A Comparative Study Of Percutaneous Hepatocentesis And Laparoscopic Drainage In The Treatment Of Isolated Bacterial Liver Abscess

Objective:To investigate the comparison of ultrasound-guided percutaneous liver puncture drainage and laparoscopic incision drainage in the treatment of isolated bacterial liver abscess.Methods:The total number of 56 patients with isolated bacterial hepatic abscess admitted to the department of hepatobiliary surgery of The First Affiliated Hospital of Chongqing Medical University from January2013 to March 2019 were selected as the subjects of this study.All the patients had no history of abdominal surgery and diseases requiring surgical treatment,and all had clinical manifestations such as abdominal pain,high fever,and tapping pain in the liver area.Laboratory examination and imaging examination indicated infectious diseases of the liver,and bacterial liver abscess was definitely diagnosed through surgery or culture results.There was no significant difference in basic conditions between the two groups(P>0.05),and this study showed comparability.Among them,Thirty-one patients(Puncture group)underwent percutaneous drainage for hepatic abscess,and 25 patients(Endoscopy group)underwent laparoscopic drainage.Location,and the size of liver abscess in patients with two groups of treatment efficacy,the incidence of postoperative complications,extubation time,length of hospital stay,hospital expenses and so on carries on the analysis comparison.In this study,SPSS 22.0software was used for data analysis.Measurement data were expressed as(x±s),T test was used,count data was expressed as percentage,and x~2test was used.If P<0.05,the difference was statistically significant.Results:There were 45 patients with diabetes mellitus.There were 23cases of klebsiella pneumoniae in the pus culture,including 2 cases of coagulase negative staphylococcus,2 cases of streptococcus constellation and 1 case of streptococcus pharyngitis.There were 42 cases of abscess located in the right lobe of the liver,5 cases of abscess 5cm,12 cases of abscess greater than 10cm,and 39 cases of abscess located between them.Abscesses were separated in 24 cases.The length of stay in the endoscopic group were better than those in the puncture group,and the data difference between the two groups showed statistical significance.The cost of hospitalization and operation time of puncture group were better than that of endoscopy group.For the two groups of patients with similar postoperative extubation time and efficacy,there was no statistical significance between the two groups.Conclusion:In the treatment of pure bacterial liver abscess,percutaneous liver puncture has a longer hospitalization time than laparoscopic surgery,and the treatment effect of the two is similar.Puncture group has the advantages of short operation time,economical and effective,simple operation,etc.,and has become the main treatment method,but it cannot completely replace the surgical treatment,and a variety of treatment methods should be considered comprehensively when necessary.