Laparoscopic cholecystectomy: proper utilization can make this a cost effective technique.

Abstract

Laparoscopy has become the preferred operative treatment for the removal of gallbladders containing symptomatic stones. Both length of stay and total unit cost has declined, through the use of the laparoscopic cholecystectomy procedure. However, the total cost of treating gallstones has increased. Consensus practice guidelines would indicate that there should be no increase in the number of gallbladder surgeries performed, as the indications for a closed cholecystectomy should be the same as those for open procedures. To correct for the variation in incidence of surgery, I propose a decision flow tree to control the rate of laparoscopic cholecystectomy within a provider organization. I also propose further studies of ablative methods versus surgical procedures to determine the cost effectiveness of expanding indications for laparoscopic cholecystectomy.