Wehrli H, Akovbiantz A
Chirurgische Klinik, Stadtspital Waid, Zürich.
Helv Chir Acta. 1992 Mar;58(5):735-9.
Our experience with 431 patients suffering from diverticular disease is presented. Indications for emergency (severe bleeding, bowel obstruction, sigmoid perforation with peritonitis) and elective surgery (recurrent attacks of diverticulitis or bleeding, painful or obstructing diverticular disease, fistula, impossibility to exclude a cancer) are given. Resection of the perforated sigmoid by the Hartmann procedure helps to reduce mortality markedly for diffuse purulent and fecal peritonitis. A resection with primary anastomosis can be performed with equal safety for a more localised peritonitis. Aggressive indication for elective surgery helps to lower mortality and morbidity in symptomatic diverticular disease.
本文介绍了我们对431例憩室病患者的治疗经验。给出了急诊手术（严重出血、肠梗阻、乙状结肠穿孔伴腹膜炎）和择期手术（憩室炎或出血反复发作、疼痛性或梗阻性憩室病、瘘管、无法排除癌症）的指征。采用哈特曼手术切除穿孔的乙状结肠有助于显著降低弥漫性脓性和粪性腹膜炎的死亡率。对于局限性腹膜炎，行一期吻合的切除术安全性相同。对有症状的憩室病积极采取择期手术指征有助于降低死亡率和发病率。
