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Laparoscopic Approach to Pyogenic Liver Abscess

NCT ID: NCT07303829

Last Updated: 2025-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2027-01-01

Brief Summary

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Assess the efficacy and safety of laparoscopic management of liver abscess in achieving complete drainage and clinical recovery compared to conventional open or percutaneous methods, and to:

1. To evaluate postoperative complications and recurrence rates.
2. To compare hospital stay, recovery time, and overall morbidity.
3. To determine patient outcomes and cost-effectiveness of laparoscopic intervention.

Detailed Description

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Liver abscess is a localized collection of pus within the liver parenchyma, most commonly resulting from bacterial or amoebic infection. It remains a serious clinical condition requiring timely diagnosis and effective management to prevent complications such as sepsis or rupture. Traditionally, open surgical drainage was the standard treatment for complicated or multiloculated abscesses and in cases where percutaneous drainage failed. However, advances in minimally invasive surgery have introduced laparoscopic drainage as a safer and more efficient alternative.

Laparoscopic management offers several advantages, including smaller incisions, reduced postoperative pain, shorter hospital stays, and faster recovery compared to open surgery. Moreover, it allows direct visualization of the abscess cavity, facilitates breaking of loculations, debridement of necrotic tissue, and precise placement of drainage catheters. These features enhance the completeness of drainage and reduce recurrence rates.

Recent studies have demonstrated the efficacy of laparoscopic drainage, particularly in large, complex, or multiloculated liver abscesses where percutaneous methods are unsuccessful or contraindicated. A meta-analysis of 17 studies involving 608 patients reported a recurrence rate of only 4.22% with no procedure-related mortality in the laparoscopic group. Consequently, laparoscopic drainage is now considered a step-up approach in the management algorithm of liver abscess, bridging the gap between percutaneous and open surgical techniques, while ensuring optimal clinical outcomes and reduced morbidity.

Conditions

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Liver Abscess, Pyogenic

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Laproscopic managment

Group Type EXPERIMENTAL

Laproscopic

Intervention Type DEVICE

Laparoscopic management uses minimally invasive trocar access with camera-guided drainage and debridement, allowing precise abscess evacuation, reduced tissue trauma, faster recovery, and lower postoperative pain compared with open surgery or percutaneous drainage used in other studies.

Interventions

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Laproscopic

Laparoscopic management uses minimally invasive trocar access with camera-guided drainage and debridement, allowing precise abscess evacuation, reduced tissue trauma, faster recovery, and lower postoperative pain compared with open surgery or percutaneous drainage used in other studies.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Adults ≥18 years.
2. Radiologically confirmed liver abscess (US/CT/MRI).
3. Abscess requiring drainage ≥5 cm,
4. Failed or contraindicated percutaneous drainage.
5. Recurrence after percutaneous drainage.

Exclusion Criteria

1. Adults ≥18 years.
2. Radiologically confirmed liver abscess (US/CT/MRI).
3. Abscess requiring drainage ≥5 cm,
4. Failed or contraindicated percutaneous drainage.
5. Recurrence after percutaneous drainage.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Ebram Nashat Bastawroos Zakaria

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

References

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Ndong A, Tendeng JN, Diallo AC, Dieye A, Diao ML, Diallo S, Diop S, Diallo MK, Diedhiou M, Fall ML, Ma Nyemb PM, Konate I. Efficacy of laparoscopic surgery in the treatment of hepatic abscess: A systematic review and meta-analysis. Ann Med Surg (Lond). 2022 Jan 31;75:103308. doi: 10.1016/j.amsu.2022.103308. eCollection 2022 Mar.

Reference Type RESULT
PMID: 35198179 (View on PubMed)

Teresi JA, Yu X, Stewart AL, Hays RD. Guidelines for Designing and Evaluating Feasibility Pilot Studies. Med Care. 2022 Jan 1;60(1):95-103. doi: 10.1097/MLR.0000000000001664.

Reference Type RESULT
PMID: 34812790 (View on PubMed)

Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res. 2016 Jun;25(3):1057-73. doi: 10.1177/0962280215588241. Epub 2015 Jun 19.

Reference Type RESULT
PMID: 26092476 (View on PubMed)

Julious SA. Sample size of 12 per group rule of thumb for a pilot study. Pharm Stat. 2005;4(4):287-291.

Reference Type RESULT

International Journal of Surgery. Laparoscopic Drainage of Pyogenic Liver Abscess: A Feasible Alternative. https://www.ijsurgery.com/index.php/isj/article/view/9473

Reference Type RESULT

Bansal V, et al. Systematic Review of Laparoscopic Drainage of Liver Abscess. Cureus. 2022;14(2):e22045. https://pmc.ncbi.nlm.nih.gov/articles/PMC8850317

Reference Type RESULT

Saravanan R, et al. Comparative Study of Laparoscopic Versus Open Surgical Drainage in Pyogenic Liver Abscess. SAR J Surg. 2024. https://sarpublication.com/media/articles/SARJS_62_10-14.pdf

Reference Type RESULT

Medscape. Liver Abscess Treatment & Management. https://emedicine.medscape.com/article/188802-treatment

Reference Type RESULT

Other Identifiers

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LMPLA

Identifier Type: -

Identifier Source: org_study_id