Document Type : Original Article
Authors
1
Departments of Surgery, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Egypt.
2
Departments of Surgery, National Hepatology and Tropical Medicine Research Institute (NHTMRI).+
3
Faculty of Medicine, Helwan University, Egypt.
4
Departments of Surgery, National Hepatology and Theodor Bilharz Research Institute, Egypt.
5
Departments of Tropical Medicine4, and Diagnostic, NHTMRI, Egypt.
6
Departments of Diagnostic and interventional Radiology, NHTMRI, Egypt.
Abstract
Hydatid disease is a worldwide zoonosis caused by the larval stage of the echinococcus tapeworm, that is endemic in many parts of the world (in Europe, Middle East, Mediterranean, South American and African countries). Hydatid disease is a relevant health problem in underdeveloped areas where veterinary control does not exist. The most frequent location of hydatid cystic lesions is the liver (up to 80% of cases), followed by the lung (about 20% of cases), and with a lower reported incidence in any other organ or tissue in the body. Currently, surgical operation remains the treatment of choice in hydatidosis. Many surgical options can be done for management of the cyst, ranging from unroofing of the cyst, pericystectomy, up to liver resection for the affected liver parenchyma site. The cyst cavity can be managed by different techniques, capitonnage, external drainage, introflexion or omentoplasty. The Omentoplasty (OP) filling technique was the method of choice for filling of the Residual Cavity (RC). The omentoplasty filling was done by two procedures Pedicle Omental Pack (POP), and Isolated Omental Pack (IOP); both techniques were applied for the filling of the residual cavity compared to non-filling of the residual cavity after surgery, in our retrospective comparative multicenter study. Seventy six patients operated for hydatid cyst between January 2010 and February 2014 were analysed retrospectively. Either with or without filling of the cavity, and either the filling was with pedicle or isolated omentoplasty were used to treat the residual cyst cavity. Patients were categorised into three groups to evaluate complications: without filling of the RC (GA), omentoplasty filling with Pedicle Omental Pack (GB), and omentoplasty filling with Isolated Omental Pack (GC). The overall mortality rates were 0%. Overall morbidity rates were 57.1% for GA, and 10.3% for GB, and 7.7% for GC respectively. Mean hospital stay was 11.8 days for GA, and 8.1 days for GB, and 8.7 days for GC. The isolated omentoplasty filling technique is a safe management in the filling of the residual cavity after surgery with less operative time and same result as pedicle omentoplasty technique. Because of omentum has a high absorptive capacity and capable to fill the residual cavity, and omentoplasty was recommended (whether with pedicle or isolated omental flap) to manage patients with hydatid cyst of the liver.
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