Cost Effectiveness of Laparoscopic Cholecystectomy

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Abstract
An investigation was undertaken to determine whether hospital charges for laparoscopic cholecystectomy are higher than those for traditional open cholecystectomy. Thirty consecutive cases of successfully completed laparoscopic procedures in a single surgeon's experience were compared to 30 open cases performed within the previous calendar year. Patients undergoing open cholecystectomy were excluded if coexisting medical problems or complications prolonged hospitalization beyond 7 days. Mean patient age was comparable (open cholecystectomy = 47.3 ± 2.9, laparoscopic cholecystectomy = 46.5 ± 2.7 years), as was the incidence of other significant medical problems. Average duration of hospitalization was significantly longer for open cholecystectomy (3.6 = 0.2 days) than for laparoscopic cholecystectomy (1.0 ± days, p <.001). Average hospital charges for open cholecystectomy were $5606 ± 496 and for laparoscopic cholecystectomy $4726 ± 98. Hospital charges from operating room and recovery room charges alone were $2684 ± 131 for laparoscopic cholecystectomy and $2196 ± 113 for open cholecystectomy. These operating room charges represent a significantly higher percentage of total hospital charges for laparoscopic cholecystectomy than open cholecystectomy patients (laparoscopic cholecystectomy = 56.3 ± 1.9%, open cholecystectomy = 41.2 ± 1.5%, p <.05). Average time for return to work or normal activity was significantly shorter for laparoscopic cholecystectomy 8.6 ± 9 days) than for open cholecystectomy (32.4 ± 3.6 days, p <.001). The authors conclude that laparoscopic cholecystectomy is a cost effective procedure for the treatment of symptomatic cholelithiasis, and that increased operative costs more than offset the significantly decreased length of hospitalization.

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