Marshall D, Clark E, Hailey D
Swedish Council on Technology Assessment in Health Care, Stockholm.
Health Policy. 1994 Jan 15;26(3):221-30. doi: 10.1016/0168-8510(94)90041-8.
The introduction of laparoscopic cholecystectomy in Canada and Australia has been associated in each country with an increase in the rates of all cholecystectomies following a period where these had remained constant. Estimated costs of cholecystectomies to health programs declined by about 13% in Canada after the laparoscopic procedure became widely available, and about 2% in Australia. Days lost to patients because of surgery, and associated costs to them, decreased in each country. Neither country is realising the potential savings through use of laparoscopic cholecystectomy because of the increase in the number of procedures. The utility of these additional operations remains unclear. These trends associated with the advent of laparoscopic cholecystectomy suggest the need for caution in the introduction and application of other minimal-access surgery techniques.
在加拿大和澳大利亚，腹腔镜胆囊切除术的引入在这两个国家都伴随着一个时期内胆囊切除术总体发生率的上升，而此前该发生率一直保持稳定。在腹腔镜手术广泛应用后，加拿大卫生项目中胆囊切除术的估计费用下降了约13%，澳大利亚下降了约2%。在这两个国家，手术给患者造成的误工天数以及相关费用都有所减少。由于手术数量的增加，这两个国家都未能通过使用腹腔镜胆囊切除术实现潜在的节省。这些额外手术的效用仍不明确。与腹腔镜胆囊切除术出现相关的这些趋势表明，在引入和应用其他微创手术技术时需要谨慎。
