Amoebiasis in endemic in the tropical countries with
amoebic liver abscesses being a common complication. Different modalities of treatment of
amoebic liver abscess are conservative (medical management), percutaneous needle aspiration, percutaneous
catheter drainage, surgical drainage and endoscopic drainage. This study was carried out to compare the efficacy, safety and outcome of needle aspiration comparing with percutaneous
catheter drainage of large (> or = 5cm diameter)
amoebic liver abscesses. This was a prospective study carried over a period of two years (2006-2008) at the general surgery department of Calcutta National Medical College and Hospital, Kolkata. A total of 45 patients were included in this study. All of them had
amoebic liver abscess with diameter of
abscess cavity > or = 5cm. They were divided into two groups. Group A included 22 patients and they were treated with needle aspiration. Group B included 23 patients and they were treated by
catheter drainage. Improvement in clinical features, liver function tests, ultrasonic evidence of decrease in the size of
abscess cavity was considered as criteria for successful treatment. The sex ratio and the age incidence in the two groups were similar. In about 80% patients the right lobe was affected, in about 18% the left lobe was affected and in rest the
abscess involved both lobes. Needle aspiration was successful in 15 (68.2%) and
catheter drainage was successful in 23 patients (100%). The mean
hospital stay of patients treated with needle aspiration was more than those treated with
catheter drainage. The mean time in days taken for 50% decrease in the size of
abscess cavity was significantly greater in group treated with needle aspiration than in those treated with
catheter drainage (9 days versus 4 days). It is concluded that percutaneous
catheter drainage is more effective in management of large
amoebic liver abscess than needle aspiration.