External tube drainage versus omentopexy in the management of residual hepatic hydatid cyst cavity

Abstract

Aim of this study:Our study is confined to the out come of management of the residual cavity of liver hydatid cysts. Background: Hydatid is a Latin word meaning a drop of water .The causative organism of Hydatid disease is the post-larval metacestode stage of tape worm Echinococcus granulosus has world-wide distribution .Despite the clinical presentation the disease is to be diagnosed and treated at the earliest because the complications of cysts like infection, rupture, biliary obstruction and anaphylaxis may be life-threatening. Patient and methods: A prospective study conducted at the department of surgery at Al Sader teaching hospital from the first of December 2008 to the end of October 2009 and included 77 patients have liver hydatid cysts divided into two groups. The residual cavity at the first group (42 patients) was managed by tube drainage procedure while the others (35 patients) managed by omentopexy procedure. Results: There were 53 females and 24 males in this study .The mean age is (32 years). The peak age incidence from (20-29 years) .Post operative bile leakage was found (9) folds more in patients treated with external tube drain than in patients treated with omentopexy gives high statistical significance between them P value =0.0027 The mean hospital stay was longer for external drainage technique in comparison to Omentopexy group and for complicated cases than uncomplicated cases.Conclusion : There is no single approach to deal with residual cavity of hydatid cysts of liver, and every case should has its individual way of intervention, we conclude that omentopexy has less morbidity, shorter hospital stay and it is the best technique in managing both complicated and uncomplicated hepatic hydatid cysts. Key words: hydatid cyst, residual cavity, omentoplasty