Use and outcomes of emergent laparoscopic resection for acute diverticulitis

BackgroundThe use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown.MethodsThe Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003–2007). Univariate and multivariate analyses including patient, hospital, and outcome variables were performed.ResultsA national estimate of 67,645 resections (4% laparoscopic) was evaluated. The rate of conversion to open operation was 55%. Ostomies were created in 66% of patients, 67% open and 41% laparoscopic. Laparoscopy was not a predictor of mortality (odds ratio [OR] =.70; confidence interval [CI], .32–1.53). Laparoscopy predicted routine discharge (OR = 1.31; CI, 1.06–1.63) and a decreased length of stay (absolute days = −.78; CI, −1.19 to −.37). There was no difference in the cost of hospitalization between the 2 groups (P = .45).ConclusionsIn acute diverticulitis, urgent laparoscopic resection decreases the length of stay. However, it is associated with a high conversion rate, no cost savings, and no difference in mortality.