Comparision of the efficacy of percutaneous needle aspiration and pigtail catheter drainage for the treatment of liver abscess

Abstract

Introduction: In recent years, image-guided percutaneous drainage has been increasingly used to treat liver abscesses with reported success rates ranging from 70-100%. Although percutaneous placement of an indwelling catheter is the method most widely preferred to drain liver abscesses, recent studies have claimed needle aspiration to be a simpler, less costly, and equally effective mode of treatment. Aim: To compare the efficacy of percutaneous needle aspiration and pigtail catheter drainage for the treatment of liver abscess. Method: This is a single centred prospective randomized comparative study in patients of liver abscess treated by needle aspiration & pigtail catheter drainage .A total no of 50 patient were included in the study which randomized into two groups; percutaneous needle aspiration (PNA) (n=25) and pigtail catheter drainage (PCD) (n=25). The effectiveness of either treatment was measured in terms of duration of hospital stay, days to achieve clinical improvement, 50% reduction in abscess cavity size and total/near total resolution of abscess cavity. Independent t-test was used to analyse these parameters. Results: Earlier clinical improvement (P=0.046) and 50% decrease in abscess cavity volume (P=0.0001) seen in the patients in PCD groups compared to those who underwent PNA. However, there was no significant difference between the duration of hospital stay or the time required for total or near-total resolution of cavity. Conclusion: Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses, which are partially liquefied or with thick pus.