Background: Patients with Crohn’s colitis have traditionally been approached with open procedures. The advent of laparoscopic colectomy has shown benefits such as quicker return of bowel function, decreased use of postoperative narcotics, and shorter hospital stay. However, due to complexity of the disease and the difficulty of such a surgical approach, little data exists comparing the outcomes of laparoscopic and open colectomy in Crohn’s disease. The purpose of this study was to compare short-term outcomes of laparoscopic (LC) versus open colectomy (OC) in the largest series to date of consecutive patients with Crohn’s colitis.Materials and Methods: We collected data on all patients undergoing colectomy for primary or recurrent Crohn’s disease confined to the colon from July 2002 to August 2008. The indications for surgery included failed medical management, obstructive symptoms, intractable pain, abscess, fistula, dysplasia and cancer. Patient and disease specific characteristics, perioperative and short-term postoperative outcomes, were prospectively collected and analyzed.Results: 119 colectomies were performed during the study period, of which 55 LC (46.2%). There were 7 (13%) conversions, included in the LC group for intent to treat analysis. There were no statistically significant differences in age, gender, body mass index, duration and severity of disease, preoperative use of steroids, nutritional status, previous abdominal surgery and procedure performed between groups. Median operative time was not significantly different between groups (275.2 ± 138.5 for LC and 297.3 ± 109.5 minutes for OC, p=0.38). There was significantly less blood loss in the LC group (192.7 ± 161.8 versus 337.4 ± 363.4 ml, p=0.01), however the transfusion requirement did not differ between groups. Duration of parenteral narcotic use and postoperative complications were not different between groups. There was a trend towards faster return of bowel function after LC as determined by passage of flatus (3.07 ± 1.7 for LC and 3.72 ± 1.5 days for OC, p=0.05). Postoperative length of stay was shorter following LC (7.04 ± 5.1 versus 8.16 ± 4.5 days, p=0.09) however this difference did not reach statistical significance. At a median follow-up of 16 months a surgical recurrence was noted in 5% of patients equally distributed between groups.Conclusions: Laparoscopic colectomy is a safe and effective technique in the hands of experienced surgeons. As experience accumulates, operative time was similar between groups. Our study suggests potential benefits of laparoscopic colectomy in Crohn’s disease in regards to operative blood loss, return of bowel function and length of stay.