Omentoplasty, also called omentopexy or omental packing, is the only cavitymanagement technique that has a preventive effect on postoperative biliary leakage, biliary fistula, and deep cavity abscess, as proved by prospective randomized studies. After unroofing the residual cavity, a pedunculated omental flap with a good blood supply is fashioned and drawn up into the cavity to obliterate the dead space, and the flap is maintained in position without tension with sutures to the pericystic wall. Omentum has a natural absorptive capacity, which decreases the risk of infection and minimizes fistula formation.
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