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Laparoscopic Versus Open Pancreatoduodenectomy: Cost-Effectiveness Analysis

Title: Laparoscopic Versus Open Pancreatoduodenectomy: Cost-Effectiveness Analysis
Authors: Borie, Frederic; Pichy, Célia; Nayeri, Mihane; Fall, Seïla
Contributors: Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)
Source: ISSN: 1092-6429.
Publisher Information: CCSD; Mary Ann Liebert
Publication Year: 2022
Collection: Université de Montpellier: HAL
Subject Terms: Cost; Effectiveness; Laparoscopic; Laparotomy; Pancreatoduodenectomy; MESH: Cost-Benefit Analysis; MESH: Humans; MESH: Laparoscopy; MESH: Length of Stay; MESH: Operative Time; MESH: Pancreatic Neoplasms; MESH: Pancreaticoduodenectomy; MESH: Postoperative Complications; MESH: Retrospective Studies; [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Description: International audience ; Background and Objectives: The role of laparoscopy during a pancreatoduodenectomy (PD) is not clearly defined. The purpose of this study was thus to compare the cost-effectiveness between laparoscopic pancreatoduodenectomy (LPD) and open pancreatoduodenectomy (OPD). Materials and Methods: From 2010 to 2019, 140 patients underwent PD (60 LPD and 80 OPD). After 60-60 matching, the clinical-pathological characteristics, surgical technique, and type of rehabilitation were identical in both groups. Complications, R0 resection, and cost were compared. Results: Complication rates were 48% (12% Clavien-Dindo grade 3-4) in the LPD group and 64% (22% Clavien-Dindo grade 3-4) in the OPD group. The LPD group had significantly fewer pulmonary complications (6%) than the OPD group (20%) (P = .04). The oncological quality of the R0 resection did not differ between the two groups. The operating time was 312 ± 50 minutes in the OPD group and 392 ± 75 minutes in the LPD group (P < .001). The mean length of hospital stay was significantly shorter for the LPD group (13 ± 10) days compared to the OPD group (19 ± 8) days (P = .02). The average cost of total hospital stay was significantly lower for the LPD group compared to the OPD group (P = .02). Conclusions: Despite longer operative times, LPD had fewer (pulmonary) complications and reduced hospital costs.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/35833839; PUBMED: 35833839; WOS: 000827611600001
DOI: 10.1089/lap.2021.0606
Availability: https://hal.science/hal-04069646; https://doi.org/10.1089/lap.2021.0606
Rights: http://hal.archives-ouvertes.fr/licences/copyright/
Accession Number: edsbas.F8B6770C
Database: BASE