Assessment of the financial implications for laparoscopic liver surgery: A single-centre UK cost analysis for minor and major hepatectomy

Mohammed Abu Hilal, Francesco Di Fabio, Shareef Syed, Robert Wiltshire, Eleonora Dimovska, David Turner, John N. Primrose, Neil W. Pearce

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: Laparoscopic hepatectomy is progressively gaining popularity. However, it is still unclear whether the laparoscopic approach offers cost advantages compared with the open approach, especially when major hepatectomies are required. Data providing useful insights into the costs of the laparoscopic approach for clinicians and hospitals are needed. The aim of this study is to assess the financial implications of the laparoscopic approach for two standardized minor and major hepatectomies: left lateral sectionectomy and right hepatectomy. Methods: A cost comparison analysis of patients undergoing laparoscopic right hepatectomy (LRH) and laparoscopic left lateral sectionectomy (LLLS) versus the open counterparts was performed. Data considered for the comparison analysis were operative costs (theatre cost, consumables and surgeon/anaesthetic labour cost), postoperative costs (hospital stay, complication management and readmissions) and overall costs. Results: A total of 149 patients were included: 38 patients underwent LRH and 46 open right hepatectomy (ORH); 46 patients underwent LLLS and 19 open left lateral sectionectomy (OLLS). For LRH the mean operative, postoperative and overall costs were £10,181, £4,037 and £14,218; for ORH the mean operative, postoperative and overall costs were £6,483 (p < 0.0001), £10,304 (p < 0.0001) and £16,787 (p = 0.886). Regarding LLLS, the mean operative, postoperative and overall costs were £5,460, £2,599 and £8,059; for OLLS the mean operative, postoperative and overall costs were £5,841 (p = 0.874), £5,796 (p < 0.0001) and £11,637 (p = 0.0001). Conclusion: Our data support the cost advantage of the laparoscopic approach for left lateral sectionectomy and the cost neutrality for right hepatectomy.

Original languageEnglish
Pages (from-to)2542-2550
Number of pages9
JournalSurgical Endoscopy
Volume27
Issue number7
Early online date26 Jan 2013
DOIs
Publication statusPublished - Jul 2013

Keywords

  • Costs
  • Hepatectomy
  • Laparoscopy
  • Liver

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