Omentoplasty or tube drainage for the management of the residual cavity following the removal of an hepatic hydatid cyst.

We have reviewed a series of 124 consecutive cases of hepatic hydatid cysts in 102 patients treated surgically in Benghazi, Libya, over a period of five years. Overall mortality was 3.9%. The rate of post-operative complications was 37.5%. Cysts already complicated with infection, intrabiliary communication or intra-peritoneal rupture accounted for 30.6% of the cases. They were all treated by means of removing the endocyst and external tube drainage of the residual cavity. In this subgroup, the post-operative complications' rate was 89%. In the 74 uncomplicated cysts, removal of the parasite was followed by omentoplasty in 25 cases and external tube drainage in 49 cases. Postoperative complications occurred in 16% of the omentoplasty group and 8.2% of the drainage group. It is concluded that omentoplasty for the obliteration of the residual cavity may be used in uninfected and relatively inaccessible cysts. In the majority of cases, however, external tube drainage retains its value as a simple and safe procedure.