Management of Acute Diverticulitis: Role of Minimally Invasive Surgery versus Nonoperative Management

Acute diverticulitis (AD) is the most common complications of diverticular disease. AD can present with a spectrum of symptoms, ranging from mild, self-limiting inflammation to severe peritonitis. A paradigm shift in the treatment of uncomplicated diverticulitis has been noted, with cumulating evidence challenging the routine use of antibiotics. High-quality evidence suggests that antibiotics may be safely omitted in healthy patients with mild AD. Nonetheless, surgery remains the mainstay treatment of patients with generalized peritonitis or recurrent, debilitating disease. In summary, current guidelines recommend an individualized approach to AD, balancing disease severity, comorbidities, quality of life, and patient preference in decision-making.