Liver is an important organ which carries out many functions including production of bile, creation of hormones, controlling of cholesterol and cleaning of toxins from medicines, alcohol, drugs etc. Liver abscess is a cyst in the liver which is filled with puss. These abscesses are formed from infection which may reach liver from nearby structures like bile duct, intestines and appendix. Liver abscesses are also developed as a result of trauma caused to liver or as a result of surgeries being carried out in the nearby organs. If liver abscess is detected in time it can be treated and cured by antibiotics. A surgical procedure used for draining the abscess. If left untreated the liver abscess can burst and result in life threatening bacterial infection.
1) Chocking or difficulty in breathing combined with high fever. 2) Changes in mental alertness and behavioral changes like lethargy and confusion. 3) Yellowing of skin and white color of your eyes(like in jaundice) 4) Upper abdominal pain and nausea without vomiting. 5) Loss of weight and weakness that cannot be explained.
Treatment for liver abscess is based on its location, number of abscess, size and cause of formation of the abscess etc. Medications can be given to reduce the symptoms and to kill the infections. Draining of the pus and surgical removal of the pus and the abscess will be attempted by the surgeons when other methods do not become fruitful.
Surgical drainage of the pus was in practice till around 1970, when percutaneous drainage using refined image-guided techniques was introduced. Open surgery for the removal of liver abscess is based on two approaches. A transperitoneal approach is used to drain the pus and explore the abdomen to identify previously undetected abscess. Posterior transpleural approach is used for high posterior lesions although this approach does not help in finding out the unidentified abscess. Both these procedures can be done in a minimally invasive laparoscopic approach also, but they are followed in select cases only. This approach helps the surgeon to explore the entire abdomen and reduces the patient morbidity. Study conducted on the liver abscess surgical procedures have revealed that the patients treated by surgical procedure have experienced lesser treatment failures and secondary procedures where as the morbidity was comparable in the two procedures.
Peculiarities of laparoscopic procedures
- Less loss of blood and less pain as the incisions required for this surgery are smaller.
- Very fast recovery and return to routine activities are possible as the wounds heal faster.
- This procedure is not suitable for obese patients and patients who suffer from diabetics and hyper tension.
- This procedure cannot be done on patients who had earlier undergone a surgical procedure in the target area.