A comparison of outcome and cost of open vs. laparoscopic cholecystectomy

One hundred elective completed laparoscopic cholecystectomies performed during the period July 1990 to June 1991 were prospectively analyzed for age, sex, and the study variables. A control group of 100 age- and sex-matched patients undergoing elective open cholecystectomy in the year prior to the advent of laparoscopic cholecystectomy was retrospectively analyzed. Both groups were comparable with regard to height, weight, severity of disease, and co-morbidity. The mean operative time for the laparoscopic cholecystectomy group was 107 min vs. 72 min for the open cholecystectomy group. Other significant differences included the use of cholangiography (24% vs. 93%), placement of drains (4% vs. 27%), and morbidity (3% vs. 7%). There was no mortality in either group. The mean length of hospital stay was 1.6 days for the laparoscopic cholecystectomy group vs. 4.8 days in the open cholecystectomy group. The resultant difference in hospital charges to the patient favored laparoscopic cholecystectomy with a mean charge of $6471 vs. $8896 for the open cholecystectomy group. The results of this study support the conclusions that laparoscopic cholecystectomy is a safe and effective alternative to open cholecystectomy and results in a significantly shorter hospital stay with considerable cost savings.