A comparison of the hospital costs of open vs. minimally invasive surgical management of necrotizing pancreatitis.

  • Beenen E
  • Brown L
  • Connor S
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Abstract

BACKGROUND: Infected necrotizing pancreatitis is a major burden for both the patient and the health care system. Little is known about how hospital costs break down and how they may have shifted with the increasing use of minimally invasive techniques. The aim of this study was to analyse inpatient hospital costs associated with pancreatic necrosectomy.

METHODS: A prospective database was used to identify all patients who underwent an intervention for necrotizing pancreatitis. Costs of treatment were calculated using detailed information from the Decision Support Department. Costs for open and minimally invasive surgical modalities were compared.

RESULTS: Twelve open and 13 minimally invasive necrosectomies were performed in a cohort of 577 patients presenting over a 50-month period. One patient in each group died in hospital. Overall median stay was 3.8 days in the intensive care unit (ICU) and 44 days on the ward. The median overall treatment cost was US$ 56,674. The median largest contributors to this total were ward (26.3%), surgical personnel (22.3%) and ICU (17.0%) costs. These did not differ statistically between the two treatment modalities.

CONCLUSIONS: Pancreatic necrosectomy uses considerable health care resources. Minimally invasive techniques have not been shown to reduce costs. Any intervention that can reduce the length of hospital and, in particular, ICU stay by reducing the incidence of organ failure or by preventing secondary infection is likely to be cost-effective.

Author-supplied keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Critical Care
  • Critical Care: economics
  • Databases, Factual
  • Databases, Factual: economics
  • Female
  • Hospital Costs
  • Hospital Costs: statistics & numerical data
  • Humans
  • Length of Stay
  • Length of Stay: economics
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Minimally Invasive Surgical Procedures: economics
  • Minimally Invasive Surgical Procedures: mortality
  • Multiple Organ Failure
  • Multiple Organ Failure: economics
  • Multiple Organ Failure: mortality
  • Pancreatectomy
  • Pancreatectomy: economics
  • Pancreatectomy: mortality
  • Pancreatitis, Acute Necrotizing
  • Pancreatitis, Acute Necrotizing: economics
  • Pancreatitis, Acute Necrotizing: mortality
  • Pancreatitis, Acute Necrotizing: surgery
  • Young Adult

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Authors

  • Edwin Beenen

  • Lisa Brown

  • Saxon Connor

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