Early non-emergent colectomy is more cost-effective and beneficial for patients with complicated diverticulitis and abscess.

• Early operation results in $8,852 lower costs per patient and an incremental increase of 0.57 quality-adjusted life years (QALYs).
• This strategy is cost-effective 96% of the time when compared to interval operation.

Surgeons should prioritize early intervention but consider patient preferences for delay, especially when quality of life is a concern.

• The threshold for cost-effectiveness from percutaneous drainage is a decrement of only 0.044 QALYs.