The best treatment for liver abscess

The best treatment for liver abscess

The best treatment for liver abscess

After the liver is infected, an abscess is formed because it is not treated in time, and it becomes a liver abscess. Liver abscesses are secondary. Clinically common are bacterial liver abscess and amoebic liver abscess; others have some special infections, such as liver tuberculosis.

1.Bacterial liver abscess

• Non-surgical treatment is suitable for localized inflammation, when abscess has not formed or multiple small abscesses. High doses of effective antibiotics and systemic supportive therapies are given on the basis of treatment of the underlying disease.
• Surgical incision and drainage puncture drainage is not smooth, abscess is not significantly reduced, clinical manifestations are not significantly improved or progressive aggravation; accompanied by primary lesions requiring surgical treatment, such as biliary hepatic abscess; abscess wall thickness, conservative Chronic liver abscess with poor therapeutic effect; the wall of the sputum has been worn or it is estimated that there is a possibility of ulceration. Surgical incision of the abscess, treatment of the primary lesion, double cannula suction, to completely drain.

It should be noted that multiple bacterial liver abscesses are generally not suitable for surgical treatment.

2. Amoebic liver abscess

(1) Medical treatment

• Anti-amebic treatment: the use of tissue-killing amoebic drugs, supplemented by intestinal killing amoebic drugs to cure.
• Liver puncture drainage: early selection of effective drug treatment, many liver abscesses have no need for puncture. For the appropriate drug treatment for 5 to 7 days, the clinical situation did not improve significantly, or the local elevation of the liver was significant, tenderness was obvious, and those who were at risk of perforation were treated with puncture drainage.
• Antibiotic treatment: When there is mixed infection, the appropriate type of antibiotics should be used for systemic application.

(2) Surgical treatment of liver abscess requires surgical drainage of <5%. Its indications are:

• Anti-amebic drug treatment and puncture drainage failure;
• Abscess position is special, close to the hilar, large blood vessels or too deep (> 8cm), puncture easily injured and adjacent organs;
• Abscess swollen into the abdominal cavity or adjacent to the internal organs and poor drainage;
• There is a secondary bacterial infection in the abscess, and the drug treatment cannot be controlled;
• Multiple abscesses, making puncture drainage difficult or failure;
• Left lobe liver abscess easily to the pericardial perforation, puncture easy to contaminate the abdominal cavity, should also consider surgery.

Drug treatment for acute but unconstrained liver abscess and multiple small abscesses. B-guided percutaneous puncture or catheter drainage is suitable for a single larger abscess. Abscess incision and drainage is suitable for large abscesses or the symptoms of systemic poisoning are still serious or complications after the above treatment. Hepatectomy is suitable for chronic liver abscess.