Wang JH, Gao ZH, Qian HL, Li JS, Ji HM, Da MX. Treatment of pyogenic liver abscess by surgical incision and drainage combined with platelet-rich plasma: A case report. World J Clin Cases 2022; 10(20): 7082-7089 [PMID: 36051112 DOI: 10.12998/wjcc.v10.i20.7082]
Corresponding Author of This Article
Zhen-Hua Gao, Chief Doctor, Professor, Department of Hepatobiliary Surgery, The First People’s Hospital of Baiyin, No. 222 Silong Road, Baiyin District, Baiyin 730900, Gansu Province, China. 602148735@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2022; 10(20): 7082-7089 Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7082
Treatment of pyogenic liver abscess by surgical incision and drainage combined with platelet-rich plasma: A case report
Jun-Hong Wang, Zhen-Hua Gao, Hong-Liang Qian, Jin-Shun Li, Hao-Min Ji, Ming-Xu Da
Jun-Hong Wang, Ming-Xu Da, The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China
Jun-Hong Wang, Zhen-Hua Gao, Hong-Liang Qian, Jin-Shun Li, Hao-Min Ji, Department of Hepatobiliary Surgery, The First People’s Hospital of Baiyin, Baiyin 730900, Gansu Province, China
Ming-Xu Da, Department of General Surgery, People’s Hospital of Gansu Province, Lanzhou 730000, Gansu Province, China
Author contributions: Da MX contributed to conceptualization; Gao ZH, Qian HL, and Li JS collected the data; Wang JH and Ji HM performed the investigation; Da MX contributed to supervision; Wang JH analysed and interpreted the data; Wang JH and Gao ZH wrote the manuscript and contributed to drafting of the manuscript; Da MX, Gao ZH, and Wang JH reviewed and edited the final manuscript; all authors issued final approval for the version to be submitted.
Supported byScience and Technology Planning Project of Gansu Province, No. 21CX6FD163; Science and Technology Planning Project of Baiyin City, No. 2021-1-18Y.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-Hua Gao, Chief Doctor, Professor, Department of Hepatobiliary Surgery, The First People’s Hospital of Baiyin, No. 222 Silong Road, Baiyin District, Baiyin 730900, Gansu Province, China. 602148735@qq.com
Received: December 17, 2021 Peer-review started: December 17, 2021 First decision: January 26, 2022 Revised: February 10, 2022 Accepted: May 27, 2022 Article in press: May 27, 2022 Published online: July 16, 2022 Processing time: 199 Days and 13.9 Hours
Abstract
BACKGROUND
Pyogenic liver abscesses are insidious in the early stage. Some cases progress rapidly, and the patient’s condition can worsen and even become life-threatening if timely treatment is not provided. Surgery and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the lumen.
CASE SUMMARY
We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment, review the literature related to the use of platelet-rich plasma (PRP) in the treatment of hepatic impairment and partial hepatectomy in animals, and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver abscesses. This is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans, providing new ideas for the treatment of this condition.
CONCLUSION
This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed medically. PRP may produce antimicrobial effects and promote the regeneration and repair of liver tissue.
Core Tip: Previously, pyogenic liver abscesses were typically treated with antibacterial drugs, percutaneous puncture and drainage, or surgical incision and drainage; treatment by surgical incision and drainage combined with platelet-rich plasma (PRP) has not been reported. By reviewing the relevant literature and combining the previously reported benefits of PRP on liver function improvement and liver tissue regeneration and repair, we treated a large abscess with complete liquefaction and a poor response to antibacterial drug treatment by surgical incision and drainage combined with PRP at our hospital. The patient was discharged after 7 d of treatment without pus cavity flushing and with no recurrence during follow-up. Therefore, we consider that PRP may have direct antimicrobial and promotional effects on liver tissue regeneration, but this needs to be confirmed in a clinical case–control study with a larger sample.
