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Pyogenic liver abscesses: a contemporary analysis of management strategies at a tertiary institution.
Rismiller, Kyle; Haaga, John; Siegel, Christopher; Ammori, John B.
Afiliación
  • Rismiller K; Department of General Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
  • Haaga J; Department of General Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
  • Siegel C; Department of General Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
  • Ammori JB; Department of General Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. Electronic address: john.ammori@uhhospitals.org.
HPB (Oxford) ; 19(10): 889-893, 2017 10.
Article en En | MEDLINE | ID: mdl-28693978
BACKGROUND: Despite equivocal evidence, non-surgical management for pyogenic liver abscess (PLA) has become the standard of care at most institutions with surgery relegated to salvage therapy for those who fail less invasive means. The aim of this study was to describe the outcomes of a step-up approach to PLA management. METHODS: A retrospective chart review was conducted at a single institution for patients diagnosed with PLA over a 10-year period. Demographic, radiologic, microbiological, treatment, and outcomes data were collected and analyzed. RESULTS: 64 patients with PLA were identified. Initial treatment included antibiotics alone (n = 9), percutaneous drainage (PD) (n = 54), and surgery (n = 1). Surgery was ultimately required in 8 patients while 50 were cured with PD and 4 with antibiotics alone. Two (3%) patients died. Overall, PD carried an 85% success rate. CONCLUSION: PLA patients should be initially treated non-operatively, barring indications for emergent surgery or inaccessibility for PD. Surgery can be reserved for failure of PD.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos del Sistema Digestivo / Drenaje / Absceso Piógeno Hepático / Centros de Atención Terciaria / Antibacterianos Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: HPB (Oxford) Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos del Sistema Digestivo / Drenaje / Absceso Piógeno Hepático / Centros de Atención Terciaria / Antibacterianos Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: HPB (Oxford) Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido