COMPARATIVE STUDY OF CATHETER DRAINAGE AND NEEDLE ASPIRATION IN THE MANAGEMENT OF LIVER ABSCESS

BACKGROUND The incidence of liver abscess both pyogenic and amoebic is steadily increasing, Liver abscess is potentially curable condition and without treatment the mortality is very high. The objectives of this study were- 1. to compare and correlate the therapeutic effectiveness of percutaneous needle aspiration and percutaneous catheter drainage in the treatment of liver abscess, and 2. to indicate the various determinants that affect the success of both the procedures. MATERIALS AND METHODS A non-randomized controlled trial was conducted between January 2017 and June 2018 among 60 cases admitted in Basaveshwara Teaching and General Hospital Gulbarga. Source of data is from a pretested proforma from the inpatient registry. Out of 60 patients studied, 30 (50%) patients were treated with percutaneous needle aspiration with 18G spinal needle. 30 (50%) patients were treated with percutaneous catheter drainage using 12F pigtail catheter. Sample size was taken for convenience. RESULTS Percutaneous needle aspiration was successful in n=19 (63.33%), with all the failures treated successfully by percutaneous catheter drainage. Percutaneous catheter drainage was successful in all n=26 (86.67%). There was a statistically significant difference in terms of success rate in catheter drainage group (p<0.001). There is a significant difference (p<0.001) in time required for 50% decrease in the size of abscess cavity, with less time required in PCD group, although hospital stay and duration of antibiotics are more in catheter group, there is no statistically significant difference between the groups (p>0.05). Two patients had complications noted in PCD group, while none reported in PNA group. CONCLUSION PCD is better modality as compared to PNA in terms of overall success rate, especially in larger abscesses, PNA is the cheaper method with its use limited to smaller abscesses, there is no statistically significant difference in terms of complications associated with PCD and PNA, So we conclude here that PCD as first line treatment option but consider PNA as an alternative in smaller abscesses.