Surgical management of pyogenic liver abscess: A retrospective cross-sectional multi-center study

Abstract Background Pyogenic liver abscess(PLA)is a potentially life-threatening disease associated with elevated risk of morbidity and mortality. Ultrasound or CT-guided percutaneous catheter drainage (PCD) and needle aspiration (PNA) are important surgical methods for the treatment of PLA. While their comparative efficacy is still debated, the aim of the study was to compare PCD and PNA in the treatment of liver abscesses. Methods Taking a retrospective comparative approach, 172 patients with liver abscesses from Shanghai Sixth People's Hospital, Shanghai Jiaotong University School of Medicine Affiliated with Renji Hospital South Campus and Xinhua Hospital were studied between April 2015 and April 2021. These were modeled using an analysis of covariance (ANCOVA) with a-priori covariates: age, sex, general health, clinical symptoms, and Sequential Organ Failure Assessment (SOFA) score was collated from medical records. Results Liver abscess was more common in middle-aged men, occurring more frequently in the right hepatic lobe. Single abscess was common in both groups. The rate of blood culture that was positive for bacteria was higher in PCD-treated patients than those treated with PNA, with Klebsiella pneumonia the most common bacteria species identified in both groups. The side effect in PCD is worse than in PLA. Conclusion Patients with liver abscess use were more seriously ill, but their mortality or fever time did not significantly increase, suggesting that PLA is beneficial for severe patients for its safety.