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Analysis of the Cost Effectiveness of Laparoscopic Pancreatoduodenectomy

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

We sought to determine if laparoscopic pancreatoduodenectomy (LPD) is a cost-effective alternative to open pancreatoduodenectomy (OPD).

Methods

Hospital cost data, discharge disposition, readmission rates, and readmission costs from periampullary cancer patient cohorts of LPD and OPD were compared. The surgical cohorts over a 40-month period were clinically similar, consisting of 52 and 50 patients in the LPD and OPD groups, respectively.

Results

The total operating room costs were higher in the LPD group as compared to the OPD group (median US$12,290 vs US$11,299; P = 0.05) due to increased costs for laparoscopic equipment and regional nerve blocks (P ≤ 0.0001). Although hospital length of stay was shorter in the LPD group (median 7 vs 8 days; P = 0.025), the average hospital cost was not significantly decreased compared to the OPD group (median $28,496 vs $28,623). Surgery-related readmission rates and associated costs did not differ between groups. Compared to OPD patients, significantly more LPD patients were discharged directly home rather than to other healthcare facilities (88% vs 72%; P = 0.047).

Conclusion

For the index hospitalization, the cost of LPD is equivalent to OPD. Total episode-of-care costs may favor LPD via reduced post-hospital needs for skilled nursing and rehabilitation.

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Acknowledgements

This was supported in part by training grant NCI 5T32CA106493-09 (D.D.), funds from the Cracchiolo Foundation (D.D.) and the Frederick A. Coller Surgical Society (D.D.)

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Authors and Affiliations

  1. Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd, Room 6165, PO Box 100109, Gainesville, FL, 32610, USA

    Michael H. Gerber, Daniel Delitto, Cristina J. Crippen, Kevin E. Behrns, Jose G. Trevino, Jessica L. Cioffi & Steven J. Hughes

  2. Department of Medicine, University of Florida College of Medicine, Gainesville, FL, 32610, USA

    Thomas J. George Jr.

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  1. Michael H. Gerber
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  2. Daniel Delitto
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  3. Cristina J. Crippen
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  4. Thomas J. George Jr.
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  5. Kevin E. Behrns
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  7. Jessica L. Cioffi
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  8. Steven J. Hughes
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Contributions

Michael H Gerber contributed to the conception of the work; design of the work; acquisition, analysis, and interpretation of data for the work; drafting the work; and revising the work critically for important intellectual content and has agreed to the final version to be published.

Daniel Delitto contributed to the design of the work; acquisition, analysis and interpretation of data for the work; drafting the work; and revising the work critically for important intellectual content and has agreed to the final version to be published.

Cristina J Crippen contributed to the acquisition, analysis, and interpretation of data for the work and revising the work critically for important intellectual content and has agreed to the final version to be published.

Thomas J George Jr. contributed to the acquisition, analysis, and interpretation of data for the work and revising the work critically for important intellectual content and has agreed to the final version to be published.

Kevin E Behrns contributed to the acquisition, analysis, and interpretation of data for the work and revising the work critically for important intellectual content and has agreed to the final version to be published.

Jose G Trevino contributed to the acquisition, analysis, and interpretation of data for the work and revising the work critically for important intellectual content and has agreed to the final version to be published.

Jessica L Cioffi contributed to the acquisition, analysis, and interpretation of data for the work and revising the work critically for important intellectual content and has agreed to the final version to be published.

Steven J Hughes contributed to the conception of the work design; acquisition, analysis, and interpretation of data for the work; drafting the work; and revising the work critically for important intellectual content and has agreed to the final version to be published.

Corresponding author

Correspondence to Steven J. Hughes.

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Gerber, M.H., Delitto, D., Crippen, C.J. et al. Analysis of the Cost Effectiveness of Laparoscopic Pancreatoduodenectomy. J Gastrointest Surg 21, 1404–1410 (2017). https://doi.org/10.1007/s11605-017-3466-2

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  • DOI: https://doi.org/10.1007/s11605-017-3466-2

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