Treatment of Patients with Pyogenic Liver Abscess

Abstract

Background: Pyogenic liver abscess (PLA) remains a serious disease with a mortality of 6–14%. Methods: Clinical data of 76 patients with PLA were analyzed. Treatment options comprised antibiotics, percutaneous puncture/drainage, endoscopic papillotomy/stenting and/or surgery as indicated. Results: Fifty-eight patients (76%) had single and 18 patients multiple PLA (right lobe: 65%; both lobes: 22%). The most frequent etiologies were: biliary (38%), hematogenous and posttraumatic (11%). Factors associated with the need for surgery included gallbladder empyema, biliary fistulas, malignancy, perforation, multicentricity, vascular complications and foreign bodies (e.g. infected ventriculo-peritoneal shunt, toothpick). Conclusions: Microbiological testing provides important information for treatment monitoring and modification. Complementary assessment of risk factors for a complicated course is crucial for timely identification of patients requiring additional treatment.

An overview on Pyogenic Liver Abscess

“…The initial course of intravenous antibiotics aids in the initial healing process. Several weeks of taking strong antibiotics by mouth can help you heal after you've had a good clinical response to surgical and parenteral antibiotic therapies [5].…”

Are we facing a post-antibiotic future in surgery?

“…Here the decisions are generally based on microbiology and sensitivity testing (for example, the spectrum of agents causing liver abscesses shows great variety both locally [9] and globally [10]) as well as on consultations with clinical microbiologists or infectious disease consultants. Notwithstanding the life-saving necessity of antibiotic therapy in sepsis and intensive care medicine, there is, however, a potential for reduction in the time span of administration.…”

Seltene Ursache einer rezidivierenden, nekrotisierenden Pankreatitis

“…Abb. 3, 4), empfiehlt sich bei ausreichender Leberrestfunktion und Allgemeinzustand die Leberteilresektion [5,21].…”