FTP5.13 Laparoscopic cholecystectomy is more cost effective than robotic cholecystectomy: a systematic review of published studies

Abstract

Abstract Objective Robotic cholecystectomy (RC) has been proven safe and postoperative outcomes have also been quoted to be equivalent to conventional laparoscopic cholecystectomy (LC). The objective of this review to evaluate the cost effectiveness of RC compared to LC. Materials and methods All types of comparative studies reporting the cost of RC versus LC were retrieved from the search of standard medical electronic databases and analysis was conducted by using the principles of meta-analysis on the statistical software RevMan version 5.4. Results Four comparative studies (one randomised trial and 3 retrospective studies) on 817 patients undergoing RC versus LC were found and deemed suitable for analysis. There were 559 patients in the LC group and 258 patients in the RC group. In the random effects model analysis, LC was associated with the reduced cost [standardised mean difference -5.39, 95%, CI (-8.97, -1.81), Z = 2.95, P=0.003] compared to RC. However, there was significant heterogeneity (Tau2 = 13.06; Chi2 = 583.52, df = 3; (p < 0.00001; I2 = 99%) among included studies. Conclusion The LC seems to be more cost effective compared to RC in terms of procedural cost. However, due to statistically significant heterogeneity among included studies and paucity of the randomised, controlled trials, these findings should be taken cautiously. A Major multicentre randomised, controlled trial is needed to validate these findings.