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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 11
Nov.  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(11): 2622-2625

A preliminary study on percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy in treatment of refractory liver abscess

DOI: 10.3969/j.issn.1001-5256.2021.11.026
  • 1.

    Department of Hepatobiliary Surgery, The Affiliated 3201 Hospital of Xi'an Jiaotong University School of Medicine, Hanzhong, Shaanxi 723000, China

  • 2.

    Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China

Research funding:

Natural Science Foundation of Heilongjiang (H2018025)

  • Received Date: 2021-03-17
  • Accepted Date: 2021-03-30
  • Published Date: 2021-11-20
    Abstract
  •   Objective  To investigate the clinical effect of percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy for necrosectomy and drainage in the treatment of refractory liver abscess after transcatheter arterial embolization (TACE).  Methods  A retrospective analysis was performed for three patients with refractory liver abscess after TACE in The Affiliated 3201 Hospital of Xi'an Jiaotong University School of Medicine from January 2018 to December 2020, and among the three patients, one had the formation of liver abscess after TACE for hepatic metastases after pancreaticoduodenectomy, one had liver abscess after repeated TACE for massive hepatocellular carcinoma, and one had secondary liver abscess after TACE for traumatic hepatic rupture. All three patients received percutaneous transhepatic drainage and sequential percutaneous nephroscopy for the treatment of refractory liver abscess, and their specific treatment process was summarized.  Results  All three patients were diagnosed with refractory liver abscess based on CT, routine blood test, procalcitonin, blood culture, and clinical manifestation. Percutaneous transhepatic catheterization under the guidance of conventional ultrasonography or CT and effective antibiotics had an unsatisfactory therapeutic effect, and after sequential percutaneous nephroscopy was performed for necrosectomy and drainage, liver abscess was cured and the patients had good prognosis.  Conclusion  For refractory liver abscess after TACE, when routine puncture treatment has an unsatisfactory therapeutic effect or a patient cannot tolerate surgical operation, percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy is safe and effective in the treatment of refractory liver abscess.

     

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