Highlights
- •Percutaneous cholecystostomy (PC) use is increasing for acute cholecystitis (AC).
- •Cost comparison of PC vs laparoscopic cholecystectomy for (AC) remains unknown.
- •Propensity matched PC patients had increased risk for 30- and 60-day readmission.
- •Matched PC patients had lower index costs, but higher 30- and 60-day costs.
Abstract
Background
Percutaneous cholecystostomy (PC) is an initial alternative to laparoscopic cholecystectomy
(LC) for complicated acute cholecystitis (AC). No studies have directly compared costs
of index hospitalization and readmissions between PC and LC patients.
Methods
The Nationwide Readmissions Database was queried for patients undergoing PC or LC
for AC from 2013 through 2014. Primary outcomes including length of stay, and index
and total hospital costs at 30- and 60-days were evaluated after 1:1 propensity score
matching for patient and hospital characteristics.
Results
PC patients had increased index hospital length of stay: 6 days vs 5 days (p < 0.01).
Index admission cost was cheaper for PC ($12,839 vs $13,345, p = 0.028). Total cost,
including readmissions, was significantly increased in PC patients: 30-days (LC: $13,947,
PC: $14,592, p = 0.029) and 60-days (LC: $14,280, PC: $16,518, p < 0.0001).
Conclusions
PC patients were more frequently readmitted, had longer hospital stays, and increased
hospital costs compared to those undergoing LC.
Keywords
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Article info
Publication history
Published online: November 01, 2018
Accepted:
October 29,
2018
Received in revised form:
October 16,
2018
Received:
September 6,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
