Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score > or =15

American Journal of Surgery
Huan-Fa HsiehChung-Bao Hsieh

Abstract

Most liver abscesses resolve after antimicrobial therapy or percutaneous tube drainage (PD). The aim of this study was to evaluate the results of hepatic resection (HR) for patients with pyogenic liver abscesses and an Acute Physiology and Chronic Health Evaluation II (APACHE II) score > or =15. We compared the clinical outcomes of 81 patients with APACHE II scores > or =15 undergoing PD and/or HR. The failure rate (3 of 65) and double-treatment rate (32 of 65) in the PD group were significantly higher than in the HR group (3 of 35 vs 0 of 35; P = .0002). The mortality rate in the PD group was significantly higher than the other 2 groups (14 of 46 vs 2 of 19 and 1 of 16; P = .038). The length of hospital stay was significantly shorter and antibiotic use less in the HR group than in the PD group (P < .05). Aggressive HR for patients with liver abscesses and APACHE II scores > or =15 produced better clinical outcomes.

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Citations

May 27, 2010·World Journal of Gastroenterology : WJG·Herwig Cerwenka
Aug 27, 2010·The British Journal of Radiology·K P De JongH S Hofker
Apr 2, 2014·Nursing & Health Sciences·Lingli PengHonghong Wang
Jan 28, 2015·International Journal of Critical Illness and Injury Science·Nader A MahmoodMuhammad Anees Khan
Aug 23, 2008·American Journal of Surgery·Damian J Mole, O James Garden
Sep 22, 2009·Gynecologic Oncology·Celestine S TungDiane C Bodurka
May 17, 2019·Clinical Microbiology Reviews·Thomas A Russo, Candace M Marr
Oct 24, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James S MoltonSophia Archuleta
Apr 30, 2020·Indian Journal of Anaesthesia·R UdhayachandharPhilip Joseph
Oct 24, 2014·Journal of Hepato-biliary-pancreatic Sciences·Joseph Zhi Wen LoWinston Wei Liang Woon
Oct 3, 2018·Infection & chemotherapy·Jae Bum Jun
Jul 20, 2010·The Surgical Clinics of North America·Kaye M Reid-LombardoGuido Sclabas

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