Skip to main content

Advertisement

SpringerLink
Log in

The Bucharest ESTES consensus statement on peritonitis

  • Guideline
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

Peritonitis is still an important health problem associated with high morbidity and mortality. A multidisciplinary approach to the management of patients with peritonitis may be an important factor to reduce the risks for patients and improve efficiency, outcome, and the cost of care.

Methods

Expert panel discussion on Peritonitis was held in Bucharest on May 2017, during the 17th ECTES Congress, involving surgeons, infectious disease specialists, radiologists and intensivists with the goal of defining recommendations for the optimal management of peritonitis.

Conclusion

This document is an updated presentation of management of peritonitis and represents the summary of the final recommendations approved by a panel of experts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wittmann DH. Intra-abdominal infection. World J Surg. 1990;14:145–7.

    CAS  Google Scholar 

  2. Sartelli M, Catena F, Ansaloni L, Moore E, Malangoni M, Velmahos G, Coimbra R, Koike K, Leppaniemi A, Biffl W, Balogh Z, Bendinelli C, Gupta S, Kluger Y, Agresta F, di Saverio S, Tugnoli G, Jovine E, Ordonez C, Gomes CA, Pereira GA, Yuan KC, Bala M, Peev MP, Cui Y, Marwah S, Zachariah S, Sakakushev B, Kong V, Ahmed A, Abbas A, Teixeira Gonsaga RA, Guercioni G, Vettoretto N, Poiasina E, Ben-Ishay O, Díaz-Nieto R, Massalou D, Skrovina M, Gerych I, Augustin G, Kenig J, Khokha V, Tranà C, Yuh Yen Kok K, Chichom Mefire A, Lee JG, Hong SK, Segovia Lohse HA, Ghnnam W, Verni A, Lohsiriwat V, Siribumrungwong B, Tavares A, Baiocchi GL, Das K, Jarry J, Zida M, Sato N, Murata K, Shoko T, Irahara T, Hamedelneel AO, Naidoo N, Kayode Adesunkanmi AR, Kobe Y, Attri AK, Sharma R, Coccolini F, El Zalabany T, Al Khalifa K, Sanjuan J, Barnabé R, Ishii W. Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study). World J Emerg Surg. 2013;8:1.

    Google Scholar 

  3. Sartelli M, Catena F, Ansaloni L, et al. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study. World J Emerg Surg. 2012;7:36. https://doi.org/10.1186/1749-7922-7-36.

    Article  Google Scholar 

  4. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche J-D, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, der Poll T, Vincent J-L, Angus DC. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10. https://doi.org/10.1001/jama.2016.0287.

    Article  CAS  Google Scholar 

  5. Meakins JL, Solomkin JS, Allo MD, Dellinger EP, Howard RJ, Simmons RL. A proposed classification of intra-abdominal infections. Stratification of etiology and risk for future therapeutic trials. Arch Surg. 1984;119:1372–8.

    CAS  Google Scholar 

  6. Dellinger EP, Wertz MJ, Meakins JL, Solomkin JS, Allo M, Howard RJ, Simmons RL. Surgical infection stratification system for intraabdominal infection. Arch Surg. 1985;120:21–9.

    CAS  Google Scholar 

  7. Christou NV, Barie PS, Dellnger EP, Waymach JP, Stone HH. Surgical infection society. Intra-abdominal infection study. Arch Surg. 1993;128:193–9.

    CAS  Google Scholar 

  8. Bosscha K, Reijinders K, Hulstaert PF, Algra A, van der Werken C. Prognostic scoring systems to predict outcome in peritonitis and intra-abdominal sepsis. Br J Surg. 1997;84:1532–4.

    CAS  Google Scholar 

  9. Hinchey EJ, Schaal PH, Richards MB. Treatment of perforated diverticular disease of the colon. Adv Surg. 1978;12:85–109.

    CAS  Google Scholar 

  10. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM. Thijs LG The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22:707–10.

    CAS  Google Scholar 

  11. Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL. Sibbald WJ Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638–52.

    CAS  Google Scholar 

  12. Le Gall JR, Klar J, Lemeshow S, Saulnier F, Alberti C, Artigas A, Teres D. ICU Scoring Group The logistic organ dysfunction system: a new way to assess organ dysfunction in the intensive care unit. JAMA. 1996;276:802–10.

    Google Scholar 

  13. Bernard GR, Doig BG, Hudson G, Lemeshow S, Marshall S, Russell JC, Sibbald J, Sprung CL, Vincent JL. Wheeler AP quantification of organ failure for clinical trials and clinical practice (abstract). Am J Respir Crit Care Med. 1995;151:A323.

    Google Scholar 

  14. Hebert PC, Drummond AJ, Singer J, Bernard GR, Russell JA. A simple multiple system organ failure scoring system predicts mortality of patients who have sepsis syndrome. Chest. 1993;104:230–5.

    CAS  Google Scholar 

  15. Wacha H, Linder MM, Feldman U, Wesch G, Gundlach E, Steifensand RA. Mannheim peritonitis index—prediction of risk of death from peritonitis: construction of a statistical and validation of an empirically based index. Theor Surg. 1987;1:169–77.

    Google Scholar 

  16. Billing A, Frollich D. Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Br J Surg. 1994;81:209–13.

    CAS  Google Scholar 

  17. Grunau G, Heemken R, Hau T. Predictors of outcome in patients with postoperative intra-abdominal infection. Eur J Surg. 1996;162:619–25.

    CAS  Google Scholar 

  18. Muralidhar VA, Madhu CP, Sudhir S, Stimivasarangan M. Efficacy of Mannheim Peritonitis Index (MPI) Score in patients with secondary peritonitis. J Clin Diagn Res. 2014;8(12):1–3.

    Google Scholar 

  19. Zeitoun G, Laurent A, Rouffet F, Hay JM, Fingerhut A, Paquet JC, Peillon C, French Association for Research in Surgery. Multicentre, randomized clinical trial of primary versus secondary sigmoid resection in generalized peritonitis complication sigmoid diverticulitis. Br J Surg. 2000;87:1366–74.

    CAS  Google Scholar 

  20. Chang R, Holcomb JB. Choice of fluid therapy in the initial management of sepsis, severe sepsis, and septic shock. Shock. 2016;46(1):17–26. https://doi.org/10.1097/SHK.0000000000000577.

    Article  Google Scholar 

  21. Finfer S, Liu B, Taylor C, Bellomo R, et al. Resuscitation fluid use in critically ill adults; an international cross-sectional study in 391 intensive care units. Crit Care. 2010;14:R185.

    Google Scholar 

  22. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):762–74.

    CAS  Google Scholar 

  23. Rivers EP, et al. Early interventions in severe sepsis and septic shock: a review of the evidence one decade later. Minerva Anesthesiol. 2012;78:712–24.

    CAS  Google Scholar 

  24. Trof RJ, Sukul SP, Twist JWR, et al. Greater cardiac response of colloid than saline fluid lading in septic and non-septic critically il patients with clinical hypovolaemia. Intensive Care Med. 2010;36:697–701.

    CAS  Google Scholar 

  25. Perel P, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2012;6:CD000567.

    Google Scholar 

  26. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017. https://doi.org/10.1007/s00134-017-4683-6.

    Article  Google Scholar 

  27. Frazee E, Kashani K. Fluid management for critically ill patients: a review of the current state of fluid therapy in the intensive care unit. Kidney Dis (Basel). 2016;2(2):64–71. https://doi.org/10.1159/000446265 (Epub 2016 May 18).

    Article  Google Scholar 

  28. De Waele J, Lipman J, Sakr Y, Marshall JC, Vanhems P, Barrera Groba C, Leone M, Vincent JL. Abdominal infections in the intensive care unit: characteristics, treatment and determinants of outcome. BMC Infect Dis. 2014;14:420. https://doi.org/10.1186/1471-2334-14-420.

    Article  Google Scholar 

  29. Puskarich MA, Trzeciak S, Shapiro MI, et al. Association between timing of antibiotic administration and mortality from septic shock inpatients treated with a quantitative resuscitation protocol. Crit Care Med. 2011;39:2066–71.

    CAS  Google Scholar 

  30. Ibrahim EH, Sherman G, Ward S, et al. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000;118:146–55.

    CAS  Google Scholar 

  31. Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, Moore FA, Velmahos G, Coimbra R, Ivatury R, Peitzman A, Koike K, Leppaniemi A, Biffl W, Burlew CC, Balogh ZJ, Boffard K, Bendinelli C, Gupta S, Kluger Y, Agresta F, Di Saverio S, Wani I, Escalona A, Ordonez C, Fraga GP, Junior GA, Bala M, Cui Y, Marwah S, Sakakushev B, Kong V, Naidoo N, Ahmed A, Abbas A, Guercioni G, Vettoretto N, Diaz-Nieto R, Gerych I, Trana C, Faro MP, Yuan KC, Kok KY, Mefire AC, Lee JG, Hong SK, Ghnnam W, Siribumrungwong B, Sato N, Murata K, Irahara T, Coccolini F, Segovia Lohse HA, Verni A, Shoko T. 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2013;8:3. https://doi.org/10.1186/1749-7922-8-3.

    Article  Google Scholar 

  32. Mazuski J, et al. The surgical infection society revised guidelines on the management of intra-abdominal infection. Surg Infect. 2017;18:1–76.

    Google Scholar 

  33. Rimola A, Garcia Tsao G, Navasa M. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. J Hepatol. 2000;32:142–53.

    CAS  Google Scholar 

  34. StuartS Booth TC, Cash CJ. Complications of continuous ambulatory peritoneal dialysis. Radiographics. 2009;29:441–60.

    Google Scholar 

  35. Bodmann KF, Grabien B, et al. Recommendations of the Paul-Ehrlich-society for chemotherapy for the empirical antimicrobial treatment of severe infections of adults. Chemother J. 2010;19:217–22.

    Google Scholar 

  36. Kumar A, Safdar N, Kethireddy S, et al. A survival benefit of combination antibiotic therapy for serious infections associated with sepsis and septic shock is contingent only of death: a meta-analytic/metaregression study. Crit Care Med. 2010;38(1651–1664):87.

    Google Scholar 

  37. Dupont H. The empiric treatment of nosocomial intra-abdominal infections. Int J Infect Dis. 2007;11:S1–6.

    Google Scholar 

  38. Eckmann C, Dryden M, Montravers P, et al. Antimicrobial treatment of complicated intra-abdominal infections and the new IDSA guidelines—a commentary and an alternative European Approach according to clinical definitions. Eur J Med Res. 2011;16:115–26.

    Google Scholar 

  39. Ling-Shan S, Yen-Hsu C, Wen-Chien K. New drugs for the treatment of complicated intra-abdominal infections in the era of increasing antimicrobial resistance. Int J Antimicrobial Agents. 2016;47:250–8.

    Google Scholar 

  40. Heyland DK, MacDonald S, Keefe L, et al. Total parenteral nutrition in the critically ill patient: a metaanalysis. JAMA. 1998;280:2013–9.

    CAS  Google Scholar 

  41. Rhodes A, Evans L, Waleed A, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock. Intensive Care Med. 2016;17:4683–6.

    Google Scholar 

  42. Chou R, Gordon DB, De Leon Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine and the American Society of Anesthesiologists Committee on Regional Anesthesia, Executive Committee and Administrative Council. J Pain. 2016;17:131–57.

    Google Scholar 

  43. Lamb CM, MacGoey P, Navarro AP, Brooks AJ. Damage control surgery in the era of damage control resuscitation. Br J Anaesth. 2014;113(2):242–9.

    CAS  Google Scholar 

  44. Weber DG, Bendinelli C, Balogh ZJ. Damage control surgery for abdominal emergencies. BJS. 2014;101:e109–18.

    CAS  Google Scholar 

  45. Chovanes J, Cannon JW, Nunez TC. The evolution of damage control surgery. Surg Clin N Am. 2012;92:859–75.

    Google Scholar 

  46. Leppäniemi A, Kimball EJ, De Laet I, Malbrain MLNG, Balogh ZJ, De Waele JJ. Management of abdominal sepsis—a paradigm shift? Anaesthesiol Intensive Ther. 2015;47(4):400–8.

    Google Scholar 

  47. Regner JL, Kobayashi L, Coimbra R. Surgical strategies for management of the open abdomen. World J Surg. 2012;36:497–510.

    Google Scholar 

  48. Waibel BH, Rotondo MF. Damage control for intra-abdominal sepsis. Surg Clin N Am. 2012;92:243–57.

    Google Scholar 

  49. Waibel BH, Rotondo MM. Damage control surgery: its evolution over the last 20 years. Rev Col Bras Cir. 2012;39:314–21.

    Google Scholar 

  50. Higa G, Friese R, O’Keeffe T, Wynne J, Bowlby P, Ziemba M, et al. Damage control laparotomy: a vital tool once overused. J Trauma. 2010;69:53–9.

    Google Scholar 

  51. Quyn AJ, Johnston C, Hall D, et al. The open abdomen and temporary abdominal closure systems—historical evolution and systematic review. Colorectal Dis. 2012;14(8):e429–38.

    CAS  Google Scholar 

  52. van Boele HP, Wind J, Dijkgraaf MG, Busch OR, Goslings JC. Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg. 2009;33(2):199–207. https://doi.org/10.1007/s00268-008-9867-3.

    Article  Google Scholar 

  53. Brock WB, Barker DE. Burns RPTemporary closure of open abdominal wounds: the vacuum pack. Am Surg. 1995;61(1):30–5.

    CAS  Google Scholar 

  54. Kubiak BD, Albert SP, Gatto LA, et al. Peritoneal negative pressure therapy prevents multiple organ injury in a chronic porcine sepsis and ischemia/reperfusion model. Shock. 2010;34:525–34. https://doi.org/10.1097/SHK.0b013e3181e14cd2.

    Article  CAS  Google Scholar 

  55. Cheatham ML, Demetriades D, Fabian TC, et al. A prospective study examining clinical outcomes associated with a negative pressure wound therapy system and Barker’s vacuum packing technique. World J Surg. 2013;37:2018–30. https://doi.org/10.1007/s00268-013-2080-z.

    Article  Google Scholar 

  56. Andrew W, Kirkpatrick AW, Roberts DJ, Faris PD, Ball CG, Kubes P, Tiruta C, Xiao Z, Holodinsky JK, McBeth PB, Doig CJ, Jenne CN. Active negative pressure peritoneal therapy after abbreviated laparotomy: the intraperitoneal vacuum randomized controlled trial. Ann Surg. 2015;262:38–46.

    Google Scholar 

  57. Petersson U, Acosta S, Björck M. Vacuum-assisted wound closure and mesh-mediated fascial traction—a novel technique for late closure of the open abdomen. World J Surg. 2007;31(11):2133–7.

    Google Scholar 

  58. Liu QX, Min JX, Deng XF, Dai JG. Is hand sewing comparable with stapling for anastomotic leakage after esophagectomy? A meta-analysis. World J Gastroenterol. 2014;20(45):17218–26.

    Google Scholar 

  59. Ryan CE, Paniccia A, Meguid RA, et al. Transthoracic anastomotic leak after esophagectomy: current. Trends Ann Surg Oncol. 2017;24:281–90.

    Google Scholar 

  60. Schaheen L, Blackmon SH, Nason KS. Optimal approach to the management of intrathoracic esophageal leak following esophagectomy: a systematic review. Am J Surg. 2014;208:536–43.

    Google Scholar 

  61. Zhou C, Ma G, Li X, et al. Is minimally invasive esophagectomy effective for preventing anastomotic leakages after esophagectomy for cancer? A systematic review and meta-analysis. Am J Surg. 2014;208:536–43.

    Google Scholar 

  62. Zehetner J, DeMeester SR, Alicuben ET, et al. Intraoperative assessment of perfusion of the gastric graft and correlation with anastomotic leaks after esophagectomy. Ann Surg. 2015;262(1):74–8.

    Google Scholar 

  63. van Boeckel A, Sijbring A, Vleggar FP, Siersema PD. Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus. Aliment Pharmacol Ther. 2011;33(12):1292.

    Google Scholar 

  64. Kim J, Azagury D, Eisenberg D, et al. American Society for Metabolicand Bariatric Surgery Clinical Issues Committee. Surg Obes Relat Dis. 2015;11:739–48.

    Google Scholar 

  65. Baker RS, Foote J, Kemmeter P, Brady R, et al. The science of stapling and leaks. Obes Surg. 2004;14(10):1290–8.

    Google Scholar 

  66. Gagner M, Buchwald JN. Comparison of laparoscopic sleeve gastrectomy leak rates in four staple-line reinforcement options: a systematic review. Surg Obes Relat Dis. 2014;10(4):713.

    Google Scholar 

  67. Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy. Systematic review and analysis if 9991 cases. Ann Surg. 2013;257(2):231.

    Google Scholar 

  68. Johansson M, Thune A, Nelvin L, Stiernstam M, Westman B, Lundell L. Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis. Br J Surg. 2005;92(1):44–9.

    CAS  Google Scholar 

  69. Banz V, Gsponer T, Candinas D, Güller U. Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy. Ann Surg. 2011;254(6):964–70.

    Google Scholar 

  70. Al-Jundi W, Cannon T, Antakia R, Anoop U, Balamurugan R, Everitt N, Ravi K. Percutaneous cholecystostomy as an alternative to cholecystectomy in high risk patients with biliary sepsis: a district general hospital experience. Ann R Coll Surg Engl. 2012;94(2):99–101.

    CAS  Google Scholar 

  71. Winbladh A, Gullstrand P, Svanvik J, Sandström P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB (Oxford). 2009;11(3):183–93.

    Google Scholar 

  72. Derici H, Kara C, Bozdag AD, Nazli O, Tansug T, Akca E. Diagnosis and treatment of gallbladder perforation. World J Gastroenterol. 2006;12(48):7832–6.

    Google Scholar 

  73. Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, Fan ST, Yokoyama Y, Crawford M, Makuuchi M, Christophi C, Banting S, Brooke-Smith M, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey J-N, Greig P, Rees M, Nimura Y, Figueras J, DeMatteo RP, Büchler MW, Büchler MW, Weitz J. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery. 2011;149(5):680–8.

    Google Scholar 

  74. Canena J, Horta D, Coimbra J, Meireles L, Russo P, Marques I, Ricardo L, Rodrigues C, Capela T, Carvalho D, Loureiro R, Dias AM, Ramos G, Coutinho AP, Romão C, Veiga PM. Outcomes of endoscopic management of primary and refractory postcholecystectomy biliary leaks in a multicentre review of 178 patients. BMC Gastroenterol. 2015;15:105. https://doi.org/10.1186/s12876-015-0334-y(Published online 2015 Aug 19).

    Article  Google Scholar 

  75. van Lent AU, Bartelsman JF, Tytgat GN, Speelman P, Prins JM. Duration of antibiotic therapy for cholangitis after successful endoscopic drainage of the biliary tract. Gastrointest Endosc. 2002;55:518–22.

    Google Scholar 

  76. Kiriyama S, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Pitt HA, Gouma DJ, Garden OJ, Buchler MW, Yokoe M, Kimura Y, Tsuyuguchi T, Itoi T, Yoshida M, Miura F, Yamashita Y, Okamoto K, Gabata T, Hata J, Higuchi R, Windsor JA, Bornman PC, Fan S-T, Singh H, de Santibanes E, Gomi H, Kusachi S, Murata A, Chen X-P, Jagannath P, Lee S, Padbury R, Chen M-F, Dervenis C, Chan ACW, Supe AN, Liau K-H, Kim M-H, Kim S-W. TG13 guidelines for diagnosis and severity grading of acute cholangitis. J Hepatobiliary Pancreat Sci. 2013;20:24–34.

    Google Scholar 

  77. Hui CK, Lai KC, Yuen MF, Ng M, Lai CL, Lam SK. Acute cholangitis—predictive factors for emergency ERCP. Aliment Pharmacol Ther. 2001;15(10):1633–7.

    CAS  Google Scholar 

  78. Kumar R, Sharma BC, Singh J, Sarin SK. Endoscopic biliary drainage for severe acute cholangitis in biliary obstruction as a result of malignant and benign diseases. J Gastroenterol Hepatol. 2004;19(9):994–7.

    Google Scholar 

  79. Lee JG. Diagnosis and management of acute cholangitis. Nat Rev Gastroenterol Hepatol. 2009;6(9):533–41.

    Google Scholar 

  80. Mulier S, Penninckx F, Verwaest C, Filez L, Aerts R, Fieuws S, Lauwers P. Factors affecting mortality in generalized postoperative peritonitis: multivariate analysis in 96 patients. World J Surg. 2003;27(4):379–84.

    Google Scholar 

  81. Sartelli M, Viale P, Koike K, Pea F, Tumietto F, van Goor H, Guercioni G, Nespoli A, Tranà C, Catena F, Ansaloni L, Leppaniemi A, Biffl W, Moore FA, Poggetti R, Pinna AD, Moore EE. WSES consensus conference: guidelines for firstline management of intra-abdominal infections. World J Emerg Surg. 2011;6:2.

    Google Scholar 

  82. Kirkpatrick AW, Baxter KA, Simons RK, Germann E, Lucas CE, Ledgerwood AM. Intra-abdominal complications after surgical repair of small bowel injuries: an international reiew. J Trauma. 2003;55(3):399–406.

    Google Scholar 

  83. Ayite A, Dosseh DE, Tekou HA, James K. Surgical treatment of singl non traumatic perforation of small bowel: excision-suture or resectionanastomosis. Ann Chir. 2005;131(2):91–5 (EL 3b).

    Google Scholar 

  84. Sinha R, Sharma N, Joshi M. Laparoscopic repair of small bowel perforation. JSLS. 2005;9:399–402.

    Google Scholar 

  85. De Graaf JS, van Goor H, Blechrodt RP. Primary small bowel anastomosis in generalized peritonitis. Eur J Surg. 1996;162(1):55–8.

    Google Scholar 

  86. Malik AM, Laghari AA, Mallah Q, Qureshi GA, Talpur AH, Effendi S, et al. Different surgical options and ileostomy in typhoid perforation. World J Med Sci. 2006;1:112–6.

    Google Scholar 

  87. Fatima J, Baron TH, Topazian MD, Houghton SG, Iqbal CW, Ott BJ, Farley DR, Farnell MB, Sarr MG. Pancreaticobiliary and duodenal perforations after periampullary endoscopic procedures: diagnosis and management. Arch Surg. 2007;142(5):448–54 (discussion 454–5).

    Google Scholar 

  88. Pokala N, Sadhasivam S, Kiran RP, Parithivel V. Complicated appendicitis—is the laparoscopic approach appropriate? A comparative study with the open approach: outcome in a community hospital setting. Am Surg. 2007;73(8):737–41 (discussion 741–2).

    Google Scholar 

  89. Lim SG, Ahn EJ, Kim SY, Chung IY, Park JM, Park SH, Choi KW. A clinical comparison of laparoscopic versus open appendectomy for complicated appendicitis. J Korean Soc Coloproctol. 2011;27(6):293–7. https://doi.org/10.3393/jksc.2011.27.6.293Epub 2011 Dec 31.

    Article  Google Scholar 

  90. Fingerhut A. Conversion from open to laparoscopic treatment of peritonitis: “Reversed Conversion” Revisited. Surg Innov. 2011;XX:1–3.

    Google Scholar 

  91. Markides G, Subar D, Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis. World J Surg. 2010;34(9):2026–40. https://doi.org/10.1007/s00268-010-0669-z.

    Article  Google Scholar 

  92. Wullstein C, Barkhausen S, Gross E. Results of laparoscopic vs. conventional appendectomy in complicated appendicitis. Dis Colon Rectum. 2001;44(11):1700–5.

    CAS  Google Scholar 

  93. Schrenk P, Rieger R, Shamiyeh A, Wayand W. Diagnostic laparoscopy through the right lower abdominal incision following open appendectomy. Surg Endosc. 1999;13:133–5.

    CAS  Google Scholar 

  94. Navez B, Delgadillo X, Cambier E, Richir C, Guiot P. Laparoscopic approach for acute appendicular peritonitis:efficacy and safety. A report of 96 consecutive cases. Surg Laparosc Endosc Percutan Tech. 2001;11:313–6.

    CAS  Google Scholar 

  95. Senekjian L, Nirula R. Tailoring the operative approach for appendicitis to the patient: a prediction model from national surgical quality improvement program data. J Am Coll Surg. 2013;216:34–40.

    Google Scholar 

  96. Thereaux Jeremie, Veyrie Nicolas, Corigliano Nicola, Servajean Stephane, Czernichow Sebastien, Bouillot Jean-Luc. Is laparoscopy a safe approach for diffuse appendicular peritonitis? Feasibility and determination of risk factors for post-operative intra-abdominal abscess. Surg Endosc. 2014;28:1908–13. https://doi.org/10.1007/s00464-013-3412-7.

    Article  Google Scholar 

  97. Thomson JE, Kruger D, Jann-Kruger C, Kiss A, Omoshoro-Jones JA, Luvhengo T, Brand M. Laparoscopic versus open surgery for complicated appendicitis: a randomized controlled trial to prove safety. Surg Endosc. 2015;29(7):2027–32. https://doi.org/10.1007/s00464-014-3906-y(Epub 2014 Oct 16).

    Article  Google Scholar 

  98. Stöltzing H, Thon K. Perforated appendicitis: is laparoscopic operation advisable? Dig Surg. 2000;17(6):610–6.

    Google Scholar 

  99. Mancini GJ, Mancini ML, Nelson HS Jr, Crass RA, Namias N, Haller JA Jr, Ballinger JF. Efficacy of laparoscopic appendectomy in appendicitis with peritonitis. Am Surg. 2005;71(1):1–5.

    Google Scholar 

  100. Tan K-K, Hong C-C, Zhang J, Liu JZ, Sim R. Surgery for perforated colorectal malignancy in an Asian population: an institution’s experience over 5 years. Int J Colorectal Dis. 2010;25:989–95. https://doi.org/10.1007/s00384-010-0945-2.

    Article  Google Scholar 

  101. Zielinski MD, Merchea A, Heller SF, Nancy Y. You emergency: management of perforated colon cancers: how aggressive should we be? J Gastrointest Surg. 2011;15:2232–8. https://doi.org/10.1007/s11605-011-1674.

    Article  Google Scholar 

  102. Song P, Qin K, Chu X, Li S. Different site, different clinical outcomes in perforated colorectal cancer? Int J Colorectal Dis. 2016;31:1517–8. https://doi.org/10.1007/s00384-016-2534-5.

    Article  Google Scholar 

  103. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Google Scholar 

  104. Asano H, Kojima K, Ogino N, Fukano H, Ohara Y, Shinozuka N. Postoperative recurrence and risk factors of colorectal cancer perforation. Int J Colorectal Dis. 2017;32:419–24. https://doi.org/10.1007/s00384-016-2694-3.

    Article  Google Scholar 

  105. Buchs NC, Gervaz P, Secic M, et al. Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study. Int J Colorectal Dis. 2008;23:265–70.

    Google Scholar 

  106. Gessler Bodil, Eriksson Olle, Angenete Eva. Diagnosis: treatment, and consequences of anastomotic leakage in colorectal surgery. Int J Colorectal Dis. 2017;32:549–56. https://doi.org/10.1007/s00384-016-2744-x.

    Article  Google Scholar 

  107. Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery. 2010;147(3):339–51.

    Google Scholar 

  108. Hirst NA, Tiernan JP, Millner PA, et al. Systematic review of methods to predict and detect anastomotic leakage in colorectal surgery. Color Dis. 2014;16(2):95–109.

    CAS  Google Scholar 

  109. Blumetti Jennifer, Chaudhry Vivek, Cintron Jose R, Park John J, Marecik Slawomir, Harrison Jacqueline L, Prasad Leela M, Abcaria Herand. Management of anastomotic leak: lessons learned from a large colon and rectal surgery training program. World J Surg. 2014;38:985–91. https://doi.org/10.1007/s00268-013-2340-y.

    Article  Google Scholar 

  110. Krarup PM, Jorgensen LN, Harling H. Management of anastomotic leakage in a nationwide cohort of colonic cancer patients. J Am Coll Surg. 2014;218(5):940–9.

    Google Scholar 

  111. Chopra SS, Mrak K, Hunerbein M. The effect of endoscopic treatment on healing of anastomotic leaks after anterior resection of rectal cancer. Surgery. 2009;145:182–8.

    Google Scholar 

  112. Chen T-LW, Bansal S, Ke T-W, Chang S-C, Huang Y-C, Kato T, Wang H-M, Fingerhut A. Combined repeat laparoscopy and transanal endolumenal repair (hybridapproach) in the early management of postoperative colorectal anastomotic leaks: technique and outcomes. Surg Endosc. 2018;32(11):4472–80. https://doi.org/10.1007/s00464-018-6193-1.

    Article  Google Scholar 

  113. Matthiessen P, Hallbook O, Rutegard J, et al. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg. 2007;246:207–14.

    Google Scholar 

  114. Chabok A, Påhlman L, Hjern F, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012;99:532–9.

    CAS  Google Scholar 

  115. Isacson D, Thorissen A, Andreasson K, et al. Outpatient, non-antibiotic management in acute uncomplicated diverticulitis: a prospective study. Int J Colorectal Dis. 2015;30:1229–34.

    CAS  Google Scholar 

  116. Mali J, Mentula P, Leppäniemi A. Symptomatic treatment for uncomplicated diverticulitis: a prospective cohort study. Dis Colon Rectum. 2016;59:529–34.

    Google Scholar 

  117. Sallinen V, Leppäniemi A, Mentula P. Staging of acute diverticulitis based on clinical, radiologic, and physiologic parameters. J Trauma Acute Care Surg. 2015;78:543–51.

    Google Scholar 

  118. Angenete E, Thornell A, Burcharth J, et al. Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA. Ann Surg. 2016;263:117–22.

    Google Scholar 

  119. Schultz JK, Yaqub S, Wallon C, SCANDIV Study Group, et al. Laparoscopic lavage vs primary resection for acute perforated diverticulitis: the SCANDIV Randomized Clinical Trial. JAMA. 2015;314:1364–75.

    CAS  Google Scholar 

  120. Vennix S, Musters GD, Mulder IM, Ladies trial colloborators, et al. Laparoscopic peritoneal lavage or sigmoidectomy for perforated diverticulitis with purulent peritonitis: a multicentre, parallel-group, randomised, open-label trial. Lancet. 2015;386:1269–77.

    Google Scholar 

  121. Ceresoli M, Coccolini F, Montori G, et al. Laparoscopic lavage versus resection in perforated diverticulitis with purulent peritonitis: a meta-analysis of randomized controlled trials. World J Emerg Surg. 2016;11:42.

    Google Scholar 

  122. Myers E, Hurley M, O’Sullivan GC, Kavanagh D, Wilson I, Winter DC. Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008;95(1):97–101.

    CAS  Google Scholar 

  123. Cirocchi R, Di Saverio S, Weber DG, Taboła R, Abraha I, Randolph J, Arezzo A, Binda GA. Laparoscopic lavage versus surgical resection for acute diverticulitis with generalised peritonitis: a systematic review and meta-analysis. Tech Coloproctol. 2017;21(2):93–110.

    CAS  Google Scholar 

  124. Nathens AB, Rotstein OD, Marshall JC. Tertiary peritonitis: clinical features of a complex nosocomial infection. World J Surg. 1998;22:158–63.

    CAS  Google Scholar 

  125. Kanaan Z, Gardner S, Carruba C, et al. Macrophage genetic reprogramming during chronic peritonitis is augmented by LPS pretreatment. J Surg Res. 2012;175:289–97.

    CAS  Google Scholar 

  126. de Ruiter J, Weel J, Manusama E, et al. The epidemiology of intra-abdominal flora in critically ill patients with secondary and tertiary abdominal sepsis. Infection. 2009;37:522–7.

    Google Scholar 

  127. Chromic AM, Meiser A, Hölling J, et al. Identification of patients at risk for development of tertiary peritonitis on a Surgical Intensive Care Unit. J Gastroenterol Surg. 2009;13:1358–67.

    Google Scholar 

  128. Carneiro HQ, Mavrakis A, Mylonakis E. Candida peritonitis: an update on the latest research and treatments. World J Surg. 2011;35:2650–9.

    Google Scholar 

  129. Maseda E, Gimenez MJ, Gilsanz F, Aguilar L. Basis for selecting optimum antibiotic regimens for secondary peritonitis. Expert Rev Anti Infect Ther. 2016;14(1):109–24. https://doi.org/10.1586/14787210.2016.1120669.

    Article  CAS  Google Scholar 

  130. Steinbach CL, Töpper C, Adam T, Kees MG. Spectrum adequacy of antibiotic regimens for secondary peritonitis: a retrospective analysis in intermediate and intensive care unit patients. Ann Clin Microbiol Antimicrob. 2015;5(14):48. https://doi.org/10.1186/s12941-015-0110-4.

    Article  CAS  Google Scholar 

  131. Theunissen C, Cherifi S, Karmali R. Management and outcome of high-risk peritonitis: a retrospective survey 2005–2009. Int J Infect Dis. 2011;15(11):e769–73. https://doi.org/10.1016/j.ijid.2011.06.008.

    Article  Google Scholar 

  132. Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, et al. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):78–82. https://doi.org/10.1007/s00534-006-1159-4.

    Article  Google Scholar 

  133. Hecker A, Uhle F, Schwandner T, Padberg W, Weigand MA. Diagnostics, therapy and outcome prediction in abdominal sepsis: current standards and future perspectives. Langenbecks Arch Surg. 2014;399(1):11–22. https://doi.org/10.1007/s00423-013-1132-z.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Anatomy Department, Carol Davila University of Medicine and Phamacy, Bucharest, Romania

    Bogdan Diaconescu & Matei Bratu

  2. Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria

    Selman Uranues & Abe Fingerhut

  3. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Minimally Invasive Surgery Center, Shanghai, 200025, P.R. China

    Abe Fingerhut

  4. Intensive Care Unit, Emergency Clinic Hospital Bucharest, Bucharest, Romania

    Mihaela Vartic

  5. General and Emergency Surgery Division, Department of Emergency and Robotic Surgery, A. Manzoni Hospital, ASST Lecco, Lecco, Italy

    Mauro Zago

  6. Emergency Surgery and Trauma Section, Department of General Surgery, Humanitas Clinical and Research Hospital Head, Milan, Italy

    Hayato Kurihara

  7. Westchester Medical Center, Valhalla, New York, USA

    Rifat Latifi

  8. Surgery Department, University Hospital Linkoping, Linköping, Sweden

    Dorin Popa

  9. Division of Gastrointestinal Surgery, Helsinki University Central Hospital, Helsinki, Finland

    Ari Leppäniemi

  10. Honorary Senior Lecturer Hull York Medical School, Chairman UEMS Division of Emergency Surgery, Heslington, UK

    Jonathan Tilsed

  11. Surgery Department, Carol Davila University of Medicine and Phamacy, Bucharest, Romania

    Mircea Beuran

Authors
  1. Bogdan Diaconescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Selman Uranues
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abe Fingerhut
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mihaela Vartic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mauro Zago
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hayato Kurihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rifat Latifi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dorin Popa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ari Leppäniemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jonathan Tilsed
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Matei Bratu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Mircea Beuran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bogdan Diaconescu.

Ethics declarations

Conflict of interest

Ideclare that Bogdan Diaconescu, Selman Uranues, Abe Fingerhut, Mihaela Vartic, Mauro Zago, Hayato Kurihara, Rifat Latifi, Dorin Popa, Ari Leppäniemi, Jonathan Tilsed, Matei Bratu, Mircea Beuran have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Diaconescu, B., Uranues, S., Fingerhut, A. et al. The Bucharest ESTES consensus statement on peritonitis. Eur J Trauma Emerg Surg 46, 1005–1023 (2020). https://doi.org/10.1007/s00068-020-01338-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-020-01338-9

Keywords

Search

Navigation