Economic evaluation of cost-effectiveness in early versus delayed laparoscopic cholecystectomy in acute cholecystitis

 Diseases of the biliary tree are prevalent in the gastrointestinal tract (GIT) and can have significant implications in terms of morbidity and mortality. Among these diseases, acute cholecystitis holds particular importance as it requires immediate attention and mandates timely diagnosis and appropriate treatment. Early laparoscopic cholecystectomy (LC) is a safe and effective procedure for managing acute cholecystitis, providing definitive treatment during the initial hospital stay and it is considered a superior option compared to delayed LC for the treatment of acute cholecystitis. The objective of the study was to examine the overall expenses incurred by hospitals and the duration of hospitalization concerning delayed laparoscopic cholecystectomy in patients diagnosed with acute cholecystitis. Materials and methods: An analytical (case-control) study was conducted involving 139 patients diagnosed with acute cholecystitis and admitted to the University Clinic for Digestive Surgery. Among them, 71 patients were assigned to the study group, while 68 patients were placed in the control group. Patients in the study group received early LC treatment within 0-7 days from the onset of symptoms, while patients in the control group underwent delayed LC treatment between 6-12 weeks from symptom onset. The selection of patients was made using a simple random selection method, following predetermined inclusion and exclusion criteria. Results: Among patients from both groups, there was no statistically significant distinction in age, gender, education, place of residence, past illnesses, comorbidity, and previous abdominal surgery for p>0.05. However, a notable dissimilarity existed between the groups regarding total costs, with significantly higher expenses observed during delayed treatment of patients with acute cholecystitis (t-test for independent samples=-37.644 df=137 p=0.0001). Conclusion: Significant variations were observed in total hospital length of stay and hospital costs between the two groups, indicating that laparoscopic treatment for acute cholecystitis was associated with higher expenses and longer hospital stays.