Comparative analysis of percutaneous aspiration and percutaneous catheter drainage for the treatment of liver abscess: A systematic review and meta-analysis

Abstract

Background: – Liver abscesses are a serious clinical condition requiring effective treatment to minimize complications and improve outcomes. Percutaneous aspiration (PA) and percutaneous catheter drainage (PCD) are the most common minimally invasive approaches for managing liver abscesses, yet their comparative efficacy and safety remain debated. This systematic review and meta-analysis aim to evaluate the effectiveness, safety, and recurrence outcomes of PA versus PCD. Methods: – A comprehensive search was conducted in PubMed, Embase, Web of Science, and Cochrane Library, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they compared PA and PCD in adult patients with liver abscesses, reported quantitative clinical outcomes, and met predefined inclusion criteria. Data extraction and quality assessment were performed independently by 2 reviewers. Statistical analyses were conducted using fixed-effects or random-effects models based on heterogeneity. Sensitivity analyses and funnel plots were employed to assess the robustness and publication bias of the findings. Results: – A total of 12 studies with 1290 participants were included. PCD demonstrated significantly higher treatment success rates than PA (RR = 1.19, 95% CI [1.10, 1.29], P < .001) and shorter time to clinical improvement (weighted mean difference = −1.92 days, 95% CI [−2.71, −1.13], P < .001). PCD also showed a lower 6-month recurrence rate (RR = 0.44, 95% CI [0.26, 0.75], P .05). Funnel plots revealed no significant publication bias. Conclusions: – This meta-analysis demonstrates that PCD offers superior outcomes over PA for treating liver abscesses, including higher success rates, faster recovery, and lower recurrence, with comparable safety profiles. Further high-quality randomized controlled trials are needed to validate these findings and refine clinical guidelines.