Early experience with laparoscopic lavage in acute complicated diverticulitis

Nir Horesh, Andrew P. Zbar, Avinoam Nevler, Nadav Haim, Mordechai Gutman, Oded Zmora

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Contemporary surgical management of complicated diverticulitis is controversial. Traditionally, the gold standard has been resection and colostomy, but recently peritoneal lavage and drainage without resection in cases of purulent peritonitis have been suggested. This study aims to review our initial experience with laparoscopic peritoneal lavage for complicated diverticulitis. Methods: Retrospective review of all patients who underwent emergent peritoneal lavage and drainage for acute complicated diverticulitis. Results: Five-hundred-thirty-eight patients admitted for acute diverticulitis between 2007 and 2012 were recorded in the database. Thirty seven underwent emergent surgery of which 10 had peritoneal lavage and drainage without colonic resection for complicated diverticulitis causing peritonitis. Peritoneal lavage and drainage resulted in the resolution of acute symptoms in all cases. In long-term follow-up, 3 (30%) patients required elective resection owing to symptomatic disease, two of these due to recurrent diverticulitis, and one owing to complicated fistula following the procedure. Conclusion: Peritoneal lavage is a feasible option for complicated diverticulitis with purulent non-fecal peritonitis, but a significant portion of the patients may require elective resection. Comparative studies with emergent resection are needed to determine the role of peritoneal lavage in complicated diverticulitis.

Original languageEnglish
Pages (from-to)108-111
Number of pages4
JournalDigestive Surgery
Volume32
Issue number2
DOIs
StatePublished - 27 Apr 2015

Keywords

  • Colonic perforation
  • Diverticulitis
  • Emergency surgery
  • Peritoneal lavage

Fingerprint

Dive into the research topics of 'Early experience with laparoscopic lavage in acute complicated diverticulitis'. Together they form a unique fingerprint.

Cite this