Cost-effectiveness of minimally invasive pancreatic resection

While clinical outcomes of minimally invasive pancreatic resection (MIPR) compared to open surgery are well examined, only few studies focus on its associated cost. The aim of this study is to evaluate cost analyses comparing MIPR to open pancreatic resection (OPR). A systematic review of the literature using PubMed of all published studies between 2000 and 2017 was performed. Studies reporting on cost of laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreatoduodenectomy (LPD) compared to open surgery were identified. Fourteen studies were included, eight that reported a cost comparison between LDP and open surgery and six that compared costs between LPD and open surgery. For both, LDP and LPD, operative costs were higher due to higher costs for surgical equipment. Reports suggest that lower postoperative costs for LDP and LPD could balance out the operative costs resulting in overall decreased costs for the laparoscopic compared to the open approach. Recent results show a positive trend towards cost savings for MIPR. To assess the overall benefit of MIPR compared to OPR comprehensive cost analyses and long-term quality outcomes need to be investigated.