A Comparative Study of Ultrasound-Guided Percutaneous Catheter Drainage Versus Ultrasound-Guided Percutaneous Needle Aspiration in the Management of Liver Abscess

Abstract

Background: Liver abscess remains a significant clinical challenge requiring prompt diagnosis and intervention. While both percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) are minimally invasive treatment modalities, their comparative efficacy remains debated.

Objective: To compare the therapeutic effectiveness, safety profile, and clinical outcomes of ultrasound-guided PCD versus PNA in the management of liver abscess.

Methods: This prospective randomized study was conducted at Basaveshwar Teaching and General Hospital, Kalaburagi, between October 2019 and March 2021. Fifty patients with ultrasonographically confirmed liver abscess were randomly allocated into two groups: PNA group (n=25) and PCD group (n=25). All patients received empirical intravenous antibiotics (Ceftriaxone 1g twice daily and Metronidazole 500mg thrice daily). Primary outcome measures included treatment success rate, clinical improvement time, hospital stay duration, and complications.

Results: The mean age was 42.06±11.92 years with male predominance (94%). Pyogenic abscesses constituted 74% of cases. The PCD group demonstrated significantly higher treatment success rate (100% vs 76%, p=0.029) compared to PNA. Mean clinical improvement time was comparable (4.44±2.12 days for PCD vs 4.92±2.25 days for PNA, p=0.441). Hospital stay duration showed no significant difference (14.64±5.85 days for PCD vs 12.88±5.50 days for PNA, p=0.278). No major complications occurred in either group.

Conclusion: Ultrasound-guided PCD is more effective than PNA for treating liver abscesses, offering superior treatment success rates with comparable safety profiles. PCD should be considered the preferred first-line interventional approach for liver abscess management.