Minimally invasive treatment of bacterial abscesses of the liver

Abstract

Introduction: The problem of early detection and treatment tactics in liver abscess in our time is not fully resolved, due to lack of in-depth study of this section surgery. Aim: The study of the effectiveness and improve puncture - aspiration treatment of patients with bacterial abscesses of the liver under laparoscopic control, reduction of morbidity and mortality. Materials and methods: Over 10 years in the hospital cured 72 patients with BAP, including men - 41 (58%), women - 31 (42%). The patientsV age from 19 to 72 years, an average of 51,7 ± 3,2 years, 40.2% were older than 50 years. Applied (in various combinations), the following methods: clinical, laboratory, ultrasound (ultrasonography) or computed tomography (CT), laparoscopy, cytological and bacteriological examination of the contents of a bacterial abscess of the liver. For the ultrasound device used sonographic «Dornier-5200» in color Doppler, using probes of 3.5 and 5 MHz. For laparoscopy and interventions under the control of machines and tools used firms «Wolf» and «Karl Storz» (Germany). BAP drainage was carried out by the installation of drainage Seldinger. Biliary drainage for used self-locking drainage «Meadox» and «Cook». Results: The patients were divided into two groups according to age, sex, location of abscess, the severity of the initial state. In group I included 34 patients who were operated on during the period 2001 - 2005. Using conventional surgical methods. In the II group included 38 patients who were hospitalized in 2006 - 2010. Surgery was carried out by puncture or drainage under laparoscopic control. In the first group of patients (34), after laparotomy, gepatotomii, sanitation and drainage of purulent center, 7 (20.6%) had observed complications (wound abscess, pneumonia) and 1 patient died from sepsis. Average length of stay in hospital the patient was 27 ± 1,9 days. Conclusions: Minimally invasive interventions for bacterial abscess of the liver under laparoscopic control reduces the duration of hospitalization by an average of 6-8 days may reduce the morbidity and mortality.