The role of omentoplasty in the surgical management of remnant cavity in hepatic hydatid cyst.

BACKGROUND: Cyst hydatid disease of the liver is still endemic in certain regions of the world. Currently, surgical operation remains the treatment of choice in hydatidosis. The cyst cavity can be managed by using capitonnage, external drainage, introflexion or omentoplasty.
METHODS: Two hundred and thirty-five patients operated for hydatid cyst between January 1990 and February 2001 were analysed retrospectively. Either omentoplasty, external drainage, capitonnage or introflexion were used to treat residual cyst cavity.
RESULTS: Patients were categorised into three groups to evaluate complications: omentoplasty alone (group A), omentoplasty combined with other techniques (group B) and other techniques (group C). The overall mortality rates were <1%. Overall morbidity rates were 8.8% for group A, 19% for group B and 25% for group C, respectively. Mean hospital stay was 7.6 days for group A, 11.9 days for group B and 15.8 days for group C. DISCUSSION: Postoperative surgical site infection, bile fistula, recurrence rate and overall morbidity were seen less frequently in patients who underwent omentoplasty in our series. Mean duration of hospital stay was significantly shorter in patients who underwent omentoplasty operations. Because omentum has a high absorptive capacity and the capability to fill the residual cavity, we recommend omentoplasty to manage patients with hydatid cyst of the liver, whether complicated or uncomplicated.