Laparoscopic hepatectomy for the treatment of pyogenic liver abscess: A retrospective case-control study

Abstract

Percutaneous catheter drainage is the first-line treatment for pyogenic liver abscess (PLA). Some patients need hepatectomy because of underling hepatobiliary pathology or unresponsiveness to nonoperative treatment, the traditional method is open hepatectomy (OH). Laparoscopic hepatectomy (LH) for PLA is rarely reported. The purpose of this study is to describe our experience of LH for treating PLA and to compare LH with OH. The medical records of patients who underwent LH for treating PLA were retrospectively analyzed, and the results were compared with those of patients with OH. From January 2015 to December 2021, 61 patients with PLA underwent hepatectomy, and 28 patients who underwent LH (LH group) were compared with 33 patients who underwent OH (OH group). There were no significant differences in the basic data between the 2 groups. Two patients in the LH group were converted to open surgery due to hemorrhage and dense perihepatic adhesions, there was no significant difference between the 2 groups in the operation time (186.2 ± 85.6 vs. 175.9 ± 76.7 minutes, P = .239), Institut Mutualiste Montsouris classification, extent of hepatectomy and drainage tube removal time, however, the blood loss (200.0 ± 100.5 vs. 470.9 ± 120.1 mL, P = .003), numerical rating scale (5.2 ± 1.8 vs. 9.1 ± 1.6, P = .042), the time to resume oral diet (12.3 ± 6.5 vs. 24.6 ± 10.2 hours, P = .005), the ambulant time (20.2 ± 7.3 vs. 40.2 ± 10.8 hours, P = .010), incidence of postoperative complications (14.3% vs.33.3%, P = .002), comprehensive complication index (46.2 vs. 60.6, P = .013), postoperative hospital stay (8.5 ± 7.3 vs. 13.5 ± 10.2 days, P = .025) in the LH group was significantly less than that in the OH group. Wit experience laparoscopic surgeons, treating PLA by LH is safe and feasible and compares favorably with OH.