A cost effective analysis of a laparoscopic versus an open left lateral sectionectomy in a liver transplant unit

HPB (Oxford). 2015 Apr;17(4):332-6. doi: 10.1111/hpb.12354. Epub 2014 Nov 17.

Abstract

Introduction: This study aimed to assess the cost effectiveness of a laparoscopic left lateral sectionectomy (LLLS) compared with an open (OLLS) procedure and its role as a training operation as well as the learning curve associated with a laparoscopic approach.

Method: Between 2004 and 2013, a prospectively maintained database was reviewed. LLLS were compared with age- and sex-matched OLLS. In addition, the outcomes of LLLS with a consultant as the primary surgeon were compared with those performed by trainees.

Results: Forty-three LLLS were performed during the study period. LLLS was a significantly cheaper operation compared with OLLS (P = 0.001, £3594.14 versus £5593.41). The median hospital stay was shorter in the laparoscopic group (P = 0.002, 3 versus 7 days). No difference was found in outcomes between a LLLS performed by a trainee or consultant (operating time, morbidity or R1 resection rate). The procedure length was significantly shorter during the later half of the study period [120 versus 129 min (P = 0.045)].

Conclusion: LLLS is a significantly cost effective operation compared with an open approach with a reduction in hospital stay. In addition, it is suitable to use as a training operation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Competence / economics
  • Cost-Benefit Analysis
  • Education, Medical, Graduate / economics
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / economics*
  • Hepatectomy / education
  • Hepatectomy / methods
  • Hospital Costs*
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / economics*
  • Laparoscopy / education
  • Laparoscopy / methods
  • Learning Curve
  • Length of Stay / economics
  • Liver Transplantation / adverse effects
  • Liver Transplantation / economics*
  • Liver Transplantation / education
  • Liver Transplantation / methods
  • Male
  • Middle Aged
  • Models, Economic
  • Process Assessment, Health Care / economics*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult