Treatment of liver abscess: prospective randomized comparison of catheter drainage and needle aspiration

BACKGROUND The aim of the study was to evaluate the clinical presentation, and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses. METHODS This is a prospective randomized comparative study of 60 patients, presented in outpatient and emergency department at the hospital, randomized equally into two groups, percutaneous needle aspiration and pigtail catheter drainage. 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 analyze these parameters. RESULTS The success rate was significantly better in catheter drainage group (P=0.006). The patients in pigtail catheter drainage group showed earlier clinical improvement (P=0.039) and 50% decrease in abscess cavity volume (P=0.000) as compared to those who underwent percutaneous needle aspiration. 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.