A financial analysis of laparoscopic and open cholecystectomy

Abstract

Laparoscopic cholecystectomy (LC) is now the method of choice in treatment of symptomatic gallstone disease. Despite its rapidly growing popularity, comparative costs of this new method and open cholecystectomy (OC) remain unclear. The most outstanding feature of laparoscopic cholecystectomy is the period of short recovery. In Sweden the social insurance office documents sick leave period, sickness allowance, as well as diagnosis and therefore provides a reliable basis for an economic analysis. The purpose of this study was to estimate the hospital cost and costs due to sick leave in a series of patients operated on with elective cholecystectomy using the two methods. In each group 50 consecutive patients were studied retrospectively. The total hospital cost was 10% lower in the laparoscopy group--$1,864 as compared to $2,030 per patient in the OC group. Median number of days off work was 14 after LC and 35 days after open surgery, which corresponds to a median sickness allowance of $516 per patient (LC) compared to $1,424 (OC). Laparoscopic cholecystectomy is more cost-effective than open cholecystectomy mainly due to a reduced sick leave period.

Laparoscopic colposuspension Is it cost-effective?

“…In the case of laparoscopic cholecystectomy, as with colposuspension, most patients are within the working age group, and those that have a laparoscopic procedure return to work or resume normal activity on average 4-6 weeks earlier than those undergoing an open procedure. This increases national productivity and decreases costs incurred by employers and insurers dramatically [18,36,37,44,49,50]. Our study did not consider this; hence, when costs incurred secondary to a delay in return to work are also considered, the benefits of the laparoscopic approach should become even more apparent.…”

Laparoscopic or open conventional cholecystectomy: clinical and economic considerations

“…The results can therefore be compared only to a limited degree. Only a handful of studies have placed their emphasis on comparing costs (15,25,49). Those studies that examined costs and made use of a design that is generally similar to ours are listed in Table V.…”

Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy

“…Most data indicate that the extra costs incurred by the laparoscopic technique are offset by the economic gains from the shorter hospitalization time, faster recovery period, and earlier return to full activity [7,20,28,30]. However, the economic benefits of any surgical treatment are best evaluated by a randomized controlled trial, and our conclusions would have to be reevaluated in the light of such clinical trials.…”