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Benefits of laparoscopic peritoneal lavage for complicated sigmoid diverticulitis.

Abstract：

BACKGROUND:The traditional therapy for perforated sigmoid diverticulitis with peritonitis is emergency colectomy usually with colostomy. We report laparoscopic exploration with peritoneal lavage as an alternative in seven patients who required emergency surgery for diverticulitis. METHODS:Six patients presented with diffuse peritonitis and one with a failure of percutaneous therapy. All patients were explored laparoscopically and the peritoneal cavity was lavaged with saline in addition to receiving intravenous antibiotics. Patient demographics, clinical response, length of stay, and complications were recorded. RESULTS:Six patients had resolution of peritonitis resolved and patients were discharged from the hospital. One of these patients who developed a pelvic abscess required a percutaneous drainage postoperatively. This patient ultimately returned 3 months later with recurrent symptoms and underwent colectomy with primary anastomosis. One patient failed to improve initially and underwent colectomy with primary anastomosis on the same admission. Five patients subsequently had elective sigmoid resections, four laparoscopic and one open. Mean length of stay was 7.7 days. There was no mortality. CONCLUSION:We conclude that laparoscopic exploration and peritoneal lavage can be performed safely in patients with diffuse, purulent peritonitis. Using this approach, most patients with purulent peritonitis can avoid emergent laparotomy with the risk of colostomy, and the need for a second surgery.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Favuzza J,Friel JC,Kelly JJ,Perugini R,Counihan TC

doi

10.1007/s00384-009-0641-2

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

797-801

issue

7

eissn

0179-1958

issn

1432-1262

journal_volume

24

pub_type

杂志文章

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