This study aims to compare the therapeutic effectiveness of continuous
catheter drainage versus intermittent needle aspiration in the percutaneous treatment of
pyogenic liver abscesses. Over a 5-year period, 64 consecutive patients with
pyogenic liver abscess were treated with intravenous
antibiotics (
ampicillin,
cefuroxime, and
metronidazole) and randomized into two percutaneous treatment groups: continuous
catheter drainage (with an 8F multi-sidehole pigtail
catheter); and intermittent needle aspiration (18G disposable
trocar needle). There was no statistically significant difference between the two groups regarding patient demographics, underlying coexisting disease,
abscess size,
abscess number, number of loculation of
abscess, the presenting clinical symptoms such as
fever,
abdominal pain, and pretreatment liver function test. Although not statistically significant, the duration of intravenous
antibiotics treatment before percutaneous treatment was longer with the
catheter group, and the change of
antibiotics after the sensitivity test was more frequent with the needle group. The needle group was associated with a higher treatment success rate, a shorter duration of
hospital stay, and a lower mortality rate, although this did not reach statistical significance. In conclusion, this study suggests that intermittent needle aspiration is probably as effective as continuous
catheter drainage for the treatment of
pyogenic liver abscess, although further proof with a large-scale study is necessary. Due to the additional advantages of procedure simplicity, patient comfort, and reduced price, needle aspiration deserves to be considered as a first-line drainage approach.