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Costs and utilization of intraoperative cholangiography.
- Source :
-
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2007 Sep; Vol. 11 (9), pp. 1162-7. Date of Electronic Publication: 2007 Jun 30. - Publication Year :
- 2007
-
Abstract
- Background: Routine intraoperative cholangiography (IOC) has been advocated as a viable strategy to reduce common bile duct injury (CDI) during cholecystectomy. This is predicated, in part, on the low cost of IOC, making it a cost-effective preventive strategy. Using billed hospital charges as a proxy for costs, we sought to estimate costs associated with the performance of IOC.<br />Methods: The 2001 National Inpatient Survey (NIS) database was assessed for IOC utilization and associated charges. Average charges for hospital admission where the primary procedure was laparoscopic cholecystectomy were compared for those associated with and without the performance of IOC.<br />Results: Eighteen percent of cholecystectomies were performed in facilities that never perform IOC. Routine IOC (defined as >75% of cholecystectomies performed in any one hospital having a concomitant IOC) was performed in only 11% of hospitals. In the remaining 71% of hospitals, selective IOC was performed. IOCs were associated with US $706-739 in additional hospital charges when performed in conjunction with laparoscopic cholecystectomy. We project a cost of US $371,356 to prevent a single bile duct injury by using routine cholangiography.<br />Conclusion: We conclude that only a minority of hospitals performs cholecystectomies with routine IOC. Because of the significant amount of hospital charges attributable to IOC, routine IOC is not cost-effective as a preventative measure against bile duct injury during cholecystectomy.
- Subjects :
- Adult
Cholelithiasis economics
Cholelithiasis surgery
Common Bile Duct injuries
Cost of Illness
Cost-Benefit Analysis
Female
Gallbladder Diseases economics
Gallbladder Diseases surgery
Humans
Intraoperative Period
Male
Middle Aged
United States
Cholangiography economics
Cholangiography statistics & numerical data
Cholecystectomy, Laparoscopic adverse effects
Health Care Costs statistics & numerical data
Hospital Charges statistics & numerical data
Intraoperative Complications prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1091-255X
- Volume :
- 11
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
- Publication Type :
- Academic Journal
- Accession number :
- 17602271
- Full Text :
- https://doi.org/10.1007/s11605-007-0209-9