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Clin Colon Rectal Surg
DOI: 10.1055/a-2760-7233
Review Article

Shared Decision-Making in Diverticulitis

Authors

  • Samuel A. Younan

    1   Section of Colon and Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States

  • Alexander T. Hawkins

    1   Section of Colon and Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Funding Information The work on this manuscript was supported by the National Institute of Diabetes and Digestive and Kidney Disease of the National Institutes of Health under award number T32DK007673 (S.A.Y.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Abstract

The management of diverticulitis has evolved significantly, shifting away from a rigid recommendation for colectomy after a specific number of episodes toward a more individualized, patient-centered approach. Evidence demonstrates that observation for recurrent uncomplicated diverticulitis does not substantially increase the risk of complications, emergency surgery, or mortality, challenging prior paradigms and supporting a focus on improving quality of life. As such, current guidelines advocate for shared decision-making that incorporates patient preferences, symptom burden, and surgical risk. The decision to pursue colectomy remains highly preference-sensitive and must balance clinical evidence with individual values and goals. Despite the importance of shared decision-making in this clinical context, decisional conflict and decision regret remain prevalent, reflecting ongoing challenges in aligning care with patient expectations. Future efforts should prioritize the integration of shared decision-making into clinical workflows through decision support tools, individualized risk models, and enhanced clinician training to improve patient-centered outcomes and quality of care in diverticulitis.

Keywords

diverticulitis - shared decision-making - colectomy - observation


Publication History

Article published online:
23 December 2025

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