[A cost analysis of laparoscopic cholecystectomy compared with the open technic]. / Análisis de costes de la colecistectomía laparoscópica en comparación con la abierta.

OBJECTIVE: The aim of this study was to compare the cost of laparoscopic cholecystectomy with that of open cholecystectomy. DESIGN: We analyzed the cost of both procedures regarding hospital stay, days of work lost and the cost derived from the morbidity of the complications of each technique in two groups of patients. With these data we were able to calculate direct and indirect costs of both procedures and compare them. RESULTS: Morbidity was similar in both groups and had no influence in the cost; cost of the material used for laparoscopic cholecystectomy was higher; hospital stay and days of lost work were significantly lower for the laparoscopic procedure than for the open one. The total cost of laparoscopic cholecystectomy was 23% cheaper than that of open cholecystectomy. CONCLUSIONS: Laparoscopic cholecystectomy appears to be cheaper than open cholecystectomy. As the laparoscopic technique becomes more widespread its cost might decrease even further.

[The nonexcisional palliative surgical treatment of carcinoma of the thoracic esophagus and cardia]. / Tratamiento quirúrgico paliativo no exerético del carcinoma de esófago torácico y cardias.

OBJECTIVE: To review our experience with the palliative treatment for unresectable carcinoma of the esophagus over a 15 years period. The available methods, their indications and results are analyzed. EXPERIMENTAL DESIGN: A retrospective study where the palliative methods used, their indication, their complications and the survival of the patients have been analyzed. PATIENTS: A whole of 114 patients with unresectable carcinoma of the thoracic esophagus and esophagogastric junction, have been included. RESULTS: The most widely used palliative method was the Celestine tube and the main indication was the unresectable tumor. Mean survival was 4.6 months, and mean hospital stay was 10 days. CONCLUSIONS: The carcinoma of the esophagus is diagnosed too late. That's why, in most cases, it is unresectable. However, it is important to offer some palliative treatment to the patients to improve, if possible, their quality of life. We suggest that the requirements for a palliative method are the following: easy and quick technique, brief hospital stay, improvement of patient comfort and low morbimortality.