A consecutive series of 227 patients with hydatid disease of the liver is reported. During the first period when marsupialization or drainage of the cyst was applied, long hospitalization and bilious leakage were reported. During the second period omentoplasty superseded the above methods. As a result, hospitalization was lowered from 36 or 52 to 12 days, while the incidence of biliary leakage was minimized from 25.2 or 60.7 per cent to 2.5 per cent respectively. The overall mortality is about 3.5 per cent. Consequently omentoplasty is considered the treatment of choice when dealing with hydatid cyst of the liver. Marsupialization or partial hepatectomy is the alternative for huge, infected cysts. ECHINOCOCCOSIS is a well‐known disease, but its surgical treatment has markedly changed during the past years. The word ‘echinococcus’ is Greek in origin and means ‘hedgehog berry’. Hydatid disease of the liver was known to Hippocrates, who refers to a ‘liver full of water’. It was not until 1782 that Goeze recognized microscopically the small taenias with their characteristic hooklets. Since then numerous reports have made absolutely clear both the pathology and epidemiology of the disease. In Greece, with a population of up to 8 million, an average of 500 cases yearly are reported, i.e., a frequency of 6 per 100,000 inhabitants (Toole, 1969).

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