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[Therapy concepts for diffuse peritonitis: When laparoscopic lavage and when open abdomen?].

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Diffuse peritonitis treatment strategies are under review. Surgical approach depends on sepsis severity, patient factors, and comorbidities, not solely on technique.

Keywords:
Diffuse peritonitisLaparoscopyLaparostomy registryLavageOpen abdomen

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Area of Science:

  • Surgical Gastroenterology
  • Critical Care Medicine

Background:

  • Secondary diffuse peritonitis presents significant morbidity and mortality.
  • Current surgical strategies are being critically evaluated for efficacy.

Purpose of the Study:

  • To review current therapeutic methods for diffuse peritonitis.
  • To critically assess the evidence-based data for various surgical approaches.

Main Methods:

  • Evidence-based review of surgical therapies for diffuse peritonitis.
  • Comparison of laparoscopic lavage versus damage control surgery.
  • Analysis of data for minimally invasive techniques in specific conditions.

Main Results:

  • Evidence for minimally invasive therapy is robust for appendicitis, cholecystitis, and ulcerated perforation.
  • Evidence for laparoscopy and minimally invasive surgery in secondary peritonitis is improving but not conclusive.
  • Surgical decision-making is influenced by sepsis severity, duration, patient age, and comorbidities.

Conclusions:

  • The choice of surgical procedure for diffuse peritonitis should prioritize patient-specific factors.
  • Further evidence is needed to definitively recommend specific minimally invasive techniques for secondary peritonitis.