An observational study in Acute Complicated Diverticulitis and Colonic Diverticulitis, sponsored by Jules Bordet Institute. Completed at 1 site in Belgium. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-22.
Sponsored by Jules Bordet Institute · Observational
Acute complicated diverticulitis (ACD) is a frequent surgical emergency that can be life-threatening. It encompasses various clinical entities, including colonic perforations, abscesses (Hinchey II), fistulas, and purulent or fecal peritonitis (Hinchey III/IV). Historically, the Hartmann procedure (HP) was established as the standard of care for diffuse peritonitis, particularly in frail patients. However, this intervention is associated with high rates of permanent stomas, long-term complications, and impaired quality of life. Over the past decade, several randomized controlled trials (RCTs) have compared HP with sigmoid resection and primary anastomosis (PA), sometimes combined with a diverting ileostomy. Results from these studies, notably the LADIES and DIVERTI trials, indicate that in hemodynamically stable and immunocompetent patients, PA is associated with superior functional outcomes, fewer late complications, and higher stoma reversal rates. Other minimally invasive approaches, such as laparoscopic peritoneal lavage for Hinchey III, have also been explored, showing promise in reducing stomas and reinterventions. However, their efficacy relies on stringent patient selection, and their use is not recommended by current guidelines (e.g., HAS 2017) due to higher reintervention rates. Recent epidemiological data suggest a trend toward reducing emergency surgical interventions in favor of more conservative strategies in selected cases, such as initial medical management followed by elective surgery. In this context of diversifying therapeutic options, choosing the optimal treatment requires a delicate balance between efficacy, morbidity, mortality, quality of life, and long-term preservation of intestinal function. Despite these advances, several questions remain, particularly regarding patient selection criteria and the real-world long-term impact of these interventions. A potentially underestimated factor is the role of the operator, as a significant portion of emergency cases (nights and weekends) are handled by surgeons in training.
Primary Objective: To provide a comprehensive overview of current management strategies for acute complicated diverticulitis by identifying preferred therapeutic modalities (conservative management, emergency surgery, delayed surgery) at the HUB (Hôpital Universitaire de Bruxelles).
Secondary Objectives: To evaluate the adherence of these therapeutic approaches to international guidelines. To identify clinical and context-specific predictive factors influencing the choice of therapeutic strategy.
27 studies on the registry are indexed under Diverticulitis, Colonic; 8 are open to participants now.
This study's enrollment of 208 is below the median of 250 across 15 observational studies indexed under Diverticulitis, Colonic.
Browse Diverticulitis, Colonic studies →Jules Bordet Institute is the lead sponsor of 106 studies on the registry; 27 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients older than 18 years who were treated for acute complicated diverticulitis between January 1, 2015 and December 31, 2024 at Erasme Hospital and Institut Jules Bordet.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Distribution of management strategies for acute complicated diverticulitis.
Percentage of patients treated by each of the following strategies: exclusive medical treatment, radiological drainage, immediate emergency surgery, rescue surgery following medical failure, or elective surgery.
Time frame: From hospital admission up to 10 years (end of study period).
Surgical Procedure Type (Hartmann Procedure vs. Primary Anastomosis) based on Hinchey Classification and Clinical Status.
The study will evaluate the association between baseline clinical parameters (including age and immunosuppression status) and radiological severity, assessed by the Hinchey classification (stages Ib to IV on admission CT scan), with the final therapeutic choice. Logistic regression analysis will be used to identify independent predictors for: (1) failure of conservative treatment and (2) selection of surgical procedure type (Hartmann Procedure vs. Primary Anastomosis). Results will be reported as Odds Ratios (OR) with 95% Confidence Intervals.
Time frame: Through study completion, an average of 14 days (duration of index hospitalization).
Success rate of conservative treatment for complicated diverticulitis.
Proportion of patients successfully managed without surgery during the index hospitalization.
Time frame: During index hospitalization (average of 12.4 days).
Post-operative morbidity and mortality.
Percentage of patients with severe complications (Clavien-Dindo III-IV) and mortality rate at 30 days post-surgery.
Time frame: 30 days post-surgery.
Stoma reversal rate.
Percentage of patients who received a temporary stoma and successfully underwent surgical restoration of bowel continuity during the follow-up period.
Time frame: Up to 10 years.
Evolution of the Rate of Laparoscopic Approach.
Percentage of patients undergoing a laparoscopic approach (including converted laparoscopies) compared to open surgery. The trend will be analyzed across three time periods (2015-2017, 2018-2020, 2021-2024) to assess the adoption of minimally invasive techniques.
Time frame: Perioperative (during initial surgery).
Length of Hospital Stay (LOS).
Number of days from hospital admission to discharge. The median length of stay will be compared across the three time periods (2015-2017, 2018-2020, 2021-2024) to evaluate the impact of changing clinical practices.
Time frame: From hospital admission to discharge (average 10-14 days).
Adherence to Guidelines Regarding Peritoneal Lavage.
Percentage of surgical cases where peritoneal lavage was performed as a standalone treatment (without resection). The evolution of this practice will be assessed across the three time periods to evaluate adherence to international guidelines (EAES/WSES) recommending the abandonment of this technique.
Time frame: Perioperative (during initial surgery).
Plan to share: No — Individual participant data (IPD) will not be shared in order to protect patient confidentiality and comply with European data protection regulations (GDPR) and institutional privacy policies.
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Ran from Dec 2025 to primary completion in Mar 2026, 3 months.
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This study is completed, as verified in May 2026. You cannot join it, but the record below documents what was studied.
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