Review
Copyright ©The Author(s) 2024.
World J Hepatol. Mar 27, 2024; 16(3): 316-330
Published online Mar 27, 2024. doi: 10.4254/wjh.v16.i3.316
Table 1 Randomised studies comparing treatment of amebic liver abscess patients with or without percutaneous aspiration
Ref./countryTreatment groups (n)ALA size/volume (cm/mL)Normalization of feverReduction of pain and/or local tendernessResolution in abscess sizeTLC declineLength of hospital stay
Sharma et al[98], IndiaMTZ (n = 20) and MTZ + PD (n = 19)7.2 ± 0.20 cm and 5.4 ± 2.2 cmSimilar on day (84 vs 94%)Similar on day 10 (67% vs 58%)No significant change at day 10 Similar between the groupsNA
Blessmann et al[99], GermanyMTZ (n = 19) and MTZ + PD
(n = 20)
169 ± 90 mL and 161 ± 49 mL100% at day 6 in both groupsSignificantly better at day 3 in MTZ + PD group: (60% vs 5%, P = 0.001)Greater reduction in MTZ + PD at day 10 (109 mL vs 64 mL, P = 0.02)Similar between groupsNA
Van Allan et al[94], United StatesMTZ (n = 21) and MTZ + PD (n = 20)8.5 ± 3.5 cm and 7.5 ± 2.4 cmSimilar between groups (3 d vs 4 d, P = 0.5)Early reduction in MTZ + PD group (3 d vs 1 d, P = 0.05)NANASimilar between groups (5 d vs 6.2 d, P = 0.19)
Ghosh et al[95], IndiaMTZ (n = 98) and MTZ + PD (n = 96)6.8 ± 2.6 cm and 6.8 ± 2.6 cmBetter at day 8 in MTZ + PD group (P < 0.001) Significantly better at day 3 in MTZ + PD group (P = 0.03)Greater reduction in MTZ + PD (P = 0.003)Better in MTZ + PD at day 8 (P < 0.001)NA
Freeman et al[93], NigeriaMTZ (n = 17) and MTZ + PD (n = 19)1.5 to 14.5 cm and 1.5 to 14.5 cmSimilar between groups at week-3 (19/19 vs 16/17)Similar between groups at week-3Greater reduction in MTZ + PD when ALA > 6 cm (P = 0.005)NANA
Bammigatti et al[100], IndiaMTZ (n = 29) and MTZ + PD (n = 28)148.4 ± 103 mL and 211.5 ± 119 mLSimilar between groups (30 h vs 17 h, P = 0.48)Median time similar between groups
(48 h vs 27 h, P = 0.16)
NAShorter in MTZ + PD group (2.4 d vs 3.7 d, P = 0.05)Similar between groups (4.5 d vs 4.4 d, P = 0.62)
Widjaya et al[96], IndonesiaMTZ (n = 16) and MTZ + PD (n = 17)NANANAShorter duration of abscess resolution in M + PA groupNANA
Tandon et al[92], IndiaMTZ (n = 14) and MTZ + PD (n = 15)> 5 cmBetter in MTZ + PD group (5.6 d vs 3.8 d; P < 0.05)Better in MTZ + PD group (P < 0.001)NASimilar between groupsShorter in MTZ + PD group (7.4 vs 5.8, P < 0.001)
de la Rey Nel et al[97], South AfricaMTZ (n = 43) and MTZ + PD (n = 37)NASimilar between groups (P > 0.05) Better in MTZ + PD group (6.9 ± 2.3 vs 4.5 ± 2.2, P < 0.05)No significant difference between groupsNANA
Table 2 Mortality rates of surgical versus non-surgical therapy in patients with amebic liver abscess with diffuse peritoneal rupture
Ref.nMedical therapy (n)Surgery (n)Medical therapy1
Surgery
Mortality (%)
Mortality (%)
Eggleston et al[104]19019-42
Memon et al[106]362016537.5
Sarda et al[107]1688050
Meng et al[40]11110050
Baijal et al[108]022-0-
Bhatia et al[109]43430-26
Priyadarshi et al[19]323200.3-
Greaney et al[105]20835020