laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis

Background: due to the increasing costs of the health system and limited financial resources, healthcare policymakers should apply more cost-effective strategies. this study aimed to compare the cost-effectiveness of laparotomy cholecystectomy with laparoscopy.methods: this economic evaluation was performed on patients with cholecystitis who were candidate for surgery in a private hospital in ahvaz, in 2021. data collection tools consisted of 4 parts: 1) demographic information checklist; 2) clinical information checklist; 3) cost checklist and 4) effectiveness assessment tool. we used spss22 and stata14.2 for data analysis. one-way sensitivity analysis and tornado diagrams were performed using tree age software.results:  the mean total effectiveness score in patients treated with laparoscopy 83.44 (sd = 11.34) was higher than those treated with laparotomy 68.39 (sd = 13.61). this difference was statistically significant in all effectiveness criteria except for postoperative infection dimensions and length of operation (p-value <0.001). the mean cost in patients undergoing laparoscopy was significantly higher than those undergoing laparotomy (481.43 $ vs 459.49 $), but overall laparoscopic treatment (5.77) was more cost-effective than laparotomy (6.71). the cost-effectiveness of the laparoscopic procedure was approximately 1.47 $ per effectiveness unit cheaper than laparotomy, according to the icer. according to one-way sensitivity analysis, the laparotomy method was still more effective by changing the cost and effectiveness components.conclusion:  although laparoscopic cholecystectomy was more expensive than laparotomy cholecystectomy, it was generally more cost-effective. the results of this research may help iran’s health system policymakers and managers in order to extend laparoscopic cholecystectomy in hospitals.