Laparoscopic peritoneal lavage for acute diverticulitis

Abstract

Background: The usual surgical management of acute diverticulitis is Hartmann operation that is associated with high rates of complications and mortality. Recently, less invasive procedures, that avoid ostomies have been proposed as treatment. Aim: To analyze the results of laparoscopic peritoneal lavage in patients with acute diverticulitis. Material and Methods: Prospective analysis of seven patients age 25 to 61 years (four males) admitted for a first episode of acute diverticulitis classified as Hinchey II or III, in whom a percutaneous drainage of collections was not possible. All were subjected to a laparoscopic peritoneal lavage and debridement. Results: The mean body mass index of patients was 30.3 kg/m(2). Operative time was 55 +/- 28 min and there was no need for ostomies or conversion to open surgery. Two patients had complications. One required a percutaneous drainage of a collection and other required an open surgical procedure for peritoneal lavage. Patients stayed with nil per os for 2 +/- 1 days, required antimicrobials for 14 +/- 4 days and stayed in the hospital for 8 +/- 4 days. Conclusions: Laparoscopic peritoneal lavage is a good alternative surgical procedure for the treatment of acute diverticulitis.