title: Early experience with laparoscopic lavage in acute complicated diverticulitis.
abstract: BACKGROUND
  Contemporary surgical management of complicated diverticulitis is controversial. Traditionally, the gold standard has been resection and colostomy, but recently peritoneal lavage and drainage without resection in cases of purulent peritonitis have been suggested. This study aims to review our initial experience with laparoscopic peritoneal lavage for complicated diverticulitis.
  
  
  METHODS
  Retrospective review of all patients who underwent emergent peritoneal lavage and drainage for acute complicated diverticulitis.
  
  
  RESULTS
  Five-hundred-thirty-eight patients admitted for acute diverticulitis between 2007 and 2012 were recorded in the database. Thirty seven underwent emergent surgery of which 10 had peritoneal lavage and drainage without colonic resection for complicated diverticulitis causing peritonitis. Peritoneal lavage and drainage resulted in the resolution of acute symptoms in all cases. In long-term follow-up, 3 (30%) patients required elective resection owing to symptomatic disease, two of these due to recurrent diverticulitis, and one owing to complicated fistula following the procedure.
  
  
  CONCLUSIONS
  Peritoneal lavage is a feasible option for complicated diverticulitis with purulent non-fecal peritonitis, but a significant portion of the patients may require elective resection. Comparative studies with emergent resection are needed to determine the role of peritoneal lavage in complicated diverticulitis.
authors.affiliation: Department of Surgery and Transplantation, Chaim Sheba Medical Center, Sackler Medical School and Tel Aviv University, Ramat Gan, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Horesh
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Zbar
authors.forename: Avinoam
authors.initials: A
authors.lastname: Nevler
authors.forename: Nadav
authors.initials: N
authors.lastname: Haim
authors.forename: Mordechai
authors.initials: M
authors.lastname: Gutman
authors.forename: Oded
authors.initials: O
authors.lastname: Zmora
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004239:Diverticulitis, Colonic / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000379:methods*; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome