Acute Care Surgery Handbook pp 333-349 | Cite as
Laparoscopy for Perforated Acute Diverticulitis
Chapter
First Online:
Abstract
The surgical approach to perforated diverticulitis has radically changed over the last few decades. In fact, during the last century, open Hartmann’s procedure has been the undisputed primary procedure for perforated diverticulitis. Recently, however, several studies have compared non-restorative resection with primary anastomosis [6, 15, 17, 20, 22, 24], and interestingly, significant differences have resulted in favor of primary anastomosis in terms of the stoma reversal rate and other complications [11]. In addition, studies have investigated the role of laparoscopic resection and laparoscopic lavage as an alternative to the standard open procedures for the treatment of complicated diverticulitis [4]. Laparoscopy in perforated diverticulitis has emerged early on not only to confirm the diagnosis but also to be therapeutic by allowing the lavage of the peritoneal cavity in cases of purulent peritonitis or the resection with or without primary anastomosis if a perforation is clearly identified.
Keywords
Primary Anastomosis Acute Diverticulitis Complicated Diverticulitis Perforated Diverticulitis Laparoscopic Lavage
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Notes
Acknowledgment
All figures and intraoperative pictures have been provided by Dr. Salomone Di Saverio MD FACS FRCS and belong to his own library of personal surgical procedures performed in emergency colorectal surgery setting.
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