Pyogenic liver abscess: Studies of therapy and analysis of risk factors

Abstract

Experience with 46 patients diagnosed with liver abscesses over a 13-year period was reviewed to ascertain the impact of percutaneous versus surgical drainage. In most of the cases the abscesses were diagnosed by sonography or computed tomography. The most common pathogenetic mechanism was ascending biliary tract infection. Of the 46 total patients, 27 were primarily treated surgically, whereas 19 underwent percutaneous drainage. In the surgical group five (18.5%) patients required reoperation. Percutaneous drainage failed in four patients (21.1%). Multivariate stepwise logistic regression analysis revealed that a high APACHE II score, low hemoglobin level, and high serum bilirubin level were significant predictors of a complicated clinical course. Death was related more closely to the overall condition of the patient, as expressed by a high APACHE II score, and the underlying disease (malignancy) than to the mode of therapy.

Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

“…This is consistent with the fact that every recurrence was ipsilateral to the first event. Mortality in our series was 7.8%, similar to that reported in the 16,17,22,27,28 studies have analyzed risk factors for mortality, including the presence of active oncologic 17,22,26,29,30 renal failure, 17,18,22,26,29 hiperbilirrubinemia, 17,29,30 hypoalbuminemia, 17,29 MDRB isolation 17,29 and multiple abscesses 17,22,26,29,30 with inconsistent results. In our series, factors associated with mortality in univariate analysis included biliary disease, multiple abscesses, the bilateral liver involvement, and bilirrubinemia >5 mg/dL.…”

“…Most previous reports of PLA prognostic factors were based on univariate analysis or included only a limited number of cases. 23,[29][30][31][32][33] We applied a multivariate analysis to a large cohort, unique in the region. Study limitations include its retrospective, single-center cross design.…”

Liver abscess caused by Ascaris lumbricoides: case report

“…Abscesses of great size located in the left lobe, because of the risk of draining to the pericardium, and 4. Patients with liver abscess and negative serology tests for E. histolytica or when performing the serological tests are impossible 8,15,17,19 . Nowadays, the liver ultrasound is the best and most frequently employed method, because it is cheap, non-invasive, non-irradiating and very comfortable for the patient; also, it has the advantage over isotope …”

Role and outcome of conventional surgery in the treatment of pyogenic liver abscess in the modern era of minimally invasive therapy

“…However, most reported series have included a heterogeneous group of patients who have undergone different treatment methods, including medical treatment alone, PD, and surgery. For the subgroup of patients undergoing surgical treatment, the mortality rate still averages 20% [16][17][18][19] . The overall mortality rate in the present surgical series is 46%.…”

“…Four patients died of multiorgan failure and two patients died of pulmonary embolism. In a multivariate analysis of forty-six patients with pyogenic liver abscess, Mischinger et al found that a high Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and the underlying disease (malignancy) but not the mode of therapy was independent predictors of mortality [18] . Chou et al also found that the systemic effects of liver abscess with sepsis and multiple organ failure were significant factors in predicting mortality [19] .…”