External Tube Drainage Versus Omentopexy In The Management Of Residual Hepatic Hydatid Cyst Cavity

Hydatid disease is a parasitic disease of worldwide distribution. Seventy-five per cent of all hydatid cysts are found in the liver. Patients may be asymptomatic for years and usually present with non-specific complaints. The principles of surgical management of hepatic echinococcosis include neutralization of parasites, evacuation of cyst, removal of germinal lining and management of the residual cavity. Our study is confined to the management of the residual cavity, carried over a period of four years with further follow-up for a period of three years. We divided the patients into two groups of 65 patients each. In one group 1, the residual cavity was managed with external tube drainage and in group 2 the residual cavity was managed by omentopexy. The results of the procedures were compared with each other as for time duration for surgery, intraoperative complications, postoperative complications and hospital stay. In the patients managed by external tube drainage, the average operation time was 1 hour and 45 minutes, hospital stay was 10-12 days, and prolonged tube drainage was seen in 9 patients (14%), while in patients managed by omentopexy average operation time was only 1 hour and 35 minutes, hospital stay was 8-10 days and none of the patients had prolonged drainage. Recurrence was seen in 8 patients (12%) managed with external tube drainage, while none of the patients managed with omentopexy had any recurrence of disease.