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Comparisons of financial and short-term outcomes between laparoscopic and open hepatectomy: benefits for patients and hospitals

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Abstract

Purposes

This retrospective analysis compared the cost outcomes for both patients and hospitals, as well as the short-term outcomes, for laparoscopic hepatectomy (LH) and open hepatectomy (OH).

Methods

The subjects comprised 70 patients who underwent LH or OH. The total hospital charge was calculated using the Japanese lump-sum payment system according to the diagnosis procedure combination.

Results

Of the 70 patients, 10 in the LH group and 16 in the OH group underwent primary single limited/anatomic resection or left lateral sectoriectomy. The operation time, blood loss, and postoperative complications did not differ significantly between the two groups. The median [range] time of inflow occlusion was significantly longer [120 (50–194) vs. 57 (17–151) min, P = 0.03] and the postoperative hospital stay was significantly shorter [5 (4–6) vs. 9 (5–12) days, P < 0.01] in the LH group than in the OH group, respectively. The mean ± standard deviation surgical costs (1307 ± 596 vs. 1054 ± 365 US$, P = 0.43) and total hospital charges (12046 ± 1174 vs. 11858 ± 2096 US$, P > 0.99) were similar in the LH and OH groups, respectively, although the charges per day were significantly higher in the LH group than in the OH group (1388 ± 217 vs. 1016 ± 134 US$, P < 0.01).

Conclusions

The costs to patients for LH are similar to those for OH. However, LH provides a financial advantage to hospitals due to a reduced hospital stay and comparable surgical costs.

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Fig. 1

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Abbreviations

LH:

Laparoscopic hepatectomy

OH:

Open hepatectomy

POD:

Postoperative day

SD:

Standard deviations

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Acknowledgments

The authors thank Ms. Junko Ibato, Mr. Hidetoshi Shimada, Mr. Takayuki Ota, Mr. Nozomu Senbonmatsu, Mr. Yui Shinno, Mr. Keizo Katagiri, Dr. Kyoji Ito, Dr. Keishi Kawasaki, and Dr. Yosuke Suka for the acquisition of the financial data and helpful insights.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan

    Yoshikuni Kawaguchi, Takashi Ishida & Norihiro Kokudo

  2. Department of Surgery, Asahi General Hospital, Chiba, Japan

    Yoshikuni Kawaguchi, Motoki Nagai, Yukihiro Nomura, Mariko Yamamoto, Masahide Otani, Yuichi Ohashi, Kotaro Sugawara, Daisuke Koike, Takashi Ishida & Nobutaka Tanaka

  3. Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan

    Yuichiro Otsuka & Hironori Kaneko

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  1. Yoshikuni Kawaguchi
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  2. Yuichiro Otsuka
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Correspondence to Yoshikuni Kawaguchi.

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Kawaguchi, Y., Otsuka, Y., Kaneko, H. et al. Comparisons of financial and short-term outcomes between laparoscopic and open hepatectomy: benefits for patients and hospitals. Surg Today 46, 535–542 (2016). https://doi.org/10.1007/s00595-015-1189-0

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  • DOI: https://doi.org/10.1007/s00595-015-1189-0

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