AI Article Synopsis
- This study aimed to evaluate the feasibility of using endoscopic ultrasound-guided liver abscess drainage (EUS-LAD) specifically for abscesses located in the right hepatic lobe, a technique that has not been previously established.
- The study involved 19 patients, primarily dealing with abscesses in segment 6 of the liver, with a technical success rate of 78.9% for the drainage procedure, and high clinical success (93.3%) without recurrence of abscesses.
- Results indicate that using a novel partially covered self-expandable metal stent (PCSEMS) for EUS-LAD is both a viable and safe option for treating right liver lobe abscesses, with manageable adverse events.
Article Abstract
Background And Aims: Although EUS-guided liver abscess drainage (EUS-LAD) has been developed, only the left hepatic or caudate lobe can traditionally be drained by EUS. However, there is no evidence for the technical feasibility of EUS-LAD for the right hepatic lobe. In this retrospective study, the technical feasibility of EUS-LAD using a novel partially covered self-expandable metal stent (PCSEMS) with an antimigration system was evaluated as a first-line drainage technique for right hepatic lobe abscesses.
Methods: This study included consecutive patients with right lobe liver abscesses between December 2020 and February 2024. The primary outcome in this study was the technical success rate of EUS-LAD. Technical success of EUS-LAD was defined as successful stent deployment from the liver abscess to the duodenum. Clinical success, procedure time, duration of hospital stay, recurrence of liver abscess, and adverse events were evaluated as secondary outcomes.
Results: Nineteen patients were enrolled in this study. The location of the liver abscesses was mainly at segment 6. The mean size of the liver abscesses was 91.8 mm. The liver abscess could be identified under EUS guidance from the duodenum in 16 patients. Puncture using a 19-gauge needle was attempted, but the needle could not reach the liver abscess in 1 patient. The novel PCSEMS was successfully deployed in all patients. The technical success rate of EUS-LAD was 78.9% (15/19). Adverse events associated with the procedure were observed in 3 patients, but conservative treatment was successful. Clinical success was obtained in 14 patients (93.3%). The median duration of stent placement was 19 days (range, 7-41). The median follow-up period was 556 days, and recurrence of liver abscess was not observed in any patients.
Conclusions: EUS-LAD for the right liver lobe using a novel PCSEMS can be feasible and safe.
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| http://dx.doi.org/10.1016/j.gie.2024.09.013 | DOI Listing |
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