Cost and Clinical Efficacy of Laparoscopic vs. Open Approach in Liver Resection

Abstract

Background: Hesitation but gradual recognition of laparoscopic liver resection has been gaining popularity in developed countries among the specialized hospitals. On contrary, there has always been a debate about high cost and complexity of laparoscopic as compared to open liver resection resulting in the delayed adoption of laparoscopic approach in many centers. Methods: We retrospectively reviewed medical records of all patients at the 6 th department (Hepatobiliary Unit) of the 1 st affiliated hospital of Harbin Medical University who underwent elective LLR (n=102) or OLR (n=198) from January 1 st , 2014 to November 1 st , 2017. Patient demographics, diagnosis, operation type, operative duration, estimated blood loss, blood transfusion requirement pathology, length of hospital stay, ICU stays and complications were compared between laparoscopic and open approach. Hospital billing data were collected for each case to determine the mean hospital costs per case. Conclusion: Our study justifies that LLR is safe with remarkably better clinical benefits as well cost advantage to some extent. Short operating duration, short hospital stay, lower chances for ICU need, less blood loss, less blood transfusion requirement, and low occurrence of complications are benefits offered by the laparoscopic procedure.

Resultados de la resección hepática laparoscópica en el hospital metropolitano

“…Finalmente, cabe recalcar la importancia del abordaje laparoscópico que la debe a sus ventajas conocidas sobre la cirugía abierta 19 . Subash et al, en un total de 300 pacientes, en los cuales se comparó las resecciones laparoscópicas con las abiertas, muestra no sólo las ventajas de la laparoscopia (menor pérdida de sangre, menor necesidad de transfusiones, y menores tasas de complicaciones en general), sino también mejores resultados costo-efectividad pese a que el abordaje laparoscópico es una técnica costosa aunque no hay mucha diferencia de costos en general en comparación con la abierta, debido al menor tiempo de estancia hospitalaria y en terapia intensiva, que disminuyen los costos indirectos 20 .…”