A $14,000 Difference at a Safety-Net Hospital
Ramser and colleagues provide the cleanest recent US cost comparison. In 231 consecutive patients with choledocholithiasis at a safety-net hospital, one-stage LCBDE halved median length of stay (2 vs 4 days, P<.001) and reduced hospital charges by roughly $14,000 ($46,685 vs $60,537, P<.001) compared with cholecystectomy plus ERCP, with identical 30-day readmission rates (5.8% in both groups). Importantly for anyone weighing adoption risk, a failed LCBDE salvaged by postoperative ERCP still cost no more than the ERCP-first pathway ($56,198) and preserved a shorter stay (3 days). The strategy is, in effect, one-way beneficial: patients gain when it succeeds and lose nothing when it does not.
Citation
Ramser B, Coleoglou Centeno A, Ferre A, et al. Laparoscopic common bile duct exploration is an effective, safe, and less-costly method of treating choledocholithiasis. Surg Endosc. 2024;38:6076-6082. doi:10.1007/s00464-024-11139-5
