Cost-effectiveness of emergencyversusdelayed laparoscopic cholecystectomy for acute gallbladder pathology

Abstract

Emergency cholecystectomy is less costly and more effective than delayed cholecystectomy. This approach is likely to be beneficial to patients in terms of improved health outcomes and to the healthcare provider owing to the reduced costs.

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

“…The aim of this study was to report the utilisation of this operative grading system for laparoscopic cholecystectomy using data collected from the recent multi-centre CholeS study [7][8][9][10][11] and assess the grading system's clinical utility in its association with outcome data.…”

Evolution in the management of acute cholecystitis in the elderly: population-based cohort study

“…Cholecystectomy represents the only definitive cure for symptomatic gallstone-related disease. In general, emergency cholecystectomy for acute cholecystitis is associated with reduced long-term biliary complications, shorter total admission length of stay, and lower overall treatment costs [ 5 – 11 ]. Clinical guidelines in the United Kingdom reflect this with the National Institute of Clinical Excellence recommending patients with acute cholecystitis receive cholecystectomy within 1 week of diagnosis [ 12 ].…”

Financial implications of laparoscopic hot gallbladder service in a nontertiary District General Hospital

“…Coupled with this, a Cochrane review highlighted that IALC is financially beneficial and offers significantly better quality of life when compared with interval or delayed LC . Furthermore, patients discharged after conservative management are at the risk of multiple readmissions with similar episodes of AC and gall stone–related pancreatitis …”

“…Robust evidence supports significant clinical advantage in offering index admission laparoscopic cholecystectomy (IALC) to all eligible patients with acute cholecystitis (AC), over “interval” or “delayed” operation, following their discharge from hospital. Further benefits include reducing inpatient bed days, which provides opportunities for additional activity, positively impacting on waiting lists and increased annual income . This practice is recommended by current National Institute for Health and Care Excellence guidelines, based on available contemporary evidence, which demonstrates clinical benefit as well as cost‐effectiveness.…”