Minimally invasive technologies in the surgical treatment of liver abscesses

Authors

  • V. O. Shaprinskyi National Pirogov Memorial Medical University, Vinnytsya
  • A. M. Formanchuk National Pirogov Memorial Medical University, Vinnytsya
  • Y. V. Shaprinskyi National Pirogov Memorial Medical University, Vinnytsya
  • V. M. Makarov National Pirogov Memorial Medical University, Vinnytsya
  • O. A. Kaminskiy National Pirogov Memorial Medical University, Vinnytsya
  • T. V. Formanchuk National Pirogov Memorial Medical University, Vinnytsya
  • O. I. Chernichenko National Pirogov Memorial Medical University, Vinnytsya

DOI:

https://doi.org/10.11603/2414-4533.2021.3.12534

Keywords:

liver abscess (LA), percutaneous echo-controlled minimally invasive interventions, open surgery

Abstract

The aim of the work: to analyze the effectiveness of traditional and minimally invasive methods of surgical treatment of liver abscesses (LA), which will improve the approaches to each of the known methods of treatment with the development of an algorithm for the surgeon in different clinical cases.

Materials and Methods. The article presents the experience of treatment of 142 patients with liver abscesses. 89 surgeries were performed by laparotomy access, 36 percutaneous drainage by ultrasound navigation, 17 surgical interventions by minimally invasive laparoscopic drainage. The age of patients varied from 26 to 84 years. LAs were 1.41 times more common in women than in men. The duration from the initial manifestation to hospitalization ranged from 4 days to 1 month. Concomitant pathology was in 121 patients (85.2%).

Results and Discussion. LA were most often located in the following segments of the liver: 3rd segment – (14.54±2.85) %, 6th segment – (24.43±3.85) %, 7th segment – (34.26± 3.77) %, in (26.77±3.34) % of cases several segments of the liver were affected. Complications were represented by suppuration of the postoperative wound – 6 (6.37±3.25) %, exudative pleuritis on the right 7 (5.16±2.85) % bile leakage – 4 (3.01±2.58) %, pneumonia – 6 (6.04±2.63) %, early adhesive intestinal obstruction – 3 (3.03±2.14) %. The length of hospital stay of patients with minimally invasive treatments for LA was shorter (5.7±0.4) days comparing with open surgery (14.7±1) (p <0.05). Preference should be given to minimally invasive treatments that are highly effective, safe, reduce the length of hospital stay and reduce mortality up to 7.04 %. If the chosen method is ineffective, surgical tactics should be based on the escalation principle, which is a timely transition to a more effective and invasive method.

References

https://emedicine.medscape.com/article/188802-overview#a5;

Brisse, S., Fevre, C., Passet, V., Issenhuth-Jeanjean, S., Tournebize, R., Diancourt, L. & Grimont, P. (2009). Virulent clones of Klebsiella pneumoniae: Identification and evolutionary scenario based on genomic and phenotypic characterization. PLoS ONE, 4 (3), p.e4982.

Ochsner, A., DeBakey, M. & Murray, S. (1938). Pyogenic abscess of the liver. The American Journal of Surgery, 40 (1), 292-319.

Nychytailo, M., Mashkovskyi, H., Kostylev, M., & Lebedeva, E. (2012). Ultrazvukova diahnostyka abstsesu pechinky, mozhlyvosti i zdobutky [Ultrasound diagnosis of liver abscess, opportunities and achievements]. Klinichna khirurhiia – Clinical Surgery, 10, 12-15 [in Ukrainian].

Bezruchko, M., Panasenko, S., Osipov, O., Drabovskyi, V. & Rybalka, Y., (2020). Dosvid zastosuvannia interventsiinoi sonohrafii v likuvanni patsiientiv iz bakterialnymy abstsesamy pechinky [Experience of application of interventional sonography in treatment of patients with bacterial hepatic abscesses]. Klinichna Khirurhiia – Clinical Surgery, 87 (3-4), 31-34 [in Ukrainian].

Serraino, C., Elia, C., Bracco, C., Rinaldi, G., Pomero, F., & Silvestri, A. et al. (2018). Characteristics and management of pyogenic liver abscess. Medicine, 97 (19), e0628. DOI: 10.1097/md.0000000000010628;

Shaprynskyi, V., Makarov, V., Suleimanova, V., Shaprynskyi, Y., & Skalskyi, S. (2020). Liver abscesses: a 10-year Vinnytsia university study]. Eureka: Health Sciences, 1, 10-14. DOI: 10.21303/2504-5679.2020.001122 [in Ukrainian].

Pang, T. (2011). Pyogenic liver abscess: An audit of 10 years’ experience. World Journal of Gastroenterology, 17(12), 1622. DOI: 10.3748/wjg.v17.i12.1622;

Mashkovskyi, T. (2012). Comparative estimation of open and miniinvasive interventions in the treatment of hepatic abscesses and accumulations of liquid of postoperative genesis [Porivnialna otsinka efektyvnosti vidkrytykh ta miniinvazyvnykh vtruchan v likuvanni abstsesu pechinky ta skupchen ridyny pisliaoperatsiinoho pokhodzhennia]. Klinichna khirurhiia – Clinical Surgery, 12, 5-8 [in Ukrainian];

Babiak, T., Zhemela, V., Ivankiv, T., & Pavlovskyi, M. (2001). Current trends in the treatment of bacterial liver abscesses [Suchasni tendentsii likuvannia bakteriinykh abstsesiv pechinky]. Shpytalna khirurhiia – Hospital Surgery, 2, 13-15 [in Ukrainian];

Cereteli, I., Ahaladze, G., & Galperin, J. (2004). Analiz faktorov riska letalnosti pri abstsessakh pecheni [Analysis of risk factors mortality in liver abscess ]. Annaly hirurgii i gepatologii – Annals of Surgery and Hepatology, 9 (1), 69-78. Retrieved from: http://hepatoassociation.ru/ASH/Volumes/Pdf91/ZherAha91.pdf [in Russian];

Chen, S., Lee, Y., Yen, C., Lai, K., Jeng, L., & Lin, D. et al. (2008). Pyogenic liver abscess in the elderly: clinical features, outcomes and prognostic factors. Age and Ageing, 38 (3), 271-276. DOI: 10.1093/ageing/afp002.

Downloads

Published

2021-12-03

How to Cite

Shaprinskyi, V. O., Formanchuk, A. M., Shaprinskyi, Y. V., Makarov, V. M., Kaminskiy, O. A., Formanchuk, T. V., & Chernichenko, O. I. (2021). Minimally invasive technologies in the surgical treatment of liver abscesses. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 12–16. https://doi.org/10.11603/2414-4533.2021.3.12534

Issue

No. 3 (2021)

Section

ORIGINAL INVESTIGATIONS

License

Copyright (c) 2021 Hospital Surgery. Journal named by L.Ya. Kovalchuk

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
  2. Лицензия Creative Commons
  3. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)