Early experience with laparoscopic lavage in acute complicated diverticulitis

Area of Science:

• Gastroenterology
• Surgical Innovation
• Diverticular Disease Management

Background:

• Management of complicated diverticulitis remains debated, with traditional resection and colostomy contrasted against newer approaches like peritoneal lavage.
• Emerging techniques suggest peritoneal lavage and drainage without resection may be viable for purulent peritonitis secondary to diverticulitis.

Purpose of the Study:

• To evaluate the initial clinical experience and outcomes of laparoscopic peritoneal lavage for acute complicated diverticulitis.
• To assess the feasibility and efficacy of minimally invasive lavage and drainage as an alternative to resection.

Main Methods:

• A retrospective review was conducted on patients undergoing emergent peritoneal lavage and drainage for acute complicated diverticulitis.
• Data from 10 patients who received this treatment between 2007 and 2012 were analyzed.

Main Results:

• All 10 patients experienced resolution of acute symptoms following peritoneal lavage and drainage.
• Long-term follow-up revealed that 30% (3 out of 10) required subsequent elective resection due to symptomatic disease, including recurrent diverticulitis or fistula formation.

Conclusions:

• Laparoscopic peritoneal lavage is a viable treatment option for complicated diverticulitis presenting with purulent non-fecal peritonitis.
• A notable percentage of patients may necessitate elective resection later, highlighting the need for comparative studies with emergent resection to define its definitive role.