Systematic Reviews
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World J Gastroenterol. Dec 14, 2014; 20(46): 17595-17602
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17595
Costs of laparoscopic and open liver and pancreatic resection: A systematic review
Paolo Limongelli, Chiara Vitiello, Andrea Belli, Madhava Pai, Salvatore Tolone, Gianmattia del Genio, Luigi Brusciano, Giovanni Docimo, Nagy Habib, Giulio Belli, Long Richard Jiao, Ludovico Docimo
Paolo Limongelli, Chiara Vitiello, Salvatore Tolone, Gianmattia del Genio, Luigi Brusciano, Giovanni Docimo, Ludovico Docimo, XI Division of General and Obesity Surgery, Second University of Naples, 80131 Naples, Italy
Andrea Belli, Division of Surgical Oncology D, National Cancer Institute of Naples, Fondazione G. Pascale, 80131 Naples, Italy
Madhava Pai, Nagy Habib, Long Richard Jiao, Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London W12 0HS, United Kingdom
Giulio Belli, Department of General and Hepato-Pancreato-Biliary Surgery, S.M. Loreto Nuovo Hospital, 80142 Naples, Italy
Author contributions: Limongelli P and Vitiello C contributed to conception, design and drafting of the article; Belli A, Pai M, Tolone S, del Genio G, Brusciano and Docimo G contributed to acquisition and interpretation of data; Habib N, Belli G, Jiao LR and Docimo L revised it critically and gave final approval of the version to be published.
Correspondence to: Paolo Limongelli, MD, PhD, XI Division of General and Obesity Surgery, Second University of Naples, Via Pansini 5, 80131 Naples, Italy. paolo.limongelli@unina2.it
Telephone: +39-81-5666237 Fax: +39-81-5666669
Received: March 5, 2014
Revised: April 20, 2014
Accepted: May 26, 2014
Published online: December 14, 2014
Processing time: 288 Days and 10.1 Hours
Abstract

AIM: To study costs of laparoscopic and open liver and pancreatic resections, all the compiled data from available observational studies were systematically reviewed.

METHODS: A systematic review of the literature was performed using the Medline, Embase, PubMed, and Cochrane databases to identify all studies published up to 2013 that compared laparoscopic and open liver [laparoscopic hepatic resection (LLR) vs open liver resection (OLR)] and pancreatic [laparoscopic pancreatic resection (LPR) vs open pancreatic resection] resection. The last search was conducted on October 30, 2013.

RESULTS: Four studies reported that LLR was associated with lower ward stay cost than OLR (2972 USD vs 5291 USD). The costs related to equipment (3345 USD vs 2207 USD) and theatre (14538 vs 11406) were reported higher for LLR. The total cost was lower in patients managed by LLR (19269 USD) compared to OLR (23419 USD). Four studies reported that LPR was associated with lower ward stay cost than OLR (6755 vs 9826 USD). The costs related to equipment (2496 USD vs 1630 USD) and theatre (5563 vs 4444) were reported higher for LPR. The total cost was lower in the LPR (8825 USD) compared to OLR (13380 USD).

CONCLUSION: This systematic review support the economic advantage of laparoscopic over open approach to liver and pancreatic resection.

Keywords: Hepatobiliary resection; Laparoscopic hepatic resection; Open liver resection; Laparoscopic pancreatic resection; Open pancreatic resection

Core tip: Laparoscopic hepatobiliary and pancreatic surgery has progressed over the last years but has been slow to gain widespread acceptance even in some referral centers worldwide. Cost implications of a mini-invasive approach to hepatobiliary and pancreatic surgery are still unknown. A systematic review of the literature was performed. The total cost was lower in patients managed by laparoscopic liver resection. The total cost was lower in the laparoscopic pancreatic resection than in open pancreatic resection. This systematic review support the economic advantage of laparoscopic over open approach to liver and pancreatic resection.