Topic: Liver abscess,peritonitis, ca pancreas
Question: Write briefly on the role of surgery in management of Liver abscess.
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Management of liver abscess:
– Drainage/aspiration: Percutaneous aspiration or catheter drainage is often the first step in treating a liver abscess. Using imaging guidance, a needle or catheter is inserted into the abscess to drain the infected fluid. This helps relieve symptoms and reduce the size of the abscess.
– Open surgical drainage: If percutaneous drainage is not successful, open surgical drainage may be performed. This involves making an incision in the abdomen and placing drainage tubes into the abscess cavity to allow continuous drainage of pus.
– Liver resection: For large, multiloculated, or multiple abscesses that do not respond to drainage, a segment of the liver containing the abscess may need to be surgically resected (removed). This is a major surgery but can be curative if the entire diseased area is removed.
– Abscess debridement: Debridement or irrigation of the abscess cavity may be done during open drainage or resection surgeries. This helps remove infected or necrotic tissue.
– Laparoscopic drainage: Some surgeons use laparoscopic (keyhole) techniques to drain liver abscesses. Small incisions are made and a camera is used to guide surgical instruments for drainage. This is less invasive than open surgery.
– Liver transplantation: For abscesses associated with underlying liver disease, a liver transplant may be the only curative option. This is rare and only considered when other treatments fail.
So in summary, surgery plays a crucial role in drainage, debridement, resection, and sometimes transplantation for cure of complex or refractory liver abscesses. The choice of technique depends on the size, location, and nature of the abscess.
