Laparoscopic partial hepatectomy is cost-effective when performed in high volume centers: A five state analysis

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Health Economics

Background:

• Previous research has not comprehensively evaluated inpatient costs associated with laparoscopic hepatic resection (LHR) versus open hepatic resection (OHR).
• Understanding the economic implications of different surgical approaches is crucial for healthcare providers and policymakers.

Purpose of the Study:

• To compare the inpatient costs and postoperative complication rates of LHR and OHR.
• To determine if LHR is a cost-effective alternative to OHR.

Main Methods:

• A retrospective cohort study was conducted using the Healthcare Cost and Utilization Project State Inpatient Databases.
• Data from 10,239 patients who underwent hepatic resection between 2010 and 2014 were analyzed.
• Statistical adjustments were made for hospital volume to compare outcomes.

Main Results:

• Laparoscopic hepatic resection (LHR) was associated with significantly lower risks of respiratory, wound, and hematologic complications compared to open hepatic resection (OHR).
• Patients undergoing LHR had a reduced likelihood of incurring the highest quartile of inpatient costs.
• In very high-volume centers, LHR resulted in substantially lower risk-adjusted 90-day aggregate costs of care compared to OHR.

Conclusions:

• Laparoscopic partial hepatectomy demonstrates a lower risk of postoperative complications than open hepatic resection.
• The adoption of LHR, particularly in high-volume centers, can lead to significant reductions in aggregate healthcare costs.