 |
| Top ten common questions about liver abscess |
Liver abscess is generally said to have a pustule (soac) on the liver. If it is caused by bacteria, it is called bacterial liver abscess; if it is caused by parasites, it is called amoebic liver abscess. Among them, bacterial liver abscess is more common, so we focus on the former. There are three kinds of patients who are prone to liver abscess: one is the patient with intrahepatic bile duct stones, how the intrahepatic bile duct stones cause liver abscess (described in the article "Top Ten Common Problems About Intrahepatic Bile Duct Stones"); the second is diabetes patients; The third is people with poor resistance. These three kinds of people are very easy to breed bacteria, bacteria run to the liver, rooting and sprouting, causing bacterial liver abscess.
2. What is the performance of a liver abscess?
"pain, heat, thin"
Abdominal pain: pustules protrude from the surface of the liver or stimulate the liver capsule and diaphragm, causing abdominal pain;
Fever: bacteria enter the bloodstream through the liver, releasing toxins to cause fever;
Weight loss: Liver abscess is like a fire in the liver burning, which consumes a lot of nutrients to the body. In addition, the patient loses his appetite due to illness and can't eat, so he will slowly lose weight.
3. How to judge whether you have a liver abscess?
The following checks are available to know:
Routine physical examination: blood test and abdominal color ultrasound;
Preoperative examination: abdominal CT or MRI.
4. What if I get a liver abscess?
Liver abscess is a serious disease that should be treated aggressively if it is found, with or without symptoms.
If you do not actively treat, there are three kinds of hazards:
- Liver abscess will become larger and larger, and patients will become more and more painful;
- Large liver abscesses, especially pustules growing on the edge of the liver may break, pus flows everywhere, if the pus is everywhere in the stomach, it will form full peritonitis, a serious life-threatening;
- Bacteria enter the bloodstream through the liver, releasing toxins to cause fever. If the bacteria in the blood are not killed, the infection will become heavier and heavier, causing septic shock (life-threatening).
5. Have a liver abscess, what are the common treatment options?
- Anti-inflammatory conservative treatment (non-surgical treatment);
- Ultrasound-guided liver abscess puncture and drainage;
- Liver abscess incision and drainage surgery;
- Liver abscess resection.
6. What are the advantages and disadvantages of various treatment options? How to choose?
Anti-inflammatory conservative treatment
Advantages: Most patients work well and do not have to bear the risks and costs associated with surgery.
Disadvantages: It is possible to prevent the development of liver abscess, and a small number of patients are getting more and more serious (the patient said that "the more the doctor is more annoyed"), and eventually forced to choose surgery.
Applicable to: early liver abscess, abscess is relatively small, no liquefaction (no pus, liver abscess is hard sputum, abscess is not "mature"), because this patient can not do surgery, surgery can not solve the problem Therefore, only conservative treatment of anti-inflammatory drugs can be selected. Of course, all patients treated with liver abscess will be treated with anti-inflammatory and nutritional support before and after surgery.
Ultrasound-guided liver abscess puncture and drainage
Put a local anesthetic on the stomach, put a tube under the guidance of the color ultrasound probe into the abscess, for drainage of pus, pus drainage is clean, liver abscess is slowly getting better.
Advantages: Ultrasound-guided liver abscess puncture and drainage tube drainage surgery is a minimally invasive surgery, which can be completed only by playing one or two small holes in the abdomen. It has the advantages of small trauma, quick recovery, little patient pain, and infection is not easy to be infected. Local anesthesia can be done, the risk of anesthesia and surgery is small, and most patients can afford it.
Disadvantages: The drainage tube takes a long time and slightly affects the quality of life.
Applicable to: anti-inflammatory conservative treatment is invalid. The liver abscess has been liquefied (the liver abscess has been pus, at this time the liver abscess becomes soft and the abscess is "mature"). Liver abscesses are not separated (a large room is not divided into many small rooms). The number of abscesses is small, such as only one or two. High-risk patients who are unable to tolerate general anesthesia (aged, more disease).
Liver abscess incision and drainage
After general anesthesia, enter the abdominal cavity, find a liver abscess, cut a hole in the abscess, "squeeze" the pus, rinse it and put the drainage tube, pus drainage is clean, liver abscess is slowly getting better.
Advantages: The effect of clearing the pus is exact, and most patients will have a significant improvement after a few days.
Disadvantages: pus contaminated wounds cause wound infection; general anesthesia, moderate surgery, anesthesia and surgery are more risky than ultrasound-guided liver abscess puncture and drainage.
Applicable to: anti-inflammatory conservative treatment is invalid. The liver abscess has been liquefied (the liver abscess has been pus, at this time the liver abscess becomes soft and the abscess is "mature"). There is a separation of liver abscesses (a large room is not divided into many small rooms), and it is estimated that the puncture and drainage tube drainage effect is poor. The liver abscess has broken or may have ruptured. A patient who can tolerate general anesthesia.
About liver abscess incision drainage surgery, surgery and hole (laparoscopic) surgery are optional, I recommend hole drilling (laparoscopic) surgery, because hole drilling (laparoscopic) surgery is minimally invasive surgery, with less trauma, quick recovery The patient has little pain and the wound is not easily infected. Of course, there are also some deficiencies. For example, the operation time is longer than that of open surgery, and the cost is higher than that of open surgery. Patients who have had multiple laparotomy in the past are not suitable for hole surgery because of abdominal adhesion.
Liver abscessectomy
Advantages: Liver abscess is a pot end, the treatment is very thorough.
Disadvantages: general anesthesia, moderate to large surgery, anesthesia, surgery risk, cost is higher than other programs.
Applicable to: chronic liver abscess that has not healed for a long time and other treatments to treat liver abscess that is ineffective.
About liver abscessectomy, surgery and hole (laparoscopic) surgery are optional, I recommend hole (laparoscopic) surgery, because the hole (laparoscopic) surgery is minimally invasive surgery, with small trauma, rapid recovery, patient The pain is small, the wound is not easy to infect and so on. Of course, there are also some deficiencies. For example, the operation time is longer than that of open surgery, and the cost is higher than that of open surgery. Patients who have had multiple laparotomy in the past are not suitable for hole surgery because of abdominal adhesion.
Personal recommendation does not have a mature liver abscess to choose anti-inflammatory conservative treatment. Mature liver abscess is the first choice for ultrasound-guided hepatic abscess puncture and drainage, followed by liver abscess incision and drainage surgery. Finally, there is no way to choose liver abscess surgery.
7. What are the risks and costs of various treatment options?
Risk: anti-inflammatory conservative treatment <ultrasound-guided liver abscess puncture drainage tube drainage operation < liver abscess incision drainage surgery < liver abscess surgery. The main risks are bleeding, infection (belly, lungs, incision inflammation), bile leakage (biliary leakage to the stomach). In general, the probability of these complications is low.
Cost: anti-inflammatory conservative treatment <ultrasound-guided liver abscess puncture drainage tube drainage operation < liver abscess incision drainage surgery < liver abscess surgery, each patient has a difference. The cost of anti-inflammatory conservative treatment is determined by the length of the liver abscess.
8. How long does it take to recover?
Hospitalization time: The length of hospital stay for anti-inflammatory conservative treatment is determined by the length of the liver abscess. Ultrasound-guided liver abscess puncture and drainage tube drainage (about 5 days) < Liver abscess incision and drainage surgery (about 7 days) < Liver abscess resection (8-10 days). The time to complete recovery was around 3 months after surgery, and each patient had a slight difference.
9. Does liver abscess recur? Will liver abscess be cancerous?
Although liver abscess is a benign disease, it may recur if it is not well maintained.
Prevention of recurrence of liver abscess should start from the root of liver abscess: First, patients with intrahepatic bile duct stones should be treated to remove stones (in the "Top Ten Frequently Asked Questions about Intrahepatic Bile Stones" and "Without a knife, you can still take out Intrahepatic bile duct stones!" is introduced in two articles); Second, diabetic patients usually have to strictly control blood sugar; third, people with poor resistance strengthen exercise and improve their own resistance.
Liver abscess is a benign disease that does not become cancerous and can be cured.
10. What should be paid attention to in patients with liver abscess?
The diet after the operation should be guided by the attending doctor, generally from water, porridge, milk, steamed eggs, fish, lean meat (chicken, duck, pig, pigeon), ordinary diet. The intake of high-quality protein, vegetables and fruits helps to recover quickly after surgery.
The patient's usual diet needs attention:
Liver abscess is like a fire in the liver burning, the body is expensive to consume, many patients will have malnutrition, weight loss, so patients with liver abscess should strengthen nutrition, eat more nutritious (high protein food such as milk, steamed egg, fish , lean meat), high vitamins (vegetables, fruits), easily digestible food. If you are a diabetic, you should pay attention to the diabetes diet and be determined not to drink porridge.
No comments:
Post a Comment