To assess the effectiveness and safety of EUS-guided drainage of liver abscesses.

Retrospective analysis of treatment results of all patients with liver abscesses who underwent endoscopic treatment at the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum Nicolaus Copernicus University in Toruń, Poland in the years 2018–2025.

Endoscopic drainage was performed in 13 patients (9 men, 4 women; mean age 66.52 [42-78] years) with liver abscesses. 11/13 (84.62%) patients had a single abscess of the left liver lobe; the remaining 2/13 (15.38%) patients had a single abscess of the right liver lobe. The mean size of the liver abscess was 85 (52-132) mm. Each patient underwent ERCP with attempted transpapillary drainage of the abscess if the abscess communicated with the bile ducts. In 3/13 (23.08%) patients in whom contrast leakage from the bile ducts into the abscess cavity was detected during ERCP, active transpapillary drainage of the liver abscess was performed; in 1 patient, additional percutaneous drainage of the liver abscess was performed during transpapillary drainage of the liver abscess. The remaining 10/13 (76.92%) patients with left hepatic abscesses were qualified for transmural abscess drainage – active transgastric drainage of the abscess was performed under EUS guidance. The mean duration of active drainage of liver abscesses was 7 (5-16) days. Clinical success of endoscopic drainage of liver abscesses was achieved in 11/13 (84.62%) patients. The mean duration of endotherapy was 224 (67-459) days. The mean follow-up period was 882 (226-1446) days. Long-term success of endoscopic treatment of liver abscesses was achieved in 9/13 (69.23%) patients during the follow-up period.

Endoscopic drainage of liver abscesses seems an effective and safe treatment method. The preferred approach is anatomical transpapillary drainage of the abscess during ERCP. If transpapillary access to the abscess cavity is impossible, extraanatomic transmural drainage of the liver abscess is an effective treatment option, which is only possible for left lobe abscesses.