Costs and effectiveness of extracorporeal gallbladder stone shock wave lithotripsy versus laparoscopic cholecystectomy : A randomized clinical trial.
Thirty-five patients were randomized to extracorporeal shock-wave lithotripsy (ESWL) and 25 to laparoscopic cholecystectomy (LC).
Stone disappearance occurred in only 12 of 32 ESWL patients [38% (95% Cl : 21-56%) ] during a 15-month follow-up.
Greater incremental gains in quality of life after 6 months were observed among LC patients (p<. 01).
Total duration of disability was 6.8 ± 8.5 days for ESWL, and 22.7 ± 16.6 days for LC (p<. 01).
Nine (28%) patients crossed over electively to the LC group, but only 44% of these underwent LC within the next 3 years.
ESWL cost Can $58.9/day of disability saved.
ESWL is limited by its selective applicability and modest stone disappearance rate.
Its cost-effectiveness is largely dependent on patient acceptance of recurrent episodes of biliary colic due to the persistence of stone fragments.
Mots-clés Pascal : Générateur onde choc, Lithotripsie, Lithiase, Vésicule biliaire, Etude comparative, Technique, Cholécystectomie, Laparoscopie, Coût, Analyse coût efficacité, Homme, Traitement, Pronostic, Qualité vie, Traitement instrumental, Voie biliaire pathologie, Appareil digestif pathologie, Chirurgie, Endoscopie, Economie santé
Mots-clés Pascal anglais : Shock wave generator, Lithotripsy, Lithiasis, Gallbladder, Comparative study, Technique, Cholecystectomy, Laparoscopy, Costs, Cost efficiency analysis, Human, Treatment, Prognosis, Quality of life, Instrumentation therapy, Biliary tract disease, Digestive diseases, Surgery, Endoscopy, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0112434
Code Inist : 002B26F. Création : 22/06/1998.