[Laparoscopic drainage of liver abscess. Initial experience].

BACKGROUND: Radiologically guided percutaneous drainage has proven to be simple and effective and currently is considered the gold standard of care with success rates between 80 and 87%. However, not all abscesses are amenable to or will resolve with percutaneous drainage. The purpose of this study is to report our 1-year initial experience with laparoscopic drainage of liver abscesses.

METHODS: Patients with diagnosis of liver abscess and who had a surgical indication and were submitted to laparoscopic drainage were studied prospectively from January to December of 2004.

RESULTS: Six patients underwent laparoscopic drainage. There were three men and three women with a mean age of 50.8 years. Four patients had single lesions and two had multiple lesions. Mean size of the abscesses was 10.9 x 7.7 cm, segments primarily affected were 5 and 8. Two patients had amebic and four pyogenic abscesses. Mean operative time was 142 min. All patients were eating by the day following surgery and were ambulating between 24 and 72 h postoperatively. All patients reported to be asymptomatic at the time of their last visit. There was one recurrence that resolved with a second procedure.

CONCLUSIONS: Success rate with the laparoscopic drainage of liver abscesses (83.3%) makes this procedure an effective and viable surgical alternative as a primary approach in selected patients or after a failed percutaneous drainage.