Economics of emergency laparoscopic cholecystectomy at an Australian tertiary centre in the post COVID-19 era.

BACKGROUND

Laparoscopic cholecystectomy (LC) is a common operation performed worldwide. Indications include acute cholecystitis (AC), with a trend of increasing complexity post-COVID-19. We aim to evaluate the health expenditure on LC at an Australian tertiary centre.

METHODS

A retrospective chart review was performed for all LC between July 1, 2022-June 30, 2023 collecting demographics, costs and wait times and comparisons performed between elective and emergency LC.

RESULTS

125 patients underwent emergency and 78 elective LC. There was no difference between age, sex or ASA. 67 patients (53.6 ​%) had emergency LC within their booking priority category. Average cost for emergency LC was $12,689.90 with a median stay of four days, compared to $7181.10 and one day for elective (p ​< ​0.01). Operative related costs were the majority with emergency LC higher ($4866.5, 38.4 ​% v $3957.6, 55.1 ​% p ​= ​0.02). The largest cost disparity was nursing costs ($2193.7, 17.3 ​% v 648.3, 9 ​% p ​< ​0.01).

CONCLUSION

Costs are likely driven by access to emergency theatre time and increased length of stay. A semi-emergency theatre model could save costs.