A case-controlled study of laparoscopic splenectomy

Background The utility of laparoscopic splenectomy (LS) has not been tested in general surgical practice. This is a case controlled study comparing the clinical results and economics of L.S. and open splenectomy (OS) in a community hospital. Methods The outcome of a series of 15 patients undergoing LS were compared to 15 patients undergoing OS matched for diagnosis, splenic weight, age, and main co-morbidites, selected by a person independent of the project. Results In both series, the indications were immune thrombocytopenic purpura, hemolytic anemias, hairy cell leukemia and, staging for Hodgkinʹs disease. LS resulted in shorter hospitalization (2.3 vs 8.8 days) with fewer post-operative complications. However, the operation was 1.7 times as long, and the operating room charge 2.9 times as high, so that the total cost of LS ($18,015) was greater than that for OS. ($14,524). If the cost of treatment of complications is included, then the total is the same for both at our institutions. Conclusion Except for a few indications not addressed in this study, LS can be used in lieu of OS.