Cost analysis of laparoscopic versus open hepatobiliary surgery: A Canadian single-center experience

Abstract

Background: In general, Minimally Invasive Surgery (MIS) has been associated with fewer postoperative complications, shorter hospital stays, decreased blood loss, better postoperative pain control, and lower readmission rates compared to open surgery. However, the uptake of laparoscopic approaches in hepato-pancreato-biliary (HPB) surgery has been slower compared to other areas of general surgery due to higher case complexity and bleeding risk, leading to concerns regarding safety and effectiveness of these approaches. Moreover, there is concern that minimal access approaches might increase complication rates in HPB surgery given the overall case complexity compounded by the effects of an MIS approach. Our center has increasingly applied the laparoscopic approach to HPB surgery, and have noted at least anecdotally improved length of stay and seemingly improved patient outcomes. Here we present the financial impact of this approach through the analysis of cost data in our initial experience with the adoption of the MIS approach to HPB cases.