The impact of laparoscopic cholecystectomy in Canada and Australia.

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.