COST-EFFECTIVENESS OF LAPAROSCOPIC CHOLECYSTECTOMY

This study retrospectively evaluated the cost-effectiveness of laparos copic cholecystectomy compared to open cholecystectomy in a single uni versity-affiliated community hospital. The medical records of all pati ents that underwent laparoscopic cholecystectomy during 1990 and open cholecystectomy during 1989 in one hospital were reviewed. Hospital st ay, hospital charges, surgeons' and anesthesiologists' fees were deter mined. Fifty patients from each group were contacted to determine reco very time to full activity after surgery. Those having common duct exp loration and those converted to open cholecystectomy after an attempte d laparoscopic cholecystectomy (n = 8) were excluded. A summary of res ults is included below (Table 1). In our early experience with laparos copic cholecystectomy we found that the total charges for laparoscopic cholecystectomy were more than for open cholecystectomy when one reco gnizes the 1-year difference in patient accrual between the two groups . Time to full recovery was markedly reduced in patients undergoing la paroscopic cholecystectomy compared to those having an open procedure. Despite the overall increased total charge with laparoscopic cholecys tectomy, the shorter recovery period allowing the patients an earlier return to full preoperative activities contributes to its cost-effecti veness when compared to open cholecystectomy. Further experience with laparoscopic cholecystectomy and refinements in management of these pa tients should allow for further reductions in charges for this procedu re.