To evaluate the efficacy of percutaneous transhepatic
abscess drainage (
PTAD) as an initial choice of treatment for
liver abscess, the medical records of 28 patients with
liver abscess were retrospectively analyzed. The patients were predominantly men (23 of 28) with a mean age of 59 years (range, 19-86 years). Their chief complaints were
fever (86%), right hypochondralgia (32%), and
jaundice (11%). Fifteen of the 28 patients (54%) had hepatobiliary and
pancreatic carcinoma, and 31% had postoperative
liver abscess.
PTAD was performed in 23 patients and surgical drainage in 5. The overall success rate for
PTAD was 83%. The success rate for
PTAD for patients with multiple
abscesses was 83% (5 of 6), compared with a success rate of 82% (14 of 17) for patients with solitary
abscess. The prognostic factors for survival were
cancer and
sepsis and the mortality rate for patients with
cancer was 40% (6 of 15) while the mortality rate for patients with
sepsis was 56% (5 of 9). As a complication of drainage, 1 patient (4%) in the
PTAD group had pleural
abscess due to the transpleural
puncture. Our findings support the use of
PTAD as the primary treatment for
liver abscess, as it is safe and effective irrespective of the number of
abscesses and the patient's condition.