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Drainage of Liver Abscess Via Laparoscopic Trocar With Local Anesthesia

Kayaalp, Cuneyt MD; Yol, Sinan MD; Nessar, Gurel MD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: April 2003 - Volume 13 - Issue 2 - p 121-124
Article

There are several methods for treatment of liver abscess. These include drainage by open surgery, laparoscopic surgery, or percutaneous catheterization. In this report a new therapeutic approach is presented. A 47-year-old man admitted to the hospital had an abscess 12 cm in diameter, originating from the left liver lobe. After the patient's permission was obtained, a laparoscopic trocar was inserted into the abscess with the patient under local anesthesia in the operating room. A 28-French chest tube catheter was introduced through the trocar cannula, and approximately 1,000 mL of pus was drained. There were no complications, and the patient was discharged on the same day. After computed tomography showed an obliterated abscess cavity, the drain was removed on postoperative day 7. The pus culture, performed on the day of surgery, was found to be positive for Escherichia coli, which was responsive to cefaclor. Oral antibiotic therapy was given for 1 month. At follow-up 2 months after surgery, the patient was asymptomatic. This report describes the first case of a liver abscess drained by a laparoscopic trocar with local anesthesia. This method can be the treatment of choice for some easily accessible liver abscesses.

From the Department of Gastrointestinal Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey

Received April 15, 2002;

revision received November 5, 2002; accepted November 13, 2002.

Address correspondence and reprint requests to Cüneyt Kayaalp, Kennedy Caddesi Yalim Sokak 8/6, Kavaklidere 06660 Ankara, Turkey. Address electronic mail to: cuneytkayaalp@hotmail.com

© 2003 Lippincott Williams & Wilkins, Inc.