The results of the economic evaluation suggest that , on average , the surgery strategy costs £ 1236 more per patient than the conservative management strategy but was , on average , more effective .
An increase in the number of people requiring surgery while treated conservatively corresponded to a reduction in the cost-effectiveness of the conservative strategy .
The results of this assessment indicate that cholecystectomy is still the treatment of choice for many symptomatic people .
However , approximately half of the people in the observation group did not require surgery or suffer complications in the long term indicating that a conservative therapeutic approach may represent a valid alternative to surgery in this group of people .
BACKGROUND Approximately 10 - 15 % of the adult population suffer from gallstone disease , cholelithiasis , with more women than men being affected .
Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones .
However , some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis .
As most of the current research focuses on the surgical management of the disease , less attention has been dedicated to the consequences of conservative management .
OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of  cholecystectomy  compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones ( biliary pain ) or cholecystitis .
Cholecystectomy: costs and health-related quality of life: a comparison of two techniques.
BACKGROUND Outcomes of previous health economic evaluations comparing  minilaparotomy cholecystectomy and laparoscopic cholecystectomy  have been inconsistent . OBJECTIVE To compare costs for minilaparotomy cholecystectomy and laparoscopic cholecystectomy and to study changes in quality of life induced by these operations . DESIGN Single-blind , r and omized controlled trial , run from 1 March 1997 to 30 April 1999 . SETTING One university hospital and four non-university hospitals in Sweden . MAIN MEASURE : Cost and perceived health estimation according to the global quality of life instrument EuroQol-5D . RESULTS Of 1719 cholecystectomy patients at five centres , 724 entered the trial and were treated with  minilaparotomy cholecystectomy or laparoscopic cholecystectomy  , 362 in each group . Total health care costs were less for minilaparotomy cholecystectomy than for laparoscopic cholecystectomy ( median values US$ 2428 for minilaparotomy cholecystectomy versus US$ 2613 or US$ 3006 for laparoscopic cholecystectomy with 100 operations per year and reusable trocars or 50 operations per year and disposable trocars , respectively ) . There was no significant difference in total costs ( including costs due to loss of production ) between minilaparotomy cholecystectomy and laparoscopic cholecystectomy with 100 operations per year and reusable trocars in laparoscopic cholecystectomy ( US$ 3731 versus US$ 3649 , respectively ) . However , in calculations assuming 50 operations per year and disposable trocars in laparoscopic cholecystectomy , this technique was more expensive than minilaparotomy cholecystectomy ( US$ 4042 versus US$ 3731 ) . Health-related quality of life was slightly but significantly lower for the minilaparotomy cholecystectomy group 1 week after surgery . One month and 1 year postoperatively no difference between the r and omized groups was found . CONCLUSION Total costs did not differ between minilaparotomy cholecystectomy and laparoscopic cholecystectomy with high-volume surgery and disposable trocars , whereas laparoscopic cholecystectomy was more expensive with fewer operations and disposable trocars . The gain in health-related quality of life with laparoscopic cholecystectomy compared with minilaparotomy cholecystectomy was small and of limited duration
The results of the economic evaluation suggest that , on average , the surgery strategy costs £ 1236 more per patient than the conservative management strategy but was , on average , more effective .
An increase in the number of people requiring surgery while treated conservatively corresponded to a reduction in the cost-effectiveness of the conservative strategy .
The results of this assessment indicate that cholecystectomy is still the treatment of choice for many symptomatic people .
However , approximately half of the people in the observation group did not require surgery or suffer complications in the long term indicating that a conservative therapeutic approach may represent a valid alternative to surgery in this group of people .
BACKGROUND Approximately 10 - 15 % of the adult population suffer from gallstone disease , cholelithiasis , with more women than men being affected .
Cholecystectomy is the treatment of choice for people who present with biliary pain or acute cholecystitis and evidence of gallstones .
However , some people do not experience a recurrence after an initial episode of biliary pain or cholecystitis .
As most of the current research focuses on the surgical management of the disease , less attention has been dedicated to the consequences of conservative management .
OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of  cholecystectomy  compared with observation/conservative management in people presenting with uncomplicated symptomatic gallstones ( biliary pain ) or cholecystitis .