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Costs of laparoscopic and open liver and pancreatic resection: a systematic review
Paolo Limongelli1, Chiara Vitiello1, Andrea Belli1
1Paolo Limongelli, Chiara Vitiello, Salvatore Tolone, Gianmattia del Genio, Luigi Brusciano, Giovanni Docimo, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy.
Aim:
To study costs of laparoscopic and open liver and pancreatic resections, all the compiled data from available observational studies were systematically reviewed.
Methods:
A systematic review of the literature was performed using the Medline, Embase, PubMed, and Cochrane databases to identify all studies published up to 2013 that compared laparoscopic and open liver [laparoscopic hepatic resection (LLR) vs open liver resection (OLR)] and pancreatic [laparoscopic pancreatic resection (LPR) vs open pancreatic resection] resection. The last search was conducted on October 30, 2013.
Results:
Four studies reported that LLR was associated with lower ward stay cost than OLR (2972 USD vs 5291 USD). The costs related to equipment (3345 USD vs 2207 USD) and theatre (14538 vs 11406) were reported higher for LLR. The total cost was lower in patients managed by LLR (19269 USD) compared to OLR (23419 USD). Four studies reported that LPR was associated with lower ward stay cost than OLR (6755 vs 9826 USD). The costs related to equipment (2496 USD vs 1630 USD) and theatre (5563 vs 4444) were reported higher for LPR. The total cost was lower in the LPR (8825 USD) compared to OLR (13380 USD).
Conclusion:
This systematic review support the economic advantage of laparoscopic over open approach to liver and pancreatic resection.
