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Laparoscopic Distal Pancreatectomy in Benign or Premalignant Pancreatic Lesions: Is It Really More Cost-Effective than Open Approach?

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Data regarding the quality of life in patients undergoing laparoscopic distal pancreatectomy are lacking and no studies have reported a real cost-effectiveness analysis of this surgical procedure. The aim of this study was to evaluate and compare the quality of life and the cost-effectiveness of a laparoscopic distal pancreatectomy with respect to an open distal pancreatectomy.

Methods

Forty-one patients who underwent a laparoscopic distal pancreatectomy and 40 patients who underwent an open distal pancreatectomy were retrospectively studied as regards postoperative results, quality of life and cost-effectiveness analysis. The Italian neutral version of the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C-30, version 3.0, was used to rate the quality of life.

Results

Postoperative results were similar in the two groups; the only difference was that the first oral intake took place significantly earlier in the laparoscopic group than in the open group (P < 0.001). Regarding quality of life, the laparoscopic approach was able to ameliorate physical functioning (P = 0.049), role functioning (P = 0.044) and cognitive functioning (P = 0.030) and reduce the sleep disturbance scale (P = 0.050). The cost-effectiveness analysis showed that the acceptability curve for a laparoscopic distal pancreatectomy had a higher probability of being more cost-effective than an open distal pancreatectomy when a willingness to pay above 5400 Euros/quality-adjusted life years (QALY) was accepted.

Conclusion

Despite the limitations of the study, laparoscopic distal pancreatectomy can be considered not only safe and feasible but also permits a better quality of life and is acceptable in terms of cost-effectiveness to Italian and European health care services.

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Conflict of Interest

All authors did not receive grant or funding. The authors declare that they have no competing interests.

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Author notes

    Authors and Affiliations

    1. Department of Medical and Surgical Sciences—DIMEC, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Via Massarenti n.9, 40138, Bologna, Italy

      Claudio Ricci, Riccardo Casadei, Giovanni Taffurelli, Selene Bogoni, Marielda D’Ambra, Carlo Ingaldi, Nico Pagano, Carlo Alberto Pacilio & Francesco Minni

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    1. Claudio Ricci
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    2. Riccardo Casadei
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    3. Giovanni Taffurelli
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    7. Nico Pagano
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    8. Carlo Alberto Pacilio
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    9. Francesco Minni
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    Correspondence to Claudio Ricci.

    Additional information

    Claudio Ricci and Riccardo Casadei contributed equally to this work.

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    Ricci, C., Casadei, R., Taffurelli, G. et al. Laparoscopic Distal Pancreatectomy in Benign or Premalignant Pancreatic Lesions: Is It Really More Cost-Effective than Open Approach?. J Gastrointest Surg 19, 1415–1424 (2015). https://doi.org/10.1007/s11605-015-2841-0

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