There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .
Comparative study of catheter drainage and needle aspiration in management of large liver abscesses
Objective To compare the effectiveness of percutaneous catheter drainage ( PCD ) and percutaneous needle aspiration ( PNA ) in the management of large ( > 10 cm diameter ) liver abscesses . Methods Seventy-two patients with liver abscess ( amebic 48 , pyogenic 24 ) were r and omly allocated to PCD or PNA ( 36 each ) , which were done within 24 hours of admission . Both groups received parenteral antibiotics for at least 10 days . PNA was repeated every third day if the cavity size had not declined to 50 % of the original for up to three times . Persistence of cavity or of clinical symptoms was considered failure of treatment . Duration to attain clinical relief , duration of hospital stay , complications , treatment failure , and deaths were recorded . Results PNA was successful in 31 of 36 ( 86 % ) patients ( one aspiration in 10 , two in 18 , and three in 3 patients ) , whereas PCD was successful in 35 ( 97 % ) patients ( p = ns ) . Duration to attain clinical relief ( 10.2 [ 2.0 ] vs. 8.1 [ 2.7 ] days ; p=0.02 ) and parenteral antibiotics needed ( 15.5 [ 1.1 ] vs. 10.9 [ 2.7 ] days ; p=0.04 ) were significantly lower in PCD group . Duration of hospital stay was similar in the two groups . One patient with PNA had a subcapsular hematoma and one with PCD had continuous bile leakage which stopped spontaneously . One patient in PCD group died . Conclusion PCD is a better treatment option than PNA for the management of large liver abscesses of size > 10 cm , in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed
There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .