Laparoscopic or open conventional cholecystectomy: Clinical and economic considerations

Objective: To compare clinical aspects and financial costs of open conventional and laparoscopic cholecystectomy. Design: Retrospective analysis of hospital records of patients who were operated on electively for symptomatic gallstone disease. Setting: University clinic, Germany. Subjects: 153 consecutive patients who had open conventional (1991-92) and 222 who had laparoscopic cholecystectomy (1993-96). A total of 251 cholecystectomies were done during 1991-92 and 523 cholecystectomies during 1993-96. Intervention: Cholecystectomy. Main outcome measures: Clinical aspects: operating time, complications, postoperative stay; financial aspects: total cost of hospital stay after cholecystectomy. Results: When open conventional was compared with laparoscopic cholecystectomy: operating time was 66 and 92 minutes; complications, 9 and 6 cases; postoperative stay, 8 and 3 days; and total cost of hospital stay, US $3434 and US $2808 respectively. Conclusion: The cost of laparoscopic cholecystectomy was 18% less than for open conventional cholecystectomy, principally because of the shorter postoperative stay.