Effectiveness of Surgery and Percutaneous Catheter Drainage (PCD) with Antibiotics for Pyogenic Liver Abscess Patients

Background: Pyogenic liver abscess is a life-threatening disease with high morbidity and mortality rates. In clinical, intra-venous antibiotics with percutaneous catheter drainage has been widely used to take place of surgery. However, which one has better effects is still lack of study.

Objective: This study compared the effectiveness of surgery and percutaneous catheter drainage (PCD) with antibiotics for pyogenic liver abscess patients.

Method: A systemic review of related articles, from 2008 to 2014, which focused on surgery or treatment for pyogenic liver abscess. The databases of Cochrane library, PubMed, CINAHL, Science Direct, and OVID were used. In total, 40 studied were found, and 5 of them met the inclusion criteria were carefully assessed. R program was applied to perform meta-analysis of 379 participants (335 received PCD and 44 received surgery).

Results: Percutaneous treatment includes PCD and needle aspiration, and PCD is more effective than needle aspiration which only has good effects on simple small abscess. There was significant difference in hospital stays, duration of antibiotics uses, and symptoms relief between these two groups. PCD has lower morbidity and costs. Surgery is suitable for patients who failed in PCD.  

Conclusions: PCD and surgery are both effective for pyogenic liver abscess patients. Past history, infectious source, pathogen and abscess distribution play importance roles in therapeutic plans. Surgery only suits for patients with large>10cm abscesses, or failed in PCD. As primary caregiver, nurse practitioners should carefully assess patients’ symptoms, laboratory results, and images in finding out patients’ treatment problem and care needs.