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A Journal on Internal Medicine

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Panminerva Medica 2001 December;43(4):239-42

language: English

Laparoscopic versus open cholecystectomy. An analysis of clinical and financial aspects

Schietroma M., Carlei F., Liakos C. *, Rossi M. *, Carloni A., Enang G. N., Pistoia M. A. *

From the Chair of Geriatric Surgery
*Chair of Endoscopic Surgery, Department of Surgical Sciences, University of L’Aquila, L’Aquila, Italy


Background. The aim of ­this ­study is to ­assess the clin­i­cal and finan­cial ­aspects of lapar­os­cop­ic chol­e­cys­tec­to­my (LC) com­pared to ­open chol­e­cys­tec­to­my (OC).
Methods. Thirty-six ­patients treat­ed ­with LC ­were pros­pec­tive­ly, not ran­dom­ized, com­pared ­with 35 ­patients ­that under­went OC. The ­data ­used ­were tak­en ­from ­local reg­is­ters, ­patient-sta­tis­tics and hos­pi­tal account­ing ­systems. We eval­u­at­ed the ­costs, mor­bid­ity and mor­tal­ity for ­both sur­gi­cal pro­ce­dures.
Results. Significant dif­fer­enc­es ­were ­observed con­cern­ing the num­ber of ­days ­that ­pain was suf­fered (­mean 7.6 ­days in LC ver­sus 18.5 ­days in OC), the dura­tion of post­op­er­a­tive hos­pi­tal­iza­tion (LC ­mean 2-3 ­days; OC 7-9 ­days), the ­extent of post­op­er­a­tive mon­i­tor­ing per­formed, and the num­ber of ­days in ­order to ­return to nor­mal activ­ity (­mean 4.4 ­days in LC; ­mean 7.6 ­days in OC). Calculation of the ­costs was ­based on the Diagnosis Related Groups (DRG). The prof­it for a DRG is the ­result of the dif­fer­ence ­between the reim­burse­ment ­obtained ­from the exe­cu­tion of the oper­a­tion and the ­cost in ­order to car­ry it out. The ­total ­cost for the exe­cu­tion of LC is Italian £ 3,332,632 ­with a prof­it of Italian £ 1,208,807 ­while for OC the ­cost is £ 4,007,359 and the prof­it is £ 347,041.
Conclusions. The ­results of our ­study is ­that, clin­i­cal­ly and finan­cial­ly, LC has obvi­ous advan­tag­es ­over OC.

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