title: [Laparoscopic versus mini-cholecystectomy: analysis of hospital costs and social costs in a prospective randomized study].
abstract: The aim of the study was to calculate the hospital and social costs in relation to efficacy of clinical outcome, hospital stay and time off work in two groups of patients randomly treated with laparoscopic or mini-cholecystectomy. One hundred and eighty-one patients with simple, symptomatic gallstone disease were included in the study; of these, 9 cases were excluded because of conversion to conventional cholecystectomy. Eighty-six cases underwent laparoscopic cholecystectomy and 86 mini-cholecystectomy. Operative time (median time: 35 minutes) and hospital stay (median stay: 3 days) were the same for both surgical procedures. The median time off work was 10 days for laparoscopic cholecystectomy and 20 days for mini-cholecystectomy (P = 0.007). Hospital expenses showed a saving of 820.48 euros for each patient undergoing mini-cholecystectomy. Since laparoscopic cholecystectomy is associated with a shorter period off work, it seems to be cheaper with a daily saving of 164.96 and 146.51 Euros per patient, according to cost/effectiveness and cost/utility analyses, respectively. Consequently, although laparoscopic cholecystectomy shows a better outcome in terms of socioeconomic aspects and patient compliance, in an attempt to rationalize hospital expenditure, we would advocate mini-cholecystectomy for those patients who do not need to return to work early.
authors.affiliation: DICMI, Sezione di Semeiotica Chirurgica B, Università degli Studi di Genova.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Secco
authors.forename: Milvia
authors.initials: M
authors.lastname: Cataletti
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Bonfante
authors.forename: Eleonora
authors.initials: E
authors.lastname: Baldi
authors.forename: Maria Doris
authors.initials: MD
authors.lastname: Davini
authors.forename: Barbara
authors.initials: B
authors.lastname: Biasotti
authors.forename: Giambattista
authors.initials: G
authors.lastname: Ravera
authors.forename: Romano
authors.initials: R
authors.lastname: Ferraris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D002763:Cholecystectomy / Q000191:economics*; D017081:Cholecystectomy, Laparoscopic / Q000191:economics*; D002769:Cholelithiasis / Q000601:surgery; D003289:Convalescence; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D014937:Work