Diagnostic laparoscopy for patients with potentially resectable pancreatic adenocarcinoma: Is it cost-effective in the current era?

C. K. Enestvedt, S. C. Mayo, B. S. Diggs, M. Mori, D. A. Austin, D. K. Shipley, B. C. Sheppard, K. G. Billingsley

Research output: Contribution to journalReview article

28 Scopus citations

Abstract

Introduction: For patients with potentially resectable pancreatic cancer, diagnostic laparoscopy may identify liver and peritoneal metastases that are difficult to detect with other staging modalities. The aim of this study was to utilize a population-based pancreatic cancer database to assess the cost effectiveness of preoperative laparoscopy. Material and Methods: Data from a state cancer registry were linked with primary medical record data for years 1996-2003. De-identified patient records were reviewed to determine the role and findings of laparoscopic exploration. Average hospital and physician charges for laparotomy, biliary bypass, pancreaticoduodenectomy, and laparoscopy were determined by review of billing data from our institution and Medicare data for fiscal years 2005-2006. Cost-effectiveness was determined by comparing three methods of utilization of laparoscopy: (1) routine (all patients), (2) case-specific, and (3) no utilization. Results and Discussion: Of 298 potentially resectable patients, 86 underwent laparoscopy. The prevalence of unresectable disease was 14.1% diagnosed at either laparotomy or laparoscopy. The mean charge per patient for routine, case-specific, and no utilization of laparoscopy was $91,805, $90,888, and $93,134, respectively. Conclusion: Cost analysis indicates that the case-specific or routine use of laparoscopy in pancreatic cancer does not add significantly to the overall expense of treatment and supports the use of laparoscopy in patients with known or suspected pancreatic adenocarcinoma.

Original languageEnglish (US)
Pages (from-to)1177-1184
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number7
DOIs
StatePublished - Jul 1 2008

Keywords

  • Cost-effective
  • Diagnostic laparoscopy
  • Laparoscopy
  • Pancreatic cancer

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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