A Clinical Study of Therapeutic Method for Pyogenic Liver Abscesses

Eiji Komatsu, Yoshinori Isobe*, Toshihide Imaizumi, Toshiaki Nakasako, Tatsuya Yoshikawa, Mitsuji Nakamura, Fujio Hanyu, Eiko Ueno**, Akiyoshi Yamada**

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
*Department of Radiology, East Hospital, Kitasato University
**Department of Radiology, Institute of Gastroenterology, Tokyo Women's Medical College

Fifty-seven cases of pyogenic liver abscesses during the last 10 years were reviewed for therapeutic methods and prognosis. Percutaneous transhepatic abscess drainage was performed in 37 cases. The patients with a solitary cystic lesion recovered completely with percutaneous hepatic abscess drainage under echographic guidance. But most of the patients with multilocular or multiple lesions did not recover within two weeks with only abscess drainage. The therapeutic results of abscess drainage for a solitary liver abscess improved, but those of multilocular or multiple liver abscesses were still not good. Transcatheter regional hepatic arterial infusion with antibiotics was performed in 16 cases with multilocular or multiple liver abscess. Systemic antibiotic therapy or abscess drainage for these cases prior to this method did not show good results. The antibiotics were infused for 4 to 38 days continuously or intermittently without major complications. The method was effective for 15 cases, but not effective for 1 case. This method should be attempted if percutaneous abscess drainage is not effective.

Key words
liver abscess, percutaneous transhepatic abscess drainage, hepatic arterial infusion with antibiotics

Reprint requests
Eiji Komatsu Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
January 11, 1995

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