Optimizing Choledocholithiasis Management
作者： Benjamin K. Poulose
DOI: 10.1001/ARCHSURG.142.1.43
关键词:
摘要: Hypothesis Endoscopic retrograde cholangiopancreatography (ERCP) is more cost-effective for managing incidental choledocholithiasis (CDL) after laparoscopic cholecystectomy and intraoperative cholangiogram (LC/IOC) than common bile duct exploration (LCBDE). Design A cost-effectiveness analysis was performed to compare ERCP with LCBDE. Sensitivity analyses were determine the key contributors between 2 treatment options. Setting Costs approached from institutional perspective considering a typical patient undergoing LC/IOC at large referral center. Patients The base case evaluated woman 18 years of age or older symptomatic cholelithiasis CDL discovered time LC/IOC. Interventions drainage procedure LCBDE during Main Outcome Measures Costs, quality-adjusted life gained, mean ratios, incremental ratios. Results In analysis, optimal choice cost $24 300 0.9 gained compared $28 400 0.88 remained strategy in multiway probabilistic sensitivity analysis. If potential operative lost $3100 less hospitalization $18 000 more, then became preferred CDL. Conclusions both costly effective Factors important choosing best management included due performance hospitalization.
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