Stevens L W
Postgrad Med. 1976 Dec;60(6):122-5. doi: 10.1080/00325481.1976.11708411.
The aim of surgery in the management of diverticulitis and complicated diverticulosis is to remove the disease process as quickly as possible. This approach reduces the likelihood of complications and often avoids the necessity of multistage procedures. Indications for resection include failure of a first attack to subside, recurrent attacks, and free perforation with spreading peritonitis. Three-stage procedures should be reserved for extremely serious disease. Other complications requiring surgery are fistula, obstruction, and massive and uncontrolled bleeding. Massive bleeding is caused by diffuse colonic diverticulosis and is rarely associated with diverticulitis. Abdominal mass, obstruction, or recurrent episodes of slight bleeding should suggest the possibility of underlying tumor and are compelling indications for early resection.
手术治疗憩室炎和复杂性憩室病的目的是尽快清除病变过程。这种方法可降低并发症的可能性，并常常避免多阶段手术的必要性。切除的指征包括首次发作未消退、反复发作以及伴有弥漫性腹膜炎的游离穿孔。三期手术应仅用于极其严重的疾病。其他需要手术治疗的并发症包括瘘管、梗阻以及大量且难以控制的出血。大量出血由弥漫性结肠憩室病引起，很少与憩室炎相关。腹部肿块、梗阻或轻微出血的反复发作应提示潜在肿瘤的可能性，是早期切除的有力指征。
