The Gupta-Akami technique for percutaneous drainage of superficial liver abscess: An indigeneous economic method for low resources setups.

Abstract

Objectives: Liver abscesses, which are purulent cavities within the liver, pose significant health challenges, particularly in developing countries where treatment resources are limited. Despite advancements in imaging and drainage technologies, conventional methods such as pigtail catheters and surgical interventions are often financially prohibitive and inaccessible in low-resource settings. This study proposes Gupta-Akami technique, an indigenous and economically viable method for percutaneous drainage, utilizes simple, readily available materials and offers a potential solution for these settings.

Material and methods: The study was conducted at a tertiary care hospital over a period of six months. It included 21 patients with liver abscesses meeting specific criteria (abscess volume >500 mL, intervening liver parenchyma <5 cm, and skin-to-abscess distance <10 cm).

Results: The average age of the patients was 45.6 years and there were more men than women. Most patients presented with fever and abdominal pain; nausea/vomiting was observed in the majority, and jaundice was noted in a few. Mean abscess volume was 890 mL. The procedure effectively drained over 87% of the abscess volume and only one patient requiring additional aspiration. Post-procedural pain decreased significantly from an average of 3.15 on a visual analog scale at 0 hours to 0.84 before discharge. The average hospital stay was 2.57 days. No complications or mortality were reported.

Conclusion: The Gupta-Akami technique demonstrates efficacy as a low-cost, accessible method for percutaneous drainage of liver abscesses in resource-limited settings. It offers a promising alternative to more expensive traditional methods, potentially improving patient outcomes and accessibility in low-resource environments.