Laparoscopic or open conventional cholecystectomy: clinical and economic considerations

Abstract

To compare clinical aspects and financial costs of open conventional and laparoscopic cholecystectomy. Retrospective analysis of hospital records of patients who were operated on electively for symptomatic gallstone disease. University clinic, Germany. 153 consecutive patients who had open conventional (1991-92) and 222 who had laparoscopic cholecystectomy (1993-96). A total of 251 cholecystectomies were done during 1991-92 and 523 cholecystectomies during 1993-96. Cholecystectomy. Clinical aspects: operating time, complications, postoperative stay; financial aspects: total cost of hospital stay after cholecystectomy. When open conventional was compared with laparoscopic cholecystectomy: operating time was 66 and 92 minutes; complications, 9 and 6 cases; postoperative stay, 8 and 3 days; and total cost of hospital stay, US $ 3434 and US $ 2808 respectively. The cost of laparoscopic cholecystectomy was 18% less than for open conventional cholecystectomy, principally because of the shorter postoperative stay.