Hospital Charges for Laparoscopic and Open Cholecystectomy-Reply

Robert J. Fitzgibbons Jr, MD
JAMA. 1991;266(24):3425-3426. doi:10.1001/jama.1991.03470240047027.
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In Reply.  —My comments concerning the hospital charges for laparoscopic cholecystectomy vs conventional open cholecystectomy were based on an analysis of the first 200 laparoscopic cholecystectomies that I performed at the Creighton University Affiliated Hospitals in Omaha, Neb. Fourteen patients were excluded from the cost analysis because they required either common bile-duct manipulation (six patients) or because they were converted to open cholecystectomy (eight patients). The average hospital charge for the remaining 186 patients was $6750. In comparison, all patients who underwent open, conventional cholecystectomies, with or without operative cholangiography, without common bile-duct exploration at Creighton University's major teaching hospital in 1988 were analyzed. The average hospital charge for an open cholecystectomy in 1988 dollars adjusted to 1989 for inflation was $7069.Dr Jordan has performed a thoughtful and careful study for which he is to be congratulated, although the group was small. As the medical director for an insurance


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