Laparoscopy May Have a Role in the Drainage of Liver Abscess: Early Experience at Owerri, Nigeria

Abstract

Background: Image‑guided percutaneous drainage with antimicrobial agents is the standard modality of treatment of liver abscess. Open surgical drainage, and lately laparoscopic drainage becomes useful in selected patients. Nigeria is awakening late to the laparoscopic surgery revolution. Public health institutions have started making enormous investments in minimal access surgery, which can augment deficient diagnostic capacities.
Objective: To describe the outcomes of the patients who underwent laparoscopic liver abscess drainage at the Federal Medical Centre, Owerri.
Materials and Methods: A retrospective analysis of the laparoscopic liver abscess drainage procedures done between the period September 2007 and December 2012 was done.
Results: A total of eight patients in the study period were worked up for abscess surgical drainage based on ultrasound (seven cases) and computed tomography (one case) supported localized collection in the liver. Intraoperatively, one patient was noticed to have nodules on the liver that was later confirmed as hepatocellular carcinoma. Operating time ranged from 37 to 126 min. There was no conversion to open surgery. On the follow‑up, one patient had residual abscess of 45 mm diameter size, after 6 weeks, and in whose aspirate acid‑fast bacilli were identified.
Conclusion: Laparoscopic drainage should be considered in the management of liver abscess.

Keywords: Drainage, laparoscopy, liver abscess