Evaluation of cost-effectiveness among open, laparoscopic and robotic distal pancreatectomy: A systematic review and meta-analysis - 12/08/21

Doi : 10.1016/j.amjsurg.2021.03.066

Stefano Partelli ^a,^b,^{^{1
These Authors share the first authorship.}}, Claudio Ricci ^c,^d,^{^{1
These Authors share the first authorship.}}, Lorenzo Cinelli ^a, Roberto Maria Montorsi ^a, Carlo Ingaldi ^c,^d, Valentina Andreasi ^a,^b, Stefano Crippa ^a,^b, Laura Alberici ^c,^d, Riccardo Casadei ^c,^d, Massimo Falconi ^a,^b,^⁎
^a Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
^b Vita-Salute San Raffaele University, Milan, Italy
^c Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studorium, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
^d Division of Pancreatic Surgery, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy

^∗Corresponding author. Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.Pancreatic Surgery UnitPancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityVia Olgettina 60Milan20132Italy

Abstract

Background

The cost-effectiveness of minimally invasive distal pancreatectomy (MIDP) is still a matter of debate. This study compares the cost-effectiveness of open (ODP), laparoscopic (LDP) and robotic distal pancreatectomy (RDP).

Methods

Pubmed, Web of Science and Cochrane Library databases were searched. Studies comparing cost-effectiveness of ODP and MIDP were included.

Results

A total of 1052 titles were screened and 16 articles were included in the study, 2431 patients in total. LDP resulted the most cost-efficient procedure, with a mean total cost of 14,682 ± 5665 € and the lowest readmission rates. ODP had lower surgical procedure costs, 3867 ± 768 €. RDP was the safest approach regarding hospital stay costs (5239 ± 1741 €), length of hospital stay, morbidity, clinically relevant pancreatic fistula and reoperations.

Conclusion

In this meta-analysis MIDP resulted as the most cost-effective approach. LDP seems to be protective against high costs, but RDP seems to be safer.

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Highlights

•	Minimally invasive distal pancreatectomy is the most cost-effective approach.
•	Laparoscopy seems to be the most cost-efficient surgical procedure.
•	Robotic approach seems to be the safest and the most effective procedure.

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Keywords : Pancreas, Distal pancreatectomy, Robotic, Laparoscopic, Cost-effectiveness

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Vol 222 - N° 3

P. 513-520 - septembre 2021 Retour au numéro

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Evaluation of cost-effectiveness among open, laparoscopic and robotic distal pancreatectomy: A systematic review and meta-analysis - 12/08/21

Abstract

Background

Methods

Results

Conclusion

Highlights

Plan

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