Comparison of the role of Percutaneous Needle Aspiration and Percutaneous Pigtail Drainage in management of liver abscess
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12
Abstract
The traditional treatment of intra-abdominal liver abscess has been operative drainage as originally described by Volkmann in 1879. But during the last few decades, with the invention of newer radiological techniques like computed tomography (CT) and ultrasonography (USG), which are not only useful for accurate localization but also helpful in their safe aspiration and drainage of these abscess thus obviating the need for surgical intervention. The recent trend in management of liver abscesses has been shifted strongly toward nonsurgical methods. Several study have shown that a large proportion of patients can be treated with excellent results with a combination of parenteral (I/V) antibiotics and image-guided percutaneous treatment. Whether to perform percutaneous catheter drainage or intermittent needle aspiration is better, remains controversial. This study aims to compare the therapeutic effectiveness and safety of ‘Percutaneous Needle Aspiration’ versus ‘Percutaneous Pigtail Drainage’. in the cases of Large sized liver abscess (≥5cm). This prospective randomized study includes total of 50 patients admitted with the diagnosis of liver abscess of size ≥5cm by ultra-sonography, from a period of November 2015 to April 2017. 25 patients were randomly distributed in each group (PCD & PNA). Intermittent needle aspiration will be done with 18G disposable needle and repeated if needed up to a maximum of three times. Different variables such as success rate of procedure, No. of times procedure required, Duration of hospital stay, volume of abscess aspirated, failure to resolve, and complications were recorded. There was No statistically significant difference seen in the procedure outcome measures in either group of patients. PNA had 96 % (24/25) success rate as compare to 84%(22/25) in PCD group. Failure to resolve was lower in patients with PNA group(1pt.) as compare to PCD group(3pt.) because PNA procedure had multiple sitting of aspiration (3 times in 8 and twice in 3) and 3 patient with PCD underwent Pigtail catheter insertion second time. Complications such as hemorrhage, septicemia was higher in patients with PCD group as compare to PNA group. Our study concluded that both the procedure is equally effective and safe and it is justifiable to undertake a multicentre study on the subject to provide a definitive answer.
Authors and Affiliations
Dr. Arvind Diwaker, Dr. Ashirvad Datey, Dr. amber Yadav, Dr. K. Singh
Keywords
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- EP ID EP428642
- DOI 10.9790/0853-1712111419.
- Views 41
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