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Introduction: The standard treatment of colovesical fistula is the removal of fistula, suture of bladder wall, and then colic resection with or without temporary colostomy. The open approach is more commonly used because the laparoscopic approach seems to have high conversion rates and morbidity. We report two cases of colovesical fistula treated with a laparoscopic conservative approach. We also focus on the long term outcome. Case presentation 1. A 69-year-old male with colovesical fistula that appeared after endoscopic polipectomy in the sigmoid diverticulum underwent a totally laparoscopic conservative treatment without colic resection. Operative time was 210 minutes and blood loss was 300 ml. Time to bowel movement was 60 hours. No complications or fistula recurrence occurred at 48-month follow-up. Case presentation 2. A 34-year-old male with colovesical fistula secondary to diverticulitis underwent totally laparoscopic conservative surgery. Operative time was 160 minutes and blood loss was 150 ml. Time to bowel movement was 72 hours. Fistula reoccurred two weeks after discharge. We performed Hartmann’s procedure and defunctioning colostomy with an open approach. No recurrence or complications were found at 36 months follow up. Conclusion: The laparoscopic conservative treatment of colovesical fistula is a safe and feasible technique. When there is no diverticular disease, the conservative approach is very effective. [ABSTRACT FROM AUTHOR]

Introduction: The duodenum is the second seat of onset of diverticula after the colon. Duodenal diverticulosis is usually asymptomatic, but duodenal perforation with abscess may occur. Case presentation: Woman, 83 years old, emergency hospitalised for generalized abdominal pain. On the abdominal tomography in the third portion of the duodenum a herniation and a concomitant full-thickness breach of the visceral wall was detected. The patient underwent emergency surgery. A surgical toilette of abscess was performed passing through the perforated diverticula and the Petzer's tube drainage was placed in the duodenal lumen; the duodenostomic Petzer was endoscopically removed 4 months after the surgery. Discussion: A review of medical literature was performed and our treatment has never been described. Conclusion: For the treatment of perforated duodenal diverticula a sequential two-stage non resective approach is safe and feasible in selected cases. [ABSTRACT FROM AUTHOR]