A propensity score matched comparison of readmissions and cost of laparoscopic cholecystectomy vs percutaneous cholecystostomy for acute cholecystitis.

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.