Prognostic factors and treatment tactics in the surgery of liver abscesses.

The prognostic factors of 21 patients with pyogenic liver abscess were analyzed. It was stated that survival is unfavourably influenced by hyperbilirubinaemia, the mixed bacterial population, the associated diseases as well as the tumorous process. As a result of portal antibiotic perfusion, there was no difference in the mortality rates of multiple and solitary liver abscesses. Based on the analysis of the prognostic factors, the surgical tactics is developed, i.e. a need for surgical exposure is supported, which imposes three tasks: exposure of the abscess/es, management of the primary process inducing the abscess and introduction of a cannula for portal antibiotic perfusion. Besides some criteria, although the author do not have experience in this field, they suggest the use of percutaneous drainage controlled by echography or CT, basically because of the lower mortality rate.