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Research Article | Volume 13 Issue 7 (July, 2023) | Pages 599 - 605
To Evaluate the Role of Laparoscopic Drainage in Cases of Pyogenic Liver Abscess
Under a Creative Commons license
Open Access
Received
June 11, 2023
Revised
June 30, 2023
Accepted
July 14, 2023
Published
July 28, 2023
Abstract
Background: Laparoscopic drainage of liver abscesses represents an attractive alternative to open surgical drainage. The advantages of laparoscopic drainage of liver abscess include minimal tissue trauma, shorter duration of the procedure, minimal postoperative pain, early ambulation and early return to daily routine. Materials & methods: A prospective study of twenty patients admitted in the Department of Surgery, Government Medical College, Jammu with liver abscess over a period of 12 months, i.e, from 1st November 2019 to 31st October 2020. All the patients were subjected to detailed history and examination and underwent laparoscopic drainage of liver abscess and the outcomes were studied. Results: The maximum number of cases were in the age range of 40-50 years and the male to female sex ratio was 3:1. The most common clinical symptoms in the study group were fever, jaundice, pain and vomiting. 80% of the patients had abscess in the right lobe of liver while 20% had abscess in the left lobe. Mean volume of abscess drained was 176ml. Mean operative time for laparoscopic drainage was 71.8 minutes. The most common causative organism was found to be E.coli present in 65% of the study population. 20% of the patients showed no growth, while 5% demonstrated K. pneumonia and 10% showed polymicrobial growth. 80% of patients showed complete resolution while recurrence occurred in 10%of patients whereas 10% patients were lost to follow up. Intraoperative bleeding occurred in only 5%of the patients. There was a single case of conversion from laparoscopic to open surgery due to the presence of dense adhesions and incomplete aspiration of the abscess. Postoperative complications (lung abscess, pneumonia and port site infection) occurred in 15% of patients. Mean duration of stay at the hospital was 10.2 days. Conclusion: Laparoscopic drainage of liver abscess is a safer alternative to open surgical drainage. Success rate of 80% with minimal morbidity makes the laparoscopic drainage of liver abscess a preferred first line treatment and should be considered invariably in all such patient who are deemed fit to undergo a laparoscopic procedure.
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