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Perforated diverticulitis managed by laparoscopic lavage.

Craig J Taylor1, Laurent Layani, Michael A Ghusn

  • 1John Flynn Gold Coast Hospital, Gold Coast, Queensland, Australia. ctaylor@keyholesurgery.org.au

ANZ Journal of Surgery
|October 24, 2006
PubMed
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Laparoscopic lavage and drainage offers a promising alternative for acute perforated diverticulitis, potentially avoiding colostomy. This minimally invasive approach showed positive outcomes in most patients, though resection remains necessary for severe cases.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Perforated diverticulitis traditionally managed with Hartmann's procedure, associated with high morbidity and colostomy.
  • Laparoscopic lavage and drainage presents a novel approach to acute management.

Purpose of the Study:

  • To evaluate the early experience and outcomes of laparoscopic lavage and drainage for acute perforated diverticulitis.

Main Methods:

  • Retrospective review of patients with surgically confirmed perforated diverticulitis.
  • Investigation of clinical presentation, operative findings, and patient outcomes.
  • Analysis of laparoscopic lavage and drainage as primary treatment.

Main Results:

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  • 14 patients (mean age 57.2) with peritonitis and sepsis treated with laparoscopic lavage and drainage.
  • 79% of patients improved and were discharged; 3 required acute resection.
  • Subsequent elective resection was performed in 8 patients, often laparoscopically.

    • Conclusions:

    • Laparoscopic lavage and drainage is a viable alternative to Hartmann's procedure for acute perforated diverticulitis.
    • Resection is indicated for faecal peritonitis or treatment failure.
    • This approach may reduce morbidity and avoid colostomy.