Percutaneous Hepatic Abscess Drainage: Do Multiple Abscesses or Multiloculated Abscesses Preclude Drainage or Affect Outcome?

Purpose: To compare the effectiveness of percutaneous abscess drainage in patients with pyogenic liver abscesses of the following types: single, single multiloculated, multiple, and multiple multiloculated.

Materials And Methods: One hundred nine patients with 149 liver abscesses who underwent percutaneous drainage during an 11-year period were divided into a single abscess group and a multiple abscess group. Of the 109 patients, 54 had multiloculated abscesses and were divided into single and multiple multiloculated abscess groups. Technical success was defined as the ability to place the catheter within the abscess cavity and clinical success was defined as improvement in the patient's symptoms. Clinical findings, management strategy, complication rate, and success rate were analyzed.

Results: Technical success rates were 96% (82 of 85) for a single abscess and 96% (23 of 24) for multiple abscesses (P = 1.0). Clinical success was achieved in 74 of 85 patients (87%) with a single abscess and 22 of 24 patients (92%) with multiple abscesses (P = .729). Technical success rates were 94% (32 of 34) for a single multiloculated abscess and 95% (19 of 20) for multiple multiloculated abscesses (P = 1.0). Clinical success was achieved in 30 of 34 patients (88%) with a single multiloculated abscess and 18 of 20 patients (90%) with multiple multiloculated abscesses (P = 1). No significant difference in hospital stay was seen between single and multiple abscess groups (P = .373) or between single multiloculated and multiple multiloculated abscess groups (P = .180). There were no major complications or mortality related to the procedure.

Conclusions: Percutaneous drainage is a safe and effective procedure in the treatment of pyogenic liver abscess, regardless of abscess complexity and/or multiplicity.