Clinical outcomes of conservative management, percutaneous needle aspiration, and catheter drainage in liver abscess: A prospective observational study

Background: Liver abscess remains a significant health concern in India, with management strategies depending on clinical presentation and imaging findings. Aims and Objectives: This study aimed to evaluate outcomes of conservative management, percutaneous needle aspiration (PNA), and percutaneous catheter drainage (PCD) in patients with liver abscess. Materials and Methods: A prospective observational study was conducted on 70 patients over 2 years. Patients were managed using three different modalities: Conservative management, PNA, and PCD, depending on clinical and radiological findings. Clinical outcomes such as symptom relief, reduction in leukocyte count, and volume of abscess cavity were assessed. Duration of hospital stay, need for re-intervention, recurrence within 1 month, and procedure-related complications were also assessed. Results: The majority of patients were males (84.3%) with a mean age of 44.3 years. Amoebic etiology was most common (67%). Right lobe and solitary abscesses predominated. The PCD provided the fastest symptom resolution (43.3% by day 1), shortest hospital stay (5.1 days) and lowest recurrence 4%. PNA resulted in maximum abscess volume reduction (84.7%). Conservative management showed slower recovery and higher recurrence (15%). Conclusion: Management based on abscess characteristics yields favorable outcomes. PCD is preferred for large, complex abscesses; PNA is suitable for moderate, liquefied lesions, while conservative therapy is appropriate for small, uncomplicated abscesses.