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A prospective comparison of costs and morbidity of laparoscopic versus open cholecystectomy
G de Pouvourville1, N Ribet-Reinhart, M Fendrick
1Centre de recherche en gestion, Ecole Polytechnique, Paris, France.
Background/Aims:
The aims of this study were to compare pain and discomfort after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC), and to quantify the costs of both procedures.
Material And Methods:
Seventy-six patients undergoing a LC were prospectively compared with 24 patients who had an OC. Pain was assessed with a visual analog scale, and two rating indexes, one day, three months, and six months postoperatively. Hospital costs per patients covered direct expenditures, hospital overhead and depreciation of equipment, and salaries allocated on a per-diem basis.
Results:
Pain and discomfort were significantly lower in the LC group than in the OC group. Cost for the operation was higher after LC, and lower for post operative care (p < 0.001). Total costs of hospitalization were similar. The mean number of days out of work was less in the LC group (14.7 days) than in the OC group (35.5 days) and the difference of cost due to loss of productivity was significant (p < 0.0001).
Conclusions:
The advantages of LC must be counter-balanced with a higher rate of postoperative complications than after OC, mainly common bile duct injuries.