Omentoplasty Versus Tube Drainage for Residual Cavity Management in Complicated Hepatic Cystic Echinococcosis

This prospective comparative study evaluated two surgical techniques for residual cavity management following conservative surgery for complicated hepatic cystic echinococcosis. Patients undergoing surgery were managed with either omentoplasty or tube drainage. The study aimed to compare postoperative outcomes between the two techniques, with particular emphasis on postoperative complications and residual cavity-related complications. Long-term follow-up was also performed to assess recurrence and other clinical outcomes.

Inclusion Criteria: * Age 18-80 years. * Complicated hepatic cystic echinococcosis requiring surgical treatment. * Cyst diameter ≥8 cm. * Cysts located in hepatic segments IV, V, VI, VII, or VIII. * WHO-IWGE CE2 or CE3b cyst stage. * Presence of at least one complication or high-risk feature, including rupture, adjacent organ involvement, cholangitis, biliary communication, or cyst infection. * ASA physical status ≤III. Exclusion Criteria: * WHO-IWGE CE1 or CE3a cyst stage. * Cysts located in hepatic segments I, II, or III. * Extensive multiple hepatic cysts. * Previous surgery for hepatic cystic echinococcosis. * Malignancy. * Pregnancy. * ASA physical status \>III.