A Comparative study of Continuous Catheter Drainage Versus Percutaneous Needle Aspiration for treatment of Liver Abscess : A Superiority Open label Randomised Controlled Trial

Liver abscess is defined as a collection of suppurative material in liver parenchyma and is one of the cystic lesions of the liver. Abscesses occur when normal hepatic metabolism is overwhelmed or the system fails. Liver abscess is a relatively common clinical problem in India and tropical countries. Liver abscesses , both amoebic and pyogenic , continue to be an important cause of morbidity and mortality in tropical countries. Liver abscess mainly affects the right lobe (~65%) much more commonly than the left lobe (~10–15%) and can also be bilobar (~20–25%). When multiple abscesses are present, pyogenic or mixed infection needs to be suspected. There are three modalities of treatment for liver abscesses -

• Antimicrobial therapy : If pyogenic liver abscess is suspected , broad spectrum antibiotics should be started immediately till the culture results come , to control ongoing bacteremia and associated complications.

• Interventional therapy for liver abscesses : Traditional treatment modalities have included both continuous catheter drainage and percutaneous needle aspiration, each with its own set of advantages and drawbacks.

• Surgical Intervention : Surgical drainage has been reserved for patients who fail to respond to treatment with either aspiration or percutaneous drainage and antibiotics or who have concurrent intra-abdominal pathology which requires surgical management.

This study aims to provide a comprehensive comparison of these two surgical interventions, shedding light on their respective impacts on clinical, biochemical, and radiological parameters in patients with liver abscesses.