Domínguez-Guzmán DJ, Moreno-Portillo M, García-Flores C, Blas-Franco M

Language: Spanish
References: 20
Page: 189-194
PDF size: 116.90 Kb.

ABSTRACT

Background: Radiologically guided percutaneous drainage has proven to be simple and effective and currently is considered the gold standard of care with success rates between 80 and 87%. However, not all abscesses are amenable to or will resolve with percutaneous drainage. The purpose of this study is to report our 1-year initial experience with laparoscopic drainage of liver abscesses.
Methods: Patients with diagnosis of liver abscess and who had a surgical indication and were submitted to laparoscopic drainage were studied prospectively from January to December of 2004.
Results: Six patients underwent laparoscopic drainage. There were three men and three women with a mean age of 50.8 years. Four patients had single lesions and two had multiple lesions. Mean size of the abscesses was 10.9 ´ 7.7 cm, segments primarily affected were 5 and 8. Two patients had amebic and four pyogenic abscesses. Mean operative time was 142 min. All patients were eating by the day following surgery and were ambulating between 24 and 72 h postoperatively. All patients reported to be asymptomatic at the time of their last visit. There was one recurrence that resolved with a second procedure.
Conclusions: Success rate with the laparoscopic drainage of liver abscesses (83.3%) makes this procedure an effective and viable surgical alternative as a primary approach in selected patients or after a failed percutaneous drainage.

REFERENCES

1. 1.Kurland JE, Brann OS. Pyogenic and amebic liver abscesses. Curr Gastroenterol Rep 2004;6:273-279.

2. 2.Ong E, Espat NJ, Helton WS. Hepatic abscess. Curr Treatment Options Infect Dis 2003;5:393-406.

3. 3.Álvarez JA, González JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess. J Am Surg 2001;181:177-186.

4. 4.Álvarez-Pérez JA, González-González JJ, Baldonedo-Cernuda RF, SanzÁlvarez L. Abscesos hepáticos piógenos. Cir Esp 2001;70:164-172.

5. 5.Escandón RC, Treviño GMN, Escobedo de la Peña J, Hernández RJ, Olvera AJ, Cabral SJ. La amebiasis y el absceso hepático amibiano en México, un problema de salud pública de actualidad. Rev Gastroenterol Mex 1996;61:378-386.

6. 6.Aguirre-Rivero R. Absceso hepático amibiano. En: Asociación Mexicana de Cirurgía General/ Consejo Mexicano de Cirugía General. Tratado de cirugía general. México: El Manual Moderno;2003. pp. 927-936.

7. 7.Mogollón PA, Molina SG, Martínez MF, y cols. Drenaje percutáneo de absceso amibiano guiado por medio de ultrasonido. Resultados preliminares. Rev Gastroenterol Mex 1999;64:134-138.

8. 8.Rodríguez-Magallán A. Absceso amibiano del hígado. Tratamiento médico con diferentes esquemas. Rev Hosp Juarez Mex 2000;67:51-54.

9. 9.Mohsen AH, Green ST, Read RC, McKendrick MW. Liver abscess in adults: ten years experience in UK center. Q J Med 2002;95:797- 802.

10. 10.Chou FF, Sheen-Chen SM, Chen YS, Chen MC. Single and multiple pyogenic liver abscesses: clinical course, etiology, and results of treatment. World J Surg 1997;21:384-389.

11. 11.Tay KH, Ravintharan T, Hoe MNY, See ACH, Ching HC. Laparoscopic drainage of liver abscesses. Br J Surg 1998;85:330-332.

12. 12.Kayaalp C, Yol S, Nessar G. Drainage of liver abscess via laparoscopic trocar with local anesthesia. Surg Laparosc Endosc Percut Techn 2003;13:121-124.

13. 13.Wang W, Lee WJ, Wei PL, Chen TC, Huang MT. Laparoscopic drainage of pyogenic liver abscesses. Surg Today 2004;34:323-325.

14. 14.Cappuccino H, Campanile F, Knecht J. Laparoscopic-guided drainage of hepatic abscess. Surg Laparosc Endosc 1994;4:234-237.

15. 15.Yanaga K, Kitano S, Hashizume M, Ohta M, Matsumata T, Surgimachi K. Laparoscopic drainage of pyogenic liver abscess. Br J Surg 1994;81:1022.

16. 16.Hansen P, Ludemannand R, Swanstrom L. Minimally invasive approaches to hepatic surgery. Hepatogastroenterology 2001;48:37-40.

17. 17.Robles PJ, Lara JG, Lancaster B. Drainage of hepatic amoebic abscess successfully treated by laparoscopy. J Laparoendosc Surg 1994;4:451–454.

18. 18.Siu WT, Chan WC, Hou SM, Li MK. Laparoscopic management of ruptured pyogenic liver abscess. Surg Laparosc Endosc 1997;7:426-428.

19. 19.Herrera GM, Chávez-Tapia N, Lizardi C. Absceso hepático amibiano. Medica Sur 2003;10:35-37.

20. 20.Cruz MI, Muñoz PJ, González PJ, Utrilla PC. Drenaje laparoscópico de abscesos hepáticos. Rev Hosp Juarez Mex 2001;68:15-18.