Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score ≥15
Abstract
Background
Most liver abscesses resolve after antimicrobial therapy or percutaneous tube drainage (PD). The aim of this study was to evaluate the results of hepatic resection (HR) for patients with pyogenic liver abscesses and an Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥15.
Methods
We compared the clinical outcomes of 81 patients with APACHE II scores ≥15 undergoing PD and/or HR.
Results
The failure rate (3 of 65) and double-treatment rate (32 of 65) in the PD group were significantly higher than in the HR group (3 of 35 vs 0 of 35; P = .0002). The mortality rate in the PD group was significantly higher than the other 2 groups (14 of 46 vs 2 of 19 and 1 of 16; P = .038). The length of hospital stay was significantly shorter and antibiotic use less in the HR group than in the PD group (P < .05).
Conclusions
Aggressive HR for patients with liver abscesses and APACHE II scores ≥15 produced better clinical outcomes.
Keywords: APACHE II, Hepatic resection, Pyogenic liver abscess
To access this article, please choose from the options below
PII: S0002-9610(08)00375-9
doi:10.1016/j.amjsurg.2007.09.051
© 2008 Elsevier Inc. All rights reserved.
