PYOGENIC LIVER-ABSCESS - STUDIES OF THERAPY AND ANALYSIS OF RISK-FACTORS

Experience with 46 patients diagnosed with liver abscesses over a 13-y ear period was reviewed to ascertain the impact of percutaneous versus surgical drainage. In most of the cases the abscesses were diagnosed by sonography or computed tomography. The most common pathogenetic mec hanism was ascending biliary tract infection. Of the 46 total patients , 27 were primarily treated surgically, whereas 19 underwent percutane ous drainage. In the surgical group five (18.5%) patients required reo peration. Percutaneous drainage failed in four patients (21.1%). Multi variate stepwise logistic regression analysis revealed that a high APA CHE II score, low hemoglobin level, and high serum bilirubin level wer e significant predictors of a complicated clinical course. Death was r elated more closely to the overall condition of the patient, as expres sed by a high APACHE II score, and the underlying disease (malignancy) than to the mode of therapy.