title: Comparisons of financial and short-term outcomes between laparoscopic and open hepatectomy: benefits for patients and hospitals.
abstract: OBJECTIVE
  This retrospective analysis compared the cost outcomes for both patients and hospitals, as well as the short-term outcomes, for laparoscopic hepatectomy (LH) and open hepatectomy (OH).
  
  
  METHODS
  The subjects comprised 70 patients who underwent LH or OH. The total hospital charge was calculated using the Japanese lump-sum payment system according to the diagnosis procedure combination.
  
  
  RESULTS
  Of the 70 patients, 10 in the LH group and 16 in the OH group underwent primary single limited/anatomic resection or left lateral sectoriectomy. The operation time, blood loss, and postoperative complications did not differ significantly between the two groups. The median [range] time of inflow occlusion was significantly longer [120 (50-194) vs. 57 (17-151) min, P = 0.03] and the postoperative hospital stay was significantly shorter [5 (4-6) vs. 9 (5-12) days, P < 0.01] in the LH group than in the OH group, respectively. The mean ± standard deviation surgical costs (1307 ± 596 vs. 1054 ± 365 US$, P = 0.43) and total hospital charges (12046 ± 1174 vs. 11858 ± 2096 US$, P > 0.99) were similar in the LH and OH groups, respectively, although the charges per day were significantly higher in the LH group than in the OH group (1388 ± 217 vs. 1016 ± 134 US$, P < 0.01).
  
  
  CONCLUSIONS
  The costs to patients for LH are similar to those for OH. However, LH provides a financial advantage to hospitals due to a reduced hospital stay and comparable surgical costs.
authors.affiliation: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan. yokawaguchi-tky@umin.ac.jp.|Department of Surgery, Asahi General Hospital, Chiba, Japan. yokawaguchi-tky@umin.ac.jp.
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kawaguchi
authors.affiliation: Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Otsuka
authors.affiliation: Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Nagai
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Nomura
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Otani
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Sugawara
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Koike
authors.affiliation: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan.|Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.affiliation: Department of Surgery, Asahi General Hospital, Chiba, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000191:economics* / Q000379:methods*; D017722:Hospital Charges; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics; D017060:Patient Satisfaction / Q000191:economics; D011182:Postoperative Care / Q000191:economics; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Financial benefit; Hospital cost; Laparoscopic hepatectomy; Open hepatectomy; Patient satisfaction