BIOMAT Database Logo BIOMAT Database Logo

Cost analysis and effectiveness comparing the routine use of intraoperative fluorescent cholangiography with fluoroscopic cholangiogram in patients undergoing laparoscopic cholecystectomy. 2014

Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Section of Minimally Invasive Surgery, Department of General Surgery, The Bariatric & Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA, fernandodip@gmail.com.

BACKGROUND Despite the standardization of laparoscopic cholecystectomy (LC), the rate of bile duct injury (BDI) has risen from 0.2 to 0.5%. Routine use of intraoperative cholangiography (IOC) has not been widely accepted because of its cost and a lack of evidence concerning its use in preventing BDI. Fluorescent cholangiography (FC), which has recently been advocated as an alternative to IOC, is a novel intraoperative procedure involving infrared visualization of the biliary structures. This study evaluated costs and effectiveness of routinely implemented FC and IOC during LC. METHODS Between February and June 2013, the authors prospectively collected the data of all patients undergoing laparoscopic cholecystectomy. We retrospectively reviewed and compared the use of FC and IOC. Procedure time, procedure cost, and effectiveness of the two methods were analyzed and compared. The surgeons involved in the cases completed a survey on the usefulness of each method. RESULTS A total of 43 patients (21 males and 22 females) were analyzed during the study period. Mean age was 49.53 ± 14.35 years and mean body mass index was 28.35 ± 8 kg/m(2). Overall mean operative time was 64.95 ± 17.43 min. FC was faster than IOC (0.71 ± 0.26 vs. 7.15 ± 3.76 min; p < 0.0001). FC was successfully performed in 43 of 43 cases (100%) and IOC in 40 of 43 cases (93.02%). FC was less expensive than IOC (US$14.10 ± 4.31 vs. US$778.43 ± 0.40; p < 0.0001). According to the survey, all surgeons found routine use of FC useful. CONCLUSIONS In this study, FC was effective in delineating important anatomic structures. It required less time and expense than IOC, and was perceived by the surgeons to be easier to perform, and at least as useful as IOC. Further prospective studies are warranted to evaluate the effectiveness of FC in decreasing BDI.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002758 Cholangiography An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken. Cholangiographies
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D003365 Costs and Cost Analysis Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs. Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D005260 Female Females
D005431 Florida State bounded on east by the Atlantic Ocean, on the south by the Gulf of Mexico, on the west by Alabama and on the north by Alabama and Georgia.
D005471 Fluoroscopy Production of an image when x-rays strike a fluorescent screen. Fluoroscopies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Intraoperative dynamic fluoroscopic cholangiogram during laparoscopic cholecystectomy.
July 1999, Journal of the American College of Surgeons,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Single-access laparoscopic cholecystectomy with routine intraoperative cholangiogram.
May 2011, Surgical endoscopy,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Outcomes From Routine Use of Intraoperative Cholangiogram in Laparoscopic Cholecystectomy: Factors Predicting Benefit From Selective Cholangiography.
January 2021, Cureus,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
[Intraoperative routine cholangiography in laparoscopic cholecystectomy].
January 1998, Langenbecks Archiv fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft fur Chirurgie. Kongress,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Is the use of a routine intraoperative cholangiogram necessary in laparoscopic cholecystectomy?
October 2023, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Routine versus selective intraoperative cholangiography during laparoscopic cholecystectomy: a survey of 2,130 patients undergoing laparoscopic cholecystectomy.
June 2006, Surgical endoscopy,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Routine operative cholangiography in patients undergoing laparoscopic cholecystectomy.
August 1993, Annals of surgery,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Routine fluoroscopic cholangiography during laparoscopic cholecystectomy: an argument.
January 1991, Surgical endoscopy,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Routine intraoperative cholangiography in elective laparoscopic cholecystectomy.
January 2010, Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society,
Fernando D Dip, and Domenech Asbun, and Armando Rosales-Velderrain, and Emanuele Lo Menzo, and Conrad H Simpfendorfer, and Samuel Szomstein, and Raul J Rosenthal
Selected versus routine use of intraoperative cholangiography during laparoscopic cholecystectomy.
December 1995, Zeitschrift fur Gastroenterologie,
Copied contents to your clipboard!