Document Detail

Endoscopic biliary drainage in patients with amebic liver abscess and biliary communication.
MedLine Citation:
PMID:  16877823     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Percutaneous drainage or surgery is required when amebic liver abscess (ALA) fails to respond to medical management. In some of these patients, non-response may be due to communication of ALA with the biliary tree. This report describes our experience with the use of endoscopic biliary draining in such patients. METHODS: Medical records of patients with ALA undergoing either needle aspiration or percutaneous pigtail drainage were retrieved; the indications for drainage were: abscess volume exceeding 250 mL, a thin rim of tissue (< 1 cm thick) around the abscess, systemic toxic features and failure to improve on medical treatment. Patients with abscess drain output >25 mL/day persisting for 2 weeks or presence of bile in the drain fluid underwent endoscopic biliary drainage. RESULTS: A total of 115 patients with ALA underwent percutaneous treatment. None of the 25 patients with needle aspiration needed any further treatment. Of the 90 who underwent catheter drainage, the catheter could be removed within one week in 77 patients; the remaining 13 patients (median age 42 years, range 24-65; all men) had an abscess-biliary communication. In them, the median catheter output was 88 mL/day (range 45-347) and 54 mL/day (28-177) at 2 days and 2 weeks after catheter placement. The drain fluid contained bile in all 13 patients and in addition contained pus in 10 patients. Eleven patients had a solitary abscess and two had multiple abscesses. Cholangiogram showed biliary communication in all 13 patients. All patients were treated with placement of 10F biliary endoprosthesis or 10F nasobiliary drain. Pigtail catheter was removed within 1 week in 11 of 13 patients. CONCLUSION: In patients with amebic liver abscess communicating with the biliary tree, biliary stenting may hasten clinical recovery and allow early removal of liver abscess catheter drain.
S M Sandeep; Vaibhav S Banait; Sanjeev K Thakur; Mukta R Bapat; Pravin M Rathi; Philip Abraham
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology     Volume:  25     ISSN:  0254-8860     ISO Abbreviation:  Indian J Gastroenterol     Publication Date:    2006 May-Jun
Date Detail:
Created Date:  2006-07-31     Completed Date:  2006-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8409436     Medline TA:  Indian J Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  125-7     Citation Subset:  IM    
Department of Gastroenterology, Seth G S Medical College and K E M Hospital, Mumbai - 400 012, India.
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MeSH Terms
Biliary Fistula / microbiology,  therapy*
Biliary Tract Surgical Procedures / instrumentation
Cholangiopancreatography, Endoscopic Retrograde*
Escherichia coli Infections / complications,  therapy*
Follow-Up Studies
Liver Abscess, Amebic / microbiology,  therapy*
Middle Aged
Pseudomonas Infections / complications,  therapy*
Pseudomonas aeruginosa*
Treatment Outcome

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