Laparoscopic versus open hemihepatectomy-a cost analysis after propensity score matching

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Cost-efficiency is crucial for high-quality healthcare delivery.
• Hemihepatectomies are increasingly performed using laparoscopic techniques.
• Evaluating the economic and clinical outcomes of laparoscopic vs. open hemihepatectomy is essential.

Purpose of the Study:

• To assess the overall costs associated with laparoscopic hemihepatectomy.
• To compare the costs of laparoscopic hemihepatectomy with conventional open hemihepatectomy.
• To analyze clinical outcomes and financial implications of both surgical approaches.

Main Methods:

• Retrospective analysis of clinical outcomes and financial data.
• Inclusion of patients who underwent hemihepatectomy between January 2015 and December 2016.
• Propensity score matching (PSM) analysis to minimize selection bias (1:1 ratio).

Main Results:

• Post-PSM, 32 patients in the laparoscopic hemihepatectomy (LH) group and 32 in the open hemihepatectomy (OH) group were analyzed.
• LH group had significantly longer surgery duration (334 min vs. 274 min) but a shorter hospital stay (5 days vs. 14.5 days).
• The OH group showed a higher rate of postoperative complications, while overall costs were comparable (€17,369.85 for LH vs. €16,103.64 for OH).

Conclusions:

• Higher intraoperative costs for LH are offset by reduced postoperative complications.
• Shorter hospital stays in the LH group contribute to overall cost-effectiveness.
• Laparoscopic hemihepatectomy presents a viable alternative to OH, balancing costs and patient outcomes.