Makarov V. The optimization of surgical tactics and treatment of patients with liver abscesses

A total of 134 patients with liver abscesses (LA) were operated on, who were treated in the Department of Abdominal Surgery of Vinnytsia Regional Clinical Hospital. MI Pirogov from 2004 to 2020. Patients with LA were divided into the following groups: comparison group - 64 patients (47.7%) operated from 2004 to 2013, who underwent a standard set of examination and treatment; study group, the main, which was representative of the first by sex, age, causes and location of LA - 70 patients (52.3%) operated from 2014 to 2020. The developed diagnostic algorithm was used in working with patients of the study group and minimally invasive surgical methods of treatment with remediation of the abscess cavity with antiseptic agents were used. Evaluating the treatment results of patients with LA using the puncture, puncture-drainage techniques under ultrasonographic control, the optimal choice of antiseptic for the rehabilitation of the abscess cavity, it was found that in such patients the postoperative period was more favorable than in patients, who had not used the suggested techniques. The use of the suggested minimally invasive methods of surgery significantly (p < 0,05) allowed to reduce the number of postoperative complications from 48,3% to 13,5%, to reduce the length of hospital stay from 14,6 ± 1,4 to 5,2 ± 0,8 days and to reduce postoperative mortality from 7,8% to 2,8% in the main group of patients in contrast to the comparison group