PA20101. A single-center study in Greece on the cost effectiveness of laparoscopic versus open cholecystectomy

Abstract Background To assess the cost effectiveness of laparoscopic cholecystectomy compared to open cholecystectomy in Greece. Methods A single-center, prospective study was conducted for a one year’s period. In total, 58 consecutive patients were recruited and the collected baseline data includes socio-demographic, anthropometric and clinical characteristics, as well as medical history. The mean cost of each procedure was estimated using the micro-costing method and the bottom-up approach, from the insurance provider perspective. Results In total, 58 patients were subjected to cholecystectomy, of which 46 to laparoscopic (17 males, 29 female) and 12 open to cholecystectomy (8 males, 4 female), between January- December 2021. The mean age of the patients for the laparoscopic and open procedures was 59.48 years ± 13.525 and 74.75 years ± 17.02, respectively, (p = 0.002). The mean (95% CI) total (direct) surgical cost (including human resources, medication, medical supplies and electricity consumption) for patients subjected to laparoscopic cholecystectomy was estimated at €728.96 (€669.99–€787.93), whereas for patients undergoing the open procedure it was estimated at €445.64 (€388.40–€502.87), (p = 0.162). The mean length of hospital stay for laparoscopic surgery was 2.04 days (range: 1-6 days), and for open surgery 7.92 (range: 2-22 days), (p < 0.001). Considering the duration of hospitalization as a measure of effectiveness, the laparoscopic procedure was found to be more cost effective than the open method, with an Incremental Cost Effectiveness Ratio, (ICER) = −€48.18/day. Conclusions The data revealed that although procedure of laparoscopic cholecystectomy is associated with a relatively high direct surgical cost, with medical supplies contributing the most, it is more cost effectiveness compared to open cholecystectomy. Key messages • Patients undergoing laparoscopic cholecystectomy have a significantly shorter mean hospital stay (2.04 days) compared to those undergoing open cholecystectomy (7.92 days) (p < 0.001) • Despite the higher direct surgical cost, laparoscopic cholecystectomy is more cost-effective due to the shorter hospital stay, with an Incremental Cost Effectiveness Ratio (ICER) of - €48.18 per day. Topic Cost effectiveness, laparoscopic cholecystectomy, open cholecystectomy.