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Background: Surgical procedures advocated for management of residual hepatic hydatid cyst cavity have been a subject of controversy. The aim of this study was to compare omentoplasty (OP) and external tube drainage (ETD).
Material and methods: This was a prospective randomized controlled study conducted on radiologically documented cases of hepatic...
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... the management of residual cavity patients were randomly allocated into two groups. This randomization was done by a computer-generated chart ( Figure 1). ETD was done in Group I (28 patients) by using a 22 F Foley's two-way catheter [Polymedicure Ltd., Faridabad, IN] placed in the cyst cavity and exteriorized through a sep- arate skin wound or any of the laparoscopic port sites. ...
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Citations
... Due to the risk of stenosis and associated complications in the biliary duct, we decided to not use the T-tube placement technique. While omentoplasty to the cyst cavity could be an effective technique, complication rates have been reported to range from 13% to 89% [13]. Simply filling the cavity with omentum without securing the biliary orifices does not entirely preclude the risk of BF or cavity infections [10]. ...
Bile leakage is a common complication following liver surgeries, particularly in the cases of liver hydatid cyst operations. Currently, there is no adequate method which could be utilized to prevent this complication effectively. Our study aimed to assess the efficacy of the biliary lipid test (BLT) in reducing biliary complications after hydatid cyst surgery. We retrospectively included patients who underwent open liver hydatid cyst surgery between January 2011 and January 2024. The study encompassed 122 patients, with 41 males and 81 females, ranging in age from 18 to 79 years. In the BLT group, a lipid solution was injected transcystically after cholecystectomy. The BLT was performed on 65 patients, while 57 patients did not undergo the test. Following the transcystic injection of the lipid solution, orifices at the site of lipid droplets that became visible were ligated with 5.0 prolene sutures. A total of 200 leak sites were sutured. Notably, none of the patients in the BLT group experienced postoperative bile leakage. Consequently, a shorter hospital stay was observed in this group. Transcystic injection of the lipid solution with distal clamping effectively demonstrated leak sites, and suturing these sites prevented postoperative bile leakage. Our study demonstrates the effectiveness of the LIpid test in LIver Hydatid Cyst Surgery (Lili-Hics) in reducing biliary complications following hydatid cyst surgery.
... Twenty-six studies on liver surgery were included [56,58,60,62,64,66,69,71,73,75,77,79,81,83,85,87,89,91,93,95,97,99,101,103,105,107] , with the majority of surgical interventions relating to hepatic hydatid cysts. This study included 1994 individuals, 1056 of whom had omentoplasty and 938 did not. ...
... Igami et al. [73] 2011 20 20 Li et al. [74] 2022 69 69 Kayaalp et al. [75] 2002 16 51 Lin et al. [76] 2017 91 27 Kouraklis et al. [77] 2005 33 12 Lo et al. [78] 2011 47 26 Manterola et al. [79] 2013 48 40 Matsuda et al. [80] 2012 157 72 Muftuoglu et al. [81] 2005 156 32 Naga et al. [82] 2020 50 50 Nanashima et al. [83] 2012 14 65 Nasiri et al. [84] 2017 62 62 Okano et al. [85] 2013 25 25 Negm et al. [86] 2022 50 50 Ozacmak et al. [87] 2000 35 73 Nosrati et al. [88] 2021 100 101 Panaro et al. [89] 2014 62 50 Ölmez et al. [90] 2019 243 46 Paquet et al. [91] 2000 87 80 Pan et al. [92] 2020 49 30 Pechlivanides et al. [93] 1991 95 57 Pilone et al. [94] 2019 96 90 Reza Mousavi et al. [95] 2005 35 30 Rosso et al. [96] 2012 33 28 Takatsuki et al. [97] 2021 50 13 Sabry and Qassem [98] 2018 1000 1000 Tsaroucha et al. [99] 2005 25 32 Shah et al. [100] 2015 101 46 Wani et al. [101] 2013 22 28 Smith D [102] 2018 77 17 Xu S [103] 2020 25 24 Tangtawee et al. [104] 2021 34 34 Zaouche et al. [105] 2001 28 49 Tani et al. [106] 2012 699 1679 a This review included 25 324 patients from 92 studies, among which 9701 patients underwent omentoplasty. In the esophageal surgery group, a total of 1177 patients underwent omentoplasty while 1005 did not. ...
... Igami et al. [73] 2011 20 20 Li et al. [74] 2022 69 69 Kayaalp et al. [75] 2002 16 51 Lin et al. [76] 2017 91 27 Kouraklis et al. [77] 2005 33 12 Lo et al. [78] 2011 47 26 Manterola et al. [79] 2013 48 40 Matsuda et al. [80] 2012 157 72 Muftuoglu et al. [81] 2005 156 32 Naga et al. [82] 2020 50 50 Nanashima et al. [83] 2012 14 65 Nasiri et al. [84] 2017 62 62 Okano et al. [85] 2013 25 25 Negm et al. [86] 2022 50 50 Ozacmak et al. [87] 2000 35 73 Nosrati et al. [88] 2021 100 101 Panaro et al. [89] 2014 62 50 Ölmez et al. [90] 2019 243 46 Paquet et al. [91] 2000 87 80 Pan et al. [92] 2020 49 30 Pechlivanides et al. [93] 1991 95 57 Pilone et al. [94] 2019 96 90 Reza Mousavi et al. [95] 2005 35 30 Rosso et al. [96] 2012 33 28 Takatsuki et al. [97] 2021 50 13 Sabry and Qassem [98] 2018 1000 1000 Tsaroucha et al. [99] 2005 25 32 Shah et al. [100] 2015 101 46 Wani et al. [101] 2013 22 28 Smith D [102] 2018 77 17 Xu S [103] 2020 25 24 Tangtawee et al. [104] 2021 34 34 Zaouche et al. [105] 2001 28 49 Tani et al. [106] 2012 699 1679 a This review included 25 324 patients from 92 studies, among which 9701 patients underwent omentoplasty. In the esophageal surgery group, a total of 1177 patients underwent omentoplasty while 1005 did not. ...
Background
Omentoplasty is commonly used in various surgeries. However, its effectiveness is unsure due to lack of convincing data and research. To clarify the impact of omentoplasty on postoperative complications of various procedures, this systematic review and meta-analysis was performed.
Methods
A systematic review of published literatures from four databases: PubMed, Web of Science, Cochrane Library, and Embase before July 14, 2022. We primarily included publications on five major surgical operations performed in conjunction with omentoplasty: thoracic surgery, esophageal surgery, gastrointestinal surgery, pelvi-perineal surgery, and liver surgery. The protocol was registered in PROSPERO.
Results
This review included 25 273 patients from 91 studies (n=9 670 underwent omentoplasty). Omentoplasty was associated with a lower risk of overall complications particularly in gastrointestinal (RR 0.53; 95%CI 0.39-0.72) and liver surgery (RR 0.54; 95%CI 0.39-0.74). Omentoplasty reduced the risk of postoperative infection in thoracic (RR 0.38; 95%CI 0.18-0.78) and liver surgery (RR 0.39; 95%CI 0.29-0.52). In patients undergoing esophageal (RR 0.89; 95%CI 0.80-0.99) and gastrointestinal (RR 0.28; 95%CI 0.23-0.34) surgery with a BMI greater than 25, omentoplasty is significantly associated with a reduced risk of overall complications compared to patients with normal BMI. No significant differences were found in pelvi-perineal surgery, except infection in patients whose BMI ranged from 25 kg/m ² to 29.9 kg/m ² (RR 1.25; 95%CI 1.04-1.50) and anastomotic leakage in patients aged over 60 (RR 0.59; 95%CI-0.39-0.91).
Conclusion
Omentoplasty can effectively prevent postoperative infection. It is associated with a lower incidence of multiple postoperative complications in gastrointestinal and liver surgery.
... One of the key points of the operation is how to dispose of the communication of cysts and biliary tracts. Suturing the bile fistula during operation is efficient prevention, but for some concealed bile fistula or residual cavity with the potential risk of bile leakage, packing with greater omentum can be used for prevention and treatment, which could absorb the liquid in the residual cavity and accelerate the healing of residual cavity and biliary fistula (19,21,22). In this case, we used greater omentum packing combined with negative pressure suction to prevent and treat postoperative biliary leakage and obtained significant effect, accumulating relevant experience consequently. ...
We report a case of a male patient who presented with multiple abdominal and pelvic echinococcosis. The patient had been diagnosed with hepatic echinococcosis for 7 years and developed intermittent distension and discomfort in the upper abdomen after an accidental fall. In recent years, the patient’s abdominal distention increased gradually. Computed tomography revealed multiple hydatid cysts in the liver, spleen, abdominal cavity, and pelvic cavity. Abdominal organs were severely compressed, such that he could not eat normally except for a liquid diet. The patient underwent radical surgical resection based on the multi-disciplinary treatment (MDT) and the operation lasted 10 h, nearly 100 hydatid cysts were excised, about 18 liters of cyst fluid and cyst contents were removed, and the patient lost 20 kg of weight after surgery. The operation was successful, but there were still some postoperative complications such as hypovolemic shock, postoperative ascites, postoperative bile leakage. Treatment measures for the patient were anti-infection, antishock, clamping the abdominal drainage tube, and negative pressure abdominal puncture drainage. At follow up the patient’s quality of life had been significantly improved with 15 kg weight gain compared to before.
... Comparisons were made in terms of biliary fistula and cavity infection. In general, the risk of biliary fistula and cavity infection was lower in capitonnage than tube drainage and omentoplasty compared to capitonnage (66)(67)(68)(69)(70). ...
Objectives:
Cystic Echinococcosis (CE) is one of the important problems of the Eurasian region. We aimed to prepare a consensus report in order to update the treatment approaches of this disease. This study was conducted by Turkish HPB Surgery Association.
Material and methods:
This study was conducted with the modified Delphi model. For this purpose, we conducted a three-stage consensus-building approach.
Results:
Six topics, including diagnosis, medical treatment, percutaneous treatment, surgical treatment, management of complications and posttreatment follow-up and recurrences in HCE were discussed.
Conclusion:
The expert panel made recommendations for every topic.
... In 71.43% of operated patients, omentoplasty was applied to close the residual cavity, ending in a smooth postoperative period without bile leakage or infection. Omentoplasty vs. tube drainage can be used even for [19,[23][24][25]. ...
Echinococcosis is a parasitic infestation with high prevalence in Iraq. Surgical treatment remains the standard gold method for treating this disease. The selection of surgical approach depends on the general condition of the patient and characters of the cyst, e.g., size, location, number of cysts, intraoperative findings, and complications such as adhesion , bile leakage, and bleeding. Our study aimed (1) to summarize the most common surgical approaches for treating liver hydatid cyst (HC) in our locality, and (2) to highlight common intraoperative and postoperative complications and the duration of hospital stay. We analyzed the clinical data of 42 patients operated for liver HC. We found that the highest incidence rate of HC was anatomically in the right hepatic lobe with or without synchronous cysts in other organs. The most frequent type of surgery was partial pericystectomy with external tube drainage (ETD) or simple endocystectomy with omentoplasty and ETD. The most important intraoperative finding was cystic-biliary communication. The majority of patients had uneventful postoperative recovery. There is no standardized surgical procedure for hepatic HC. The surgical technique should be modified according to the cyst size, anatomic location of cyst/cysts, number of cysts, cystobiliary communications, cystic infection, and the presence of extrahepatic hydatid cyst or cysts. The surgeon's experience plays a vital role in selecting the surgical technique for hepatic hydatid cystectomy.
... The management of the residual cavity after the hydatid cyst removal of the liver remains a matter of contention, with most authorities indicating external tube drainage (ETD) and omentoplasty (OP) as the procedures of choice [39]. Because of the high absorptive capacity of the omentum and its ability to fill the residual cavity, omentoplasty is recommended for the treatment of hepatic hydatid cysts, both complicated and uncomplicated [40]. ...
Introduction:
There still exist controversies about the advantages and disadvantages of laparoscopic and traditional open surgery.
Aim:
This meta-analysis aimed to compare the efficacy and safety of laparoscopic versus traditional laparotomy in hepatic cystic hydatidosis.
Material and methods:
A systematic literature search was conducted for studies about liver hydatid surgery. After the quality assessment and relevant data extraction, the article was screened and included according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software.
Results:
Thirteen studies included 1211 cases, 362 in the laparoscopic group, and 849 in the open surgery group. According to meta-analysis, laparoscopic surgery is superior to traditional open surgery in terms of length of hospital stay, the recovery time of gastrointestinal function, total complications, and the risk of incision infection. There were no significant differences between laparoscopic surgery and traditional open surgery in operation time, postoperative time of abdominal drainage tube removal, recurrence rate, bile leakage rate, biliary fistula rate, and residual cavity infection rate.
Conclusions:
Laparoscopy is superior to traditional open surgery in terms of length of hospital stay, the recovery time of gastrointestinal function, total complications, and the risk of incision infection. There was no significant difference in postoperative recurrence between laparoscopy and open surgery. In addition, we think laparoscopy can achieve the same clinical effect as laparotomy. However, the reliability and validity of our conclusion need to be verified by more randomized controlled trials (RCTs).
... Omental packing could reduce morbidity due to the physiologic characteristics of the momentum. In fact it reduces intra abdominal infection and postoperative biliary fistula [42]. ...
Background
The purpose of the present paper is to assess the morbidity specifics risk factors of hepatic hydatid cyst after conservative surgery.
Methods
We conducted a retrospective study of 102 patients over a period of 13 years, from 2006 to 2019. We included all patients operated on hydatid cyst of the liver, complicated and uncomplicated, in the Department of General Surgery in Tahar Sfar hospital, Mahdia, Tunisia. We excluded patients who received an exclusive medical treatment and those who have other hydatic cyst localizations.
Results
The cohort was composed of 102 patients with a total of 151 cysts operated on using conservative surgery, among them there was 75 women (73.5%) and 27 men (26.5%). The median age was 43, with extremes ranging from 12 to 88 years. The majority of patients (94.1%) were from rural areas. The cysts were uncomplicated in about half of the cases (48%), elsewhere complications such as compression of neighboring organs (25.5%), opening in the bile ducts (16.7%), infection (9.8%), and rupture in the peritoneum (2%) were found. Conservative surgery was the mainstay of treatment with an overall mortality rate of 1.9%. The overall morbidity rate was 22%: 14% specific morbidity and 8% non-specific morbidity. External biliary fistula was the most common postoperative complication (9%). The predictive factors of morbidity in univariate analysis were: preoperative hydatid cyst infection (P = 0.01), Compressive cysts (P = 0.05), preoperative fever and jaundice, (respectively P = 0.03 and P = 0.02), no one achieved statistical significance in the multivariate model.
Conclusions
Preoperative hydatid cyst infection, compressive cysts and preoperative fever and jaundice could be predictor factors of morbidity after conservative surgery for liver hydatid cyst. They must be considered in the treatment and the surgical decision for patients with hydatid cyst.
... Omentoplasty could reduce morbidity due to the physiologic characteristics of resorption and the macrophage phagocytose of the momentum .In fact it reduces intra abdominal infection and postoperative biliary stula [34] Capitonnage could erase the residual cavity by closing it wall one against the other .It could help to reduce the consequences of kysto-biliairy stula [35] . ...
Background: Hepatic hydatid cyst is an endemic parasitosis in Tunisia. Although most of these cysts are benign; their treatment may lead to several complications which can cause an important post-operative morbidity and mortality.
The purpose of the present paper is to assess the morbidity and mortality specifics risk factors of hepatic hydatid cysts after conservative surgery.
Methods:
We conducted a retrospective study of 102 patients over a period of 13 years, from 2006 to 2019. We included all patients operated on for hydatid cyst of the liver, complicated and uncomplicated, in the Department of General Surgery of Mahdia, Tunisia.
We excluded patients who received an exclusive medical treatment and those who have other hydatic cyst localizations.
Descriptive statistics,bivariate analysis using chi-squared test and Fisher’s exact test for categorical variables;t-test,ANOVA , and Kruskal–Wallis for continuous variables; odds ratio calculations, ordinal and multivariate logistic regression models were applied
Results: The cohort was composed of 102 patients with a total of 151 cysts operated on using conservative surgery, among them there was 75 women (73, 5%) and 27 men (26.5%). The median age was 43, with extremes ranging from 12 to 88 years. The majority of patients (94. 1%) were from rural areas. The cysts were uncomplicated in about half of the cases (48%), elsewhere complications such as compression of neighboring organs (25,5%), opening in the bile ducts (16,7%), infection (9,8%), and rupture in the peritoneum (2%) were found. Conservative surgery was the mainstay of treatment with an overall mortality rate of 1. 9%. The overall morbidity rate was 22%: 14% specific morbidity and 8% non-specific morbidity. External biliary fistula was the most common postoperative complication (9%). The predictive factors of morbidity in univariate analysis were Preoperative hydatid cyst infection (P = 0.01), Compressive cysts (P=0.05), preoperative fever and jaundice, (respectively P=0. 03 and P=0. 02), no one achieved statistical significance in the multivariate model
Conclusions:
Preoperative hydatid cyst infection, compressive cysts and preoperative fever and jaundice are significant predictor factors of morbidity after conservative surgery for liver hydatid cyst. They must be considered in the treatment and the surgical decision for patients with hydatid cyst.
... [17,18] In two studies by Ozacmak et al. and Wani et al. comparing the omentoplasty with external drainage, it was concluded that omentoplasty was the better method due to fewer side effects and shorter hospital stay. [2,19] Furthermore, in a study comparing capitonnage and external drainage by Mehrabi Bahar et al., the postoperative complications were less observed in the capitonnage group. [20] Furthermore, in a study by Panteleyev, omentoplasty and capitonnage did not have any superiority to each other. ...
Background:
Surgery is one of the treatments commonly used to treat liver hydatid cyst. Remaining of the residual cavity after conservative surgery may lead to some harmful complications. In this study, we evaluated the role of different factors affecting the disappearance of the residual cyst.
Materials and methods:
Seventy-five patients were evaluated in 2.5 years. Patients were divided into two groups based on the remaining or disappearance of the residual cavity in follow-up visits. The baseline demographic features, preoperative cysts' size, type of technique used to eliminate the residual cavity, and cavity wall characteristics were compared in the two groups.
Results:
Residual cavity was disappeared in 46 (61%) patients after 2 years. Calcification of the wall and wall stiffness were more common in patients with the remained residual cavity (89.6% vs. 8.7% [P < 0.001] and 58.6% vs. 30.4% [P < 0.01], respectively). Demographic features, preoperative cysts' characteristics, and the procedure used during surgery were not statistically different between groups.
Conclusions:
Cyst wall calcification and wall stiffness had a role in predicting residual cavity disappearance. These factors can help surgeons to predict patients at higher risk of posthydatid cyst resection residual cavity.
... [19,20] In our study, we found that the average hospital stay and average days taken to resume normal routine work were both shorter in omentoplasty group as compared to drainage procedure group. Similar findings were reported by Akin et al., [21] Gourgiotis, [22] and Wani et al. [23] In our study, complication rate and formation of the biliary fistula was high in drainage procedure group as compared to omentoplasty group. Similar findings were noted by Reza Mousavi et al. [4] and Wani et al. [23] in their studies. ...
... Similar findings were reported by Akin et al., [21] Gourgiotis, [22] and Wani et al. [23] In our study, complication rate and formation of the biliary fistula was high in drainage procedure group as compared to omentoplasty group. Similar findings were noted by Reza Mousavi et al. [4] and Wani et al. [23] in their studies. The longer stay, longer work resuming time, and high infection rate can be explained by additional tube drain in the abdomen in drainage procedure which interfered with early ambulation, and the drain can be important factor in the entrance of microorganisms into the peritoneum, thus increasing peritoneal infections. ...
... [24] An important finding which we noted in our study is high recurrence rate in case of tube drainage procedure. This finding was also noted by Wani et al. [23] in their study. This decreased risk of recurrence can be attributed to protective properties of omentum, assistance in healing of raw surface and promoting resorption of serosal fluid. ...
