title: Managing gallbladder disease in a cost-effective manner.
abstract: The advent of laparoscopic cholecystectomy has resulted in an increase in total health care costs for gallstone disease despite a reduced unit cost for the procedure. The total number of cholecystectomies performed annually has increased, reflecting an alteration in referral patterns and threshold for surgery in these patients. Cost-effective management of gallstones is possible by adopting strategies to limit length of stay, with discharge possible on the day of surgery for many patients. Selective cholangiography, laparoscopic common bile duct exploration, and judicious postoperative use of ERCP also have a role in cost-effective gallstone treatment. Institutions must analyze all costs and patterns of use to make informed decisions about reusable and disposable instrumentation.
authors.affiliation: Hartford Hospital, CT, USA.
authors.forename: R
authors.initials: R
authors.lastname: Orlando
authors.forename: J C
authors.initials: JC
authors.lastname: Russell
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000191:economics; D002758:Cholangiography / Q000191:economics; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000191:economics; D017081:Cholecystectomy, Laparoscopic / Q000191:economics*; D003362:Cost-Benefit Analysis; D004209:Disposable Equipment / Q000191:economics; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000191:economics* / Q000601:surgery*; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics