Scholarlink

Background <p>Acute diverticulitis with perforation and peritonitis is a serious complication affecting up&#xa0;to 12% of patients. Peritonitis is classified into purulent (Hinchey III) or fecal (Hinchey IV) categories. The standard treatment has traditionally involved emergency surgery, such as bowel resection with or without anastomosis or Hartmann’s procedure, both of which carry high morbidity and mortality risks.</p> Methods <p>In 2008, laparoscopic peritoneal lavage (LPL) emerged as a less invasive alternative for treating purulent peritonitis. This article outlines the LPL technique, emphasizing patient selection, procedural steps, and postoperative care.</p> Results <p>Several clinical trials have compared LPL to traditional resection methods. These trials show that while LPL is associated with lower stoma prevalence and shorter recovery times, it also carries a higher risk of reoperation and misdiagnosis, especially in cases of fecal peritonitis. Proper patient selection, such as excluding immunosuppressed patients and those with Hinchey IV peritonitis, and careful intraoperative assessment are crucial for successful outcomes. While LPL is not superior to resection, it is a viable alternative in select cases.</p> Conclusion <p> LPL offers a minimally invasive option for treating complicated diverticulitis in appropriately selected patients, though careful surgical expertise and patient-centered decision-making are essential to optimizing results.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Laparoscopic lavage: an option for surgical management of complicated diverticulitis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年3月26日

查看全文
  • Héloïse Giron,
  • Fabian Grass,
  • Dieter Hahnloser

摘要

Background

Acute diverticulitis with perforation and peritonitis is a serious complication affecting up to 12% of patients. Peritonitis is classified into purulent (Hinchey III) or fecal (Hinchey IV) categories. The standard treatment has traditionally involved emergency surgery, such as bowel resection with or without anastomosis or Hartmann’s procedure, both of which carry high morbidity and mortality risks.

Methods

In 2008, laparoscopic peritoneal lavage (LPL) emerged as a less invasive alternative for treating purulent peritonitis. This article outlines the LPL technique, emphasizing patient selection, procedural steps, and postoperative care.

Results

Several clinical trials have compared LPL to traditional resection methods. These trials show that while LPL is associated with lower stoma prevalence and shorter recovery times, it also carries a higher risk of reoperation and misdiagnosis, especially in cases of fecal peritonitis. Proper patient selection, such as excluding immunosuppressed patients and those with Hinchey IV peritonitis, and careful intraoperative assessment are crucial for successful outcomes. While LPL is not superior to resection, it is a viable alternative in select cases.

Conclusion

LPL offers a minimally invasive option for treating complicated diverticulitis in appropriately selected patients, though careful surgical expertise and patient-centered decision-making are essential to optimizing results.