Qiu F, Yang TC, Han W. Clinical application of ultrasound-guided surgical puncture and drainage in early treatment of pyogenic liver abscess. World J Gastrointest Surg 2025; 17(7): 107544 [DOI: 10.4240/wjgs.v17.i7.107544]
Corresponding Author of This Article
Wei Han, MD, Doctor, Department of General Surgery, Beijing Luhe Hospital, Capital Medical University, No. 82 Xinhua South Road, Tongzhou District, Beijing 101149, China. diovne@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2025; 17(7): 107544 Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.107544
Clinical application of ultrasound-guided surgical puncture and drainage in early treatment of pyogenic liver abscess
Feng Qiu, Tian-Chi Yang, Wei Han
Feng Qiu, Tian-Chi Yang, Wei Han, Department of General Surgery, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
Author contributions: Qiu F drafted the manuscript and gave final approval of the version to be published; Yang TC and Han W designed the study, and collected and analyzed the data; all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Beijing Luhe Hospital Ethics Committee.
Informed consent statement: We guarantee that all the medical data used in this study are the data agreed to be provided by the subjects and do not contain any data that the subjects have explicitly refused to use before.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: Not applicable.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Han, MD, Doctor, Department of General Surgery, Beijing Luhe Hospital, Capital Medical University, No. 82 Xinhua South Road, Tongzhou District, Beijing 101149, China. diovne@163.com
Received: March 28, 2025 Revised: April 15, 2025 Accepted: May 21, 2025 Published online: July 27, 2025 Processing time: 117 Days and 3.4 Hours
Abstract
BACKGROUND
Pyogenic liver abscess (PLA) is a prevalent liver infection with gradual onset and severe symptoms, including fever, abdominal pain, jaundice, and vomiting. Complications like sepsis or toxic shock can also occur.
AIM
To investigate the clinical value of early ultrasound-guided percutaneous drainage (PCD) in PLA patients, specifically those with non-liquefied abscesses, and evaluate the feasibility of early intervention.
METHODS
This retrospective analysis included 143 patients with PLA who were admitted to the Department of General Surgery between January 2018 and March 2023. All patients underwent ultrasound-guided PCD. Based on the liquefaction status of the abscess, patients were divided into two groups: Liquefied group and non-liquefied group. Clinical outcomes, including puncture success rate, puncture duration, length of hospital stay, time to fever resolution, abscess shrinkage rate, and complication rates, were compared between the two groups.
RESULTS
The puncture success rate for all patients was 99.3%, with a postoperative complication rate of 5.59%, and no intraoperative deaths occurred. Compared to the liquefied group, the non-liquefied group had significantly shorter hospital stays (3.9 ± 1.8 days vs 5.1 ± 2.7 days), faster fever resolution (2.4 ± 1.1 days vs 4.9 ± 2.2 days), and quicker abscess shrinkage (> 50%) (4.7 ± 1.5 days vs 8.6 ± 3.3 days) (P < 0.05). There were no significant differences in puncture success rates or complication rates between the two groups.
CONCLUSION
Early ultrasound-guided PCD can be safely and effectively performed in PLA, even when the abscess is not fully liquefied or is non-liquefied, supporting the clinical feasibility of early intervention.
Core Tip: This study demonstrated that early ultrasound-guided percutaneous drainage (PCD) is safe and effective for pyogenic liver abscess (PLA), even in non-liquefied abscesses. By analyzing 143 PLA patients, we found that non-liquefied cases treated with early PCD had shorter hospital stays (3.9 vs 5.1 days), faster fever resolution (2.4 vs 4.9 days), and quicker abscess shrinkage compared to liquefied abscesses, with no increase in complications. These results challenge the traditional requirement for abscess liquefaction prior to intervention, advocating for early PCD to accelerate recovery and reduce healthcare burdens. This approach redefines clinical strategies for PLA management.
