©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2016; 8(5): 371-375
Published online May 27, 2016. doi: 10.4240/wjgs.v8.i5.371
Published online May 27, 2016. doi: 10.4240/wjgs.v8.i5.371
Critical appraisal of laparoscopic lavage for Hinchey III diverticulitis
Pascal Gervaz, Division of Coloproctology, Clinique Hirslanden La Colline, 1205 Geneva, Switzerland
Patrick Ambrosetti, Clinique Générale-Beaulieu, 1206 Geneva, Switzerland
Author contributions: Gervaz P and Ambrosetti P contributed equally to this work in researching the literature and analyzing data; Gervaz P wrote the paper.
Conflict-of-interest statement: None.
Correspondence to: Pascal Gervaz, MD, Division of Coloproctology, Clinique Hirslanden La Colline, Avenue de la Roseraie 76A, 1205 Geneva, Switzerland. pascalgervaz@gmail.com
Telephone: +41-22-7895050 Fax: +41-22-7890591
Received: November 11, 2015
Peer-review started: November 13, 2015
First decision: November 27, 2015
Revised: February 1, 2016
Accepted: February 23, 2016
Article in press: February 24, 2016
Published online: May 27, 2016
Processing time: 187 Days and 20.6 Hours
Peer-review started: November 13, 2015
First decision: November 27, 2015
Revised: February 1, 2016
Accepted: February 23, 2016
Article in press: February 24, 2016
Published online: May 27, 2016
Processing time: 187 Days and 20.6 Hours
Core Tip
Core tip: Laparoscopic lavage and drainage for purulent peritonitis due to perforated diverticulitis has many limitations, which have been overlooked in the previously published case series of the literature. The available data from the unique RCT indicates that these results will not be reproduced in a trial where patients’ selection is avoided. There are three main limitations to the technique: (1) the risk of missing a persistent (incompletely sealed) perforation - 30% of cases; (2) the risk of missing fecal peritonitis enclosed within the sigmoid loop - 10% of cases; and (3) the risk of missing sigmoid carcinoma - 10% of cases).