The choice of surgical treatment method of patients with bacterial liver abscesses

Abstract

Aim. To improve the results of surgical treatment of patients with bacterial abscesses of the liver. Methods. During the period from 2000 to 2010 treated were 118 patients with bacterial liver abscesses, 75 men and 43 women aged from 18 to 80 years (mean age 52.1 years). Management of the patients was based on the developed algorithm of diagnosis and treatment of liver abscesses. Two groups of patients were formed: the main group (treatment consisted of percutaneous puncture and drainage of the abscesses under ultrasound guidance) - 94 patients, the comparison group - 24 patients. In the comparison group surgical interventions were performed using the transabdominal access: laparotomy, opening and drainage of the abscess (18 patients), hepatic resection (3 patients), left-sided hemihepatectomy (2 patients), right-sided hemihepatectomy (1 patient). Results. In the patients of the comparison group the following early postoperative complications developed: wound infection - 4, intra-abdominal hemorrhage - 1, bile leakage - 1, abscesses of the abdominal cavity - 2, exudative pleuritis - 2, pneumonia - 3 cases. The average duration of patient hospitalization was 19.5±1.6 bed-days. In the main group the average duration of patient hospitalization was 9.2±±0.6 bed-days. Early postoperative complications in patients of the main group included: intra-abdominal hemorrhage - 1, bile leakage - 1, abscesses of the abdominal cavity - 1, exudative pleuritis - 2, pneumonia - 2 cases. There were no deaths in either of the groups. Conclusion. Puncture and drainage of bacterial liver abscesses under ultrasound guidance is an effective method of treatment that makes it possible to reduce the number of abdominal operations, reduce the number of postoperative complications and shorten the hospital stay.

Keywords

abscess / liver / ultrasound / surgical treatment

References

[1] Агзамходжаев С.М., Яругский Е.Е. Современные принципы лечения абсцессов печени // Вестн. хирург. - 1990. - №8. - С. 122-124.

[2] Благитко Е.М., Бромбин А.И. Лечение больных с бактериальными абсцессами печени // Анн. хирург. гепатол. - 1999. - Т. 4, №2. - С. 85-86.

[3] Борисов А.Е. Руководство по хирургии печени и желчевыводящих путей. - СПб.: Предприятие ЭФА, 2002. - 448 с.

[4] Зиганшина Л.Е., Красильников Д.М., Фаррахов А.З. Антибактериальные препараты в абдоминальной хирургии: профилактика и терапия. - Казань.: КГМУ, 2006. - 32 с.

[5] Мирошников Б.И., Ананьев Н.В., Кондаков С.Б. Лечение абсцессов печени // Анн. хирург. гепатол. - 1999. - Т. 4, №2. - С. 118.

[6] Харченко В.П., Котляров П.М., Карпенко В.Н. Интервенционные вмешательства под ультразвуковым контролем в лечении очаговых образований печени // Клин. геронтол. - 2007. - Т. 13, №5. - С. 56-59.

RIGHTS & PERMISSIONS

Tolstikov A.P.