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Video-assisted hepatic abscess debridement
Authors:Christian D Klink  Marcel Binneb?sel  Maximilian Schmeding  Ronald M van Dam  Cornelis H Dejong  Karsten Junge  Ulf P Neumann
Institution:1. Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany;2. Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
Abstract:BackgroundPyogenic liver abscesses are currently treated by either percutaneous computer tomography (CT)-guided drainage or by laparoscopic and a conventional liver resection when conservative treatment fails but may be associated with substantial morbidity and mortality.MethodsA minimally invasive technique involving debridement of right liver abscesses was employed using a minimally invasive video-assisted hepatic abscess debridement (VAHD) after unsuccessful percutaneous CT-guided drainage. Clinical data, complication rates and outcomes of patients were recorded retrospectively.ResultsBetween 2011 and 2014, VAHD was performed on 10 patients at two centres with no observed recurrence of a liver abscess. The median age of the patients was 57 years (range 42–78) with a median pre-operative size of a liver abscess of 78 mm (range 40–115). The median operation time was 47 min (range 23–75), and the median postoperative hospital stay was 9 days (range 7–69). One patient developed a subcutaneous abscess that required further surgery. No patient died, and there were no major complications related to the VAHD.ConclusionsVideo-assisted hepatic abscess debridement is a feasible technique that shows promising results for the treatment of a recurrent right liver abscess.
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