Percutaneous catheter drainage versus needle aspiration for liver abscess: a systematic review and meta-analysis of efficacy and safety.

Abstract

Background: Percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) are the two primary image-guided interventions for liver abscesses. However, their comparative efficacy and safety profiles remain debated.

Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) directly comparing PCD and PNA in adults with liver abscesses. The primary outcomes were clinical treatment success rate and procedure-related complication rate. Data were pooled using random-effects models, and heterogeneity was assessed with the I2 statistic.

Results: Twelve RCTs involving 1425 patients were included. Meta-analysis showed that PCD was associated with a significantly higher treatment success rate compared to PNA [odds ratio (OR) = 4.12, 95% confidence interval (CI) = 2.01-8.45; P  < 0.001; I2  = 56%]. Subgroup analyses by abscess size and etiology confirmed the consistency of this benefit. There was no statistically significant difference in the overall complication rates between the two procedures (OR = 1.02, 95% CI = 0.30-3.50; P  = 0.97; I2  = 46%).

Conclusion: For the treatment of liver abscesses, PCD is superior to needle aspiration in achieving clinical success without increasing the risk of procedure-related complications. PCD should be considered the preferred percutaneous drainage technique.