Cost analysis of laparoscopic cholecystectomy in children

A detailed analysis of the hospital-related costs of laparoscopic cholecyst ectomy in children was performed. Data on 10 laparoscopic cholecystectomies were collected prospectively. Pre-, intra- and postoperative variables wer e assessed by standardized questionnaires. The hotel costs and costs for nu rsing, physicians, medicaments and equipment were calculated in detail. Reu sable instruments were assumed to be used for 50 operations per year over 5 years and the costs for disposable instruments were calculated for compari son. In addition, the data of 10 children who underwent open cholecystectom y were analyzed retrospectively. The mean hospital costs for one laparoscop ic cholecystectomy was 3685 DM. The costs for the operation itself represen ted 36.5 % of the hospital costs and were mainly due to expenses for surgeo ns and nurses. The costs for laparoscopic equipment and instruments represe nted only 8.5 % of the total costs. If an open procedure instead of a lapar oscopic operation had been performed with a similar duration of hospital st ay, the hospital costs would have been reduced by 425 DM (11.5 %). In lapar oscopic cholecystectomy the costs for medical treatment in addition to the operation were 32.8 % of the total costs and were mainly due to expenses fo r nursing and physicians, which added up to 165 DM per day. The hotel costs represented 30.7 % of the total costs and added another 189 DM per day. Th erefore, potential savings in the operation theatre are limited and most ef fective savings may be achieved by shortening the hospital stay. The use of disposable instruments would have increased the costs by 844 DM and alread y 20 operations per year would have been cheaper performed with reusable co mpared to disposable instruments. Reusable instruments are recommended. Add itional 60 minutes operating time cost 312 DM (5.20 DM/minute) and therefor e, laparoscopic training courses for surgeons may be cost-effective in orde r to reduce the costs for training in the operation theatre.