External Tube drainage Versus Omentoplasty In the Management of Residual Hepatic Hydatid Peri-cyst Cavity in Children.

Abstract

Introduction: Management of the residual pericyst cavity after hepatic hydatid cyst surgery is a major determinant of postoperative morbidity. Several options are available, but this aspect of treatment is not well studied in children. The aim of this study was to compare the outcome of external tube drainage (ETD) and omentoplasty (OP) in hepatic hydatid cyst residual cavity, the two most commonly used methods.

Material and Methods: This study was a prospective randomized study. Children with hydatid cyst liver were divided into two groups by simple randomization method. In one group ETD was performed and in another OP was done. The groups were matched for age, sex, location of cysts, number of cysts, size of cysts, type of cysts and methods of surgical access.

Results: Sixty patients were included in the study with 30 patients [total number of cysts (37)] in ETD group and 30 patients [total number of cysts (37)] in OP group. There was no statistically significant difference in mean operative time, return to full orals, ambulation and bowel movement. Pain scores were significantly lower in OP as compared to ETD. Hospital stay was comparatively less with OP. The overall complication rate was higher in ETD (36.6%) as compared to OP (13.3%).

Conclusion: Omentoplasty should remain the preferred option in the management of residual hepatic hydatid cyst cavity in children whenever possible as it is associated with short hospital stay, less post operative morbidity compared to external tube drainage.