Abstract: Objective The purpose of this study was to investigate efficacy of ultrasound (US)-guided catheter drainage in the treatment of patients with pyogenic liver abscess (PLA). Methods 91 patients with PLA were encountered in our hospital between January 2023 and June 2025, and were randomly assigned to underwent catheter drainage (CD) under US guidance in 45 cases or underwent puncture and aspiration (PAA) under US guidance in another 46 cases. Results Fever subsidence and abscess cavity closure times in CD-treated patients were(4.2±1.3)d and (10.7±2.8)d, both significantly shorter than [(5.8±1.6)d and (14.3±3.1)d, respectively, P<0.05], and puncture times, administration of antibiotics and defined daily doses (DDD) of antibiotics were (1.3±0.5)times, (12.1±3.0)d and (30.2±2.8), all significantly shorter or lower than [(3.1±1.0)times, (15.6±3.4)d and (44.8±5.5), respectively, P<0.05] in PAA-treated patients; by 24 hours and 3 days after operation, there were no significant differences as respect to visual analog scale (VAS) scores [(3.8±1.0)vs. (3.6±1.2) and (2.1±0.8)vs.(2.2±1.0)], or to physical performance measure / score by day 7 [(69.2±7.5) vs. (67.5±8.3), P>0.05] between the two groups, while hospital stay in CD-treated patients was (13.5±3.8)d, much shorter than [(15.7±4.6)d, P<0.05], and recurrence of abscess was 2.2%, much lower than 13.0% (P<0.05) in PAA-treated patients. Conclusion Ultrasound-guided puncture and catheter drainage is a safe and effective minimally invasive treatment for patients with PLA, which could significantly improve clinical symptoms subside, accelerate abscess cavity closure, with shorten antibiotic therapy and hospitalization.

Key words: Pyogenic liver abscess, Ultrasound guidance, Puncture and catheter drainage, Therapy