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A Cost-Utility Study of Laparoscopic Cholecystectomy for the Treatment of Symptomatic Gallstones

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

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Abstract

Background

Laparoscopic cholecystectomy is a high-volume surgery that is an end-stage treatment for gallstones. There is little understanding of the surgery’s effect on the gain in patients’ health relative to its cost. The objective of this study is to measure health gain, cost and cost utility of elective laparoscopic cholecystectomy.

Methods

Participants completed the EQ-5D(3L) pre-operatively and post-operatively. Quality adjusted life years attributable to cholecystectomy were calculated by comparing health state utility values between the pre- and post-operative time points. Laparoscopic cholecystectomy cost was calculated from a health system perspective and included hospital and specialists’ fees (in 2016 Canadian dollars). Cost per QALY was calculated for the entire sample and demographic sub-groups.

Results

The cohort consisted of 135 participants who completed surveys between February 2013 and June 2017. The response rate among eligible patients was 50%. Assuming that health gain accrued to the participant for 25 years after cholecystectomy, the mean gain in QALYs was 1.7430, corresponding to an average cost per QALY of $2102. Older patients, on average, had less gain in QALYs than younger patients.

Conclusion

Laparoscopic cholecystectomies are inexpensive relative to the gains in health they provide patients. The gains in health were not uniform across age categories. These results should provide health system planners confidence that incremental increases in surgical capacity for elective cholecystectomies is beneficial.

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Funding

This study was funded by the Canadian Institutes for Health Research (CIHR) and in-kind support of Vancouver Coastal Health (VCH) Authority. The first author is a Scholar of the Michael Smith Foundation for Health Research (MSFHR). CIHR, VCH, and MSFHR had no role in developing the methods, data analyses, interpreting the results or manuscript preparation.

Author information

Authors and Affiliations

  1. Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Jason M. Sutherland, Janice Mok & Guiping Liu

  2. Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada

    Ahmer Karimuddin

  3. Department of Surgery, University of Calgary, Calgary, Canada

    Trafford Crump

Authors
  1. Jason M. Sutherland
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  2. Janice Mok
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  3. Guiping Liu
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  4. Ahmer Karimuddin
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  5. Trafford Crump
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Contributions

JS contributed to the study in the conceptualization of the study, acquisition of the data, analysis of the data, interpretation of the results, writing of the manuscript, final approval of the text and is responsible for the accuracy and integrity of the study.

JM contributed to the study in the interpretation of the results, writing of the manuscript, final approval of the text and is responsible for the accuracy and integrity of the study.

GL contributed to the study in the acquisition of the data, analysis of the data, interpretation of the results, writing of the manuscript, final approval of the text and is responsible for the accuracy and integrity of the study.

AK contributed to the study in the conceptualization of the study, acquisition of the data, interpretation of the results, final approval of the text and is responsible for the accuracy and integrity of the study.

TC contributed to the study in the conceptualization of the study, acquisition of the data, interpretation of the results, writing of the manuscript, final approval of the text and is responsible for the accuracy and integrity of the study.

Corresponding author

Correspondence to Jason M. Sutherland.

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Conflict of Interest

Dr. Jason M. Sutherland has no conflicts of interest or financial ties to disclose.

Ms. Janice Mok has no conflicts of interest or financial ties to disclose.

Dr. Guiping Liu has no conflicts of interest or financial ties to disclose.

Dr. Ahmer Karimuddin has no conflicts of interest or financial ties to disclose.

Dr. Trafford Crump has no conflicts of interest or financial ties to disclose.

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Sutherland, J.M., Mok, J., Liu, G. et al. A Cost-Utility Study of Laparoscopic Cholecystectomy for the Treatment of Symptomatic Gallstones. J Gastrointest Surg 24, 1314–1319 (2020). https://doi.org/10.1007/s11605-019-04268-z

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  • DOI: https://doi.org/10.1007/s11605-019-04268-z

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