding patient demographics, underlying disease, abscess size or number, number of loculation of abscess, presenting clinical symptoms, and pretreatment liver function test.
|The needle group was associated with a higher treatment success rate.|
The duration of intravenous antibiotics treatment before percutaneous treatment was longer in the catheter group, and the change of antibiotics after the sensitivity test was more frequent with the needle group.
The team found that the needle group was associated with a higher treatment success rate, a shorter duration of hospital stay, and a lower mortality rate. However, this difference was not statistically significant.
Dr Simon Yu's team concluded, "Intermittent needle aspiration is probably as effective as continuous catheter drainage for the treatment of pyogenic liver abscess, although further proof with a large-scale study is necessary".
"Due to the additional advantages of procedure simplicity, patient comfort, and reduced price, needle aspiration deserves to be considered as a first-line drainage approach".