• Eva Angenete, Anders Thornell, Jakob Burcharth, Hans-Christian Pommergaard, Stefan Skullman, Thue Bisgaard, Per Jess, Zoltan Läckberg, Peter Matthiessen, Jane Heath, Jacob Rosenberg, and Eva Haglind.
• *Department of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden †Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej, Herlev, Denmark ‡Department of Surgery, Skaraborgs Hospital, Skovde, Sweden §GastroUnit, Surgical Division, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark ¶Department of Surgery, Roskilde Hospital, Denmark ||NÄL Hospital Group, Trollhättan, Sweden **Department of Surgery, Örebro University Hospital, Örebro, Sweden.
• Ann. Surg. 2016 Jan 1;263(1):117-22.

ObjectiveTo evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial.BackgroundPerforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection and stoma (Hartmann procedure) with considerable postoperative morbidity and mortality. Laparoscopic lavage has been suggested as a less invasive surgical treatment.MethodsLaparoscopic lavage was compared with colon resection and stoma in a randomized controlled multicenter trial, DILALA (ISRCTN82208287). Initial diagnostic laparoscopy showing Hinchey III was followed by randomization. Clinical data was collected up to 12 weeks postoperatively.ResultsEighty-three patients were randomized, out of whom 39 patients in laparoscopic lavage and 36 patients in the Hartmann procedure groups were available for analysis. Morbidity and mortality after laparoscopic lavage did not differ when compared with the Hartmann procedure. Laparoscopic lavage resulted in shorter operating time, shorter time in the recovery unit, and shorter hospital stay.ConclusionsIn this trial, laparoscopic lavage as treatment for patients with perforated diverticulitis Hinchey III was feasible and safe in the short-term.

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